A study published today on bmj.com has found that infant death rates remain high in deprived communities in England and among ethnic minorities. The research says that in spite of Government targets to reduce the gap in infant mortality recent figures show both infant and perinatal deaths remain high in many primary care trusts areas.
The researchers looked at detailed data because while PCTs with the worst mortality rates have been given “Spearhead” status by the Department of Health it is not clear whether the rates arise from poor service provision and lack of expenditure or from demographic factors such as deprivation or ethnicity. The researchers studied the numbers of infant and perinatal deaths, ethnicity, deprivation, maternal age, spending on maternal services, and “Spearhead” status for all 303 PCTs in England.
Over three years they found rates of infant mortality varied by PCT from 1.4 to 10.83 deaths per 1,000 live births, and perinatal mortality varied from 3.93 to 16.66 per 1,000 births. They say a combination of deprivation, ethnicity and maternal age explained just over 80 per cent of the differences between PCTs. Variations in spending by PCTs on maternal services did not explain any of the observed differences.
The researchers say that on the basis of their findings, most PCTs can be confident that social conditions and the ethnic make up of the areas they serve are more important in determining these outcomes than levels of expenditure on maternity services. They add, however, that absolute rates of infant and perinatal mortality remain high in parts of England with the burden of avoidable deaths resting largely on deprived communities and ethnic minorities.