Social deprivation and the causes of stillbirth and infant mortality

Guildea, Z. E. S.

doi:10.1136/adc.84.4.307

Cited by 61 publications

(56 citation statements)

References 18 publications

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“…The impact of local social determinants that may play a role in increasing health inequalities, including a bearing on infant mortality and stillbirth rates (Guildea et al 2001;Olsen and Madsen 1999;Wagstaff 2000;Weightman et al 2012), remains unexplored to date. As the discussions on consanguinity and genetic risk in Luton are just evolving, it is unclear yet if a wide ranging community approach or a more targeted family approach to promoting health information on genetic risk (Darr et al 2013) will be successful.…”

Section: Discussionmentioning

confidence: 99%

UK Pakistani views on the adverse health risks associated with consanguineous marriages

2015

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This is a qualitative study exploring the perceptions of members from the Pakistani/Kashmiri community living in Luton, UK, on the adverse health risks associated with consanguineous marriages. Rates of stillbirths and infant mortality are higher than the national average in Luton and the existing evidence base suggests that these higher rates may be associated with consanguinity (especially first cousin marriages) in highly consanguineous populations, such as the Pakistani/Kashmiri ethnic group. This qualitative study included 9 focus groups and 10 one to one in-depth interviews (n=58) with members from the Pakistani/Kashmiri community in Luton during 2012. Audio-recorded transcripts were analysed using framework analysis. Emerging themes included a limited knowledge, opposition to evidence and need for a more culturally sensitive health services approach. Findings from the focus group and interview discussions indicated that participants had a limited and varied understanding of genetic risk and indicated a lack of discussion within the community regarding genetic risk. They also opposed evidence that may link consanguineous marriages with infant mortality, stillbirth or genetic disorders that led to disability. The participants stressed the need for culturally sensitive and locally constructed services for information on genetic risk and services. These findings may be used to address higher rates of infant mortality and adverse health impacts associated with higher rates of consanguinity in Luton and elsewhere, through a partnership approach, improve upon current services and develop culturally appropriate services.

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Section: Discussionmentioning

confidence: 99%

UK Pakistani views on the adverse health risks associated with consanguineous marriages

2015

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“…112 The most voluminous literature in this area has demonstrated a marked inverse relationship between socioeconomic status and SIDS, which in turn has informed the design and implementation of public health policy initiatives aimed at its prevention. [114][115][116] A further body of work explores the relationship between socioeconomic indicators and death during specific periods of childhood 99, [117][118][119][120] . There is conflicting evidence on the period of infancy where socioeconomic deprivation has its greatest effect on mortality rates.…”

Section: Panel 4; Socio-economic Gradients In Child Mortalitymentioning

confidence: 99%

Understanding why children die in high-income countries

et al. 2014

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Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work of researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. AbstractThrough a structured narrative review of the literature, we have identified a wide range of factors influencing child and adolescent mortality in high income countries. These can be conceptualised within the four domains of intrinsic factors, the physical environment, the social environment, and service delivery factors. The most prominent factors in the literature are socio-economic gradients, although the mechanisms through which these gradients exert their effects are complex, affecting all four domains, and often poorly understood. While some factors are relatively fixed, including the child's gender, age, ethnicity and inherent genetic make-up, some parental characteristics, and some wider 3 environmental conditions, others may be amenable to interventions that could lessen risks and help to prevent future child deaths. A number of examples of systemic health service factors that may impact child survival are given, along with interventions such as modifications to the physical or social environmental that may impact more distal factors.

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“…7,8,9 The literature on the relationship between social class and deprivation indices is mixed, with some authors suggesting that deprivation indices can be used as a proxy for social class, and other authors expressing caution and suggesting that area-based deprivation has an independent effect on mortality.…”

Section: Introductionmentioning

confidence: 99%

Multivariate analysis of infant death in England and Wales in 2005–06, with focus on socio-economic status and deprivation

et al. 2009

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Current health inequality targets include the goal of reducing the differential in infant mortality between social groups. This article reports on a multivariate analysis of risk factors for infant mortality, with specific focus on deprivation and socio-economic status. Data on all singleton live births in England and Wales in 2005-06 were used and deprivation quintile (Carstairs index) was assigned to each birth using postcode at birth registration. Deprivation had a strong independent effect on infant mortality, risk of death tending to increase with increasing levels of deprivation. The strength of this relationship depended, however, on whether the babies were low birthweight, preterm or small-for-gestational-age. Trends of increasing mortality risk with increasing deprivation were strongest in the postneonatal period. Uniquely, this article reports the number and proportion of all infant deaths which would potentially be avoided if all levels of deprivation were reduced to that of the least deprived group. It estimates that one quarter of all infant deaths would potentially be avoided if deprivation levels were reduced in this way.

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Social deprivation and the causes of stillbirth and infant mortality

Cited by 61 publications

References 18 publications

UK Pakistani views on the adverse health risks associated with consanguineous marriages

UK Pakistani views on the adverse health risks associated with consanguineous marriages

Understanding why children die in high-income countries

Multivariate analysis of infant death in England and Wales in 2005–06, with focus on socio-economic status and deprivation

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