1. The UK did not match the progress made in infant, child, adolescent, and young adult mortality by similar countries since 1970 despite previously having had a significant mortality advantage.
2. In every age group, reductions in total mortality in the UK were smaller than the mean when compared to similar countries, with all-cause mortality in the UK dropping into the worst quartile for infants and children aged 1-4 years, and close to the median mortality for older age groups by 2008.
Evidence Rating Level: 2 (Good)
Study Rundown: The UK is not keeping pace with other wealthy countries to reduce the mortality of children and young people. This study used data from national death registries to compare mortality trends in children and young people aged 0-24 years in the UK from 1970-2008 with trends from 17 similar high-income countries known as the EU15+ (see in-depth section for the specific countries involved in comparison). Despite ranking near or in the best quartile in 1970 for all-cause mortality, the UK had fallen below the EU15+ average. By 2008, the UK ranked in the worst quartile for infants and children mortality aged 1-4. Neonatal, postnatal, and non-communicable diseases (NCD) mortality were the key topics identified for future action. A strength of this study was the completeness of mortality data utilized from countries previously compared to the UK. This study was limited by the variance in mortality that existed at the beginning of the study period.
In-Depth [retrospective cohort]: This study compared UK mortality data to those of the EU15+ countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, Australia, Canada, and Norway) using the WHO World Mortality Database. Data was categorized into age groups of younger than 1 year, 1-4, 5-9, 10-14, 15-19, and 20-24 years, and sorted by sex. Infant data were subdivided into neonatal (day 0-27) and postneonatal (day 28-365). The Global Burden of Disease classification was utilized to categorize causes of death. Deaths were classified into group I (communicable, nutritional, or maternal causes), group II (non-communicable disease [NCD] causes), or group III (injury causes).
Compared to the EU15+ median, the UK had an annual excess mortality of 1,035 deaths for infants and 134 for children ages 1-9 years in 2008. Mortality from non-communicable diseases resulted in 446 annual excess deaths in 2008. These worsening trends contrast the UK’s historically low injury mortality, which remained in the best quartile throughout the study period.
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