Babies from poor and minority ethnic families at greater risk of dying | Society

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Government action has failed to reduce the higher risk of infant and perinatal mortality among these groups, the study says.</p><p>The authors, led by Nick Freemantle, professor of clinical epidemiology and biostatistics at Birmingham University, conclude that: "The government introduced targets in 2003 to reduce the relative gap in infant mortality by at least 10% between the 'routine and manual groups' and the population as a whole.</p><p>"[However], data available from the introduction of the public service agreement target indicate that the rates of both infant and perinatal mortality remain high in many primary care trusts and the target seems challenging given the current performance across the NHS."</p><p>The three-year study used data from a variety of official sources to probe the wide variations between PCTs on these two key areas of health outcomes. They found that rates of infant mortality, or death before a child is one, varied from 1.4 per 1,000 live births to 10.83 per 1,000 live births. Similarly, rates of perinatal mortality ranged from 3.93 to 16.66 per 1,000 live births.</p><p>But the amount spent on maternity services was not a factor. The researchers said: "Most PCTs can be confident on the basis of these findings that the social conditions and ethnicity of the communities they serve are more important determinants of these particular health outcomes than current variation in levels of expenditure on maternity services".</p><p>But, they conclude: "Nevertheless, the absolute rates of infant and perinatal mortality remain high in parts of England, and the burden of avoidable deaths remain largely with deprived communities and ethnic minorities."</p><p>Three factors were "highly statistically significant" predictors of infant mortality, which explained 70% of the wide variations. They were: "Increased birth rates at the PCT level of deprivation, Pakistani population, and maternal age under 18 years".</p><p>Meanwhile, for perinatal, the researchers identified four factors which again were statistically significant in explaining the gap between rates between PCTs.</p><p>They said: "Increased PCT level birth rates associated with black ethnicity and deprivation were strong determinants of increased perinatal mortality. We also observed a weak detrimental effect for the PCT level birth rates associated with Pakistani ethnicity". These explained 80.5% of the intra-PCT differences, the study says.</p><p>Disproportionately high rates of both infant and perinatal mortality among mothers of Pakistani origin may be due to the marriage of close relations in that community, but that remains "controversial", Freemantle and colleagues said.</p> </div> </div> <div id="related"> <ul id="article-toolbox-side"> <li class="printable"><a href="http://web.archive.org/web/20090808170552/http://www.guardian.co.uk/society/2009/aug/05/perinatal-infant-mortality-rates/print" rel="nofollow" id="printlink" class="printable rollover" title="Link to a printer-friendly version" name="&lid={pageToolbox}{Printer-friendly version}&lpos={pageToolbox}{1}"><img src="http://web.archive.org/web/20090808170552im_/http://static.guim.co.uk/static/77210/common/images/icon_print.gif" alt="Print this" class="trail-icon"/><span>Printable version</span></a></li> <li><a class="rollover sendlink" 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Babies from poor and minority ethnic families at greater risk of dying | Society | guardian.co.uk