The UK has one of the highest rates of death for children under five in western Europe , according to new research published in The Lancet.
The findings come from a new study coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, USA. Their figures provide a comprehensive new analysis of global progress towards reducing child mortality.
Although, by international standards, the UK has very low rates of deaths in children, the figures show that within western Europe, the UK has a higher rate of deaths in children than nearly every other country in the region. The mortality rate in the UK for children under five is 4.9 deaths per 1000 births, more than double that in Iceland (2.4 per 1000 births), the country with the lowest mortality rates. 3800 children under five died in the UK in 2013, the highest absolute number of deaths in the region.
In addition to calculating overall mortality rates for children under five, the researchers also analysed mortality rates for subdivided age categories. The UK was shown to have the worst outcomes compared with nearly every other western European nation for early neonatal deaths (death between 0 and 6 days), post-neonatal deaths (death between 29 and 364 days), and the worst outcomes of any country for childhood deaths (death between 1 and 4 years).
Across Europe as a whole, child mortality rates are substantially worse in Central Europe (average mortality rate 6.7 deaths per 1000 births) and Eastern Europe (average mortality rate 9.7 deaths per 1000 births); the UK's under-5 mortality rate is comparable to that of Serbia and Poland. Outside of Europe, the UK has a higher child mortality rate than Australia, Israel, Japan, Singapore, and South Korea.
"We were surprised by these findings because the UK has made so many significant advances in public health over the years," said Dr Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) and the study's senior author. "The higher than expected child death rates in the UK are a reminder to all of us that, even as we are seeing child mortality decline worldwide, countries need to examine what they are doing to make sure more children grow into adulthood."
Globally, rates of child deaths have been declining since 1990, with a sharper rate of decline in many countries observed since the Millennium Development Goals were established in 2000. In the UK, although the rate of child deaths per 1000 births declined overall between 1990 and 2013, but the rate of decline has slowed, and in 2000-2013 was half that seen in the previous decade (1990�).
Richard Horton, Editor-in-Chief of The Lancet, commented: "These figures show the significant health burden that children bear in the UK compared with their European neighbours. The reasons for this are likely to be complex, but undoubtedly include the poor organisation of children's health services in the UK. Until our politicians begin to take the health of children—the health of the next generation of British citizens—more seriously, newborns and older children will continue to suffer and die needlessly."
The findings appear in the study Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, which is published alongside another study, Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
For a press release from IHME outlining the global findings from each of these studies, see http://press.thelancet.com/IHMEpressreleaseMay2014.pdf
NOTES TO EDITORS:
The study was funded by the Bill & Melinda Gates Foundation and US Agency for International Development.
 The countries included in Western Europe are: Andorra; Austria; Belgium; Cyprus; Denmark; Finland; France; Germany; Greece; Iceland; Ireland; Israel; Italy; Luxembourg; Malta; Netherlands; Norway; Portugal; Spain; Sweden; Switzerland; and UK.
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