Countdown for UK Child Survival 2017: mortality progress and targets

Arch Dis Child. 2018 May;103(5):474-479. doi: 10.1136/archdischild-2017-314184. Epub 2018 Mar 28.

Abstract

Background: The Countdown for UK Child Survival tracks recent UK child mortality trends and makes recommendations for improvement.

Methods: We used data from the WHO World Mortality Database to calculate mortality from 1970 to 2014 for 0-19 year olds in the UK and a comparable group of wealthy countries (the EU15+). We used Poisson regression models to assess the significance of apparent differences. We extrapolated model coefficients to estimate future disparites between the UK and the EU15+ to 2030. We proposed goals and intermediate indicators to track UK mortality in keeping with the UN Sustainable Development Goals.

Results: UK infant mortality continues to track in the worst decile of EU15+ mortality with 1-4 year mortality in the worst quartile. Annual reductions in total UK mortality have been significantly lower than the EU15+ since 1990 for infant, postneonatal and 1-4 year mortality. If current trends persist, by 2030 UK infant mortality and 1-4 year mortality could be respectively 180% and 145% of EU15+ median mortality. UK non-communicable disease (NCD) mortality among 1-4 years and 15-19 years persists in the worst quartile. UK injury mortality continues in the best quartile. A framework of goals and indicators for UK child survival and health is presented.

Discussion: UK mortality among under 10 years of age continues to diverge from the EU15+ median, and UK NCD mortality remains persistently poor. We propose a set of goals to improve UK childhood survival by 2030 and an annual Countdown mechanism to monitor progress towards these targets.

Keywords: health service; mortality.

MeSH terms

  • Adolescent
  • Child
  • Child Mortality / trends*
  • Child, Preschool
  • Databases, Factual
  • European Union / statistics & numerical data
  • Goals
  • Health Status Disparities
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Perinatal Mortality / trends
  • United Kingdom / epidemiology
  • Young Adult