The Royal Baby: a winner in Britain's infant mortality lottery
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Version 0 of 1. Prince William and I were born 9 months apart, about half way back to the founding of the NHS. I could do a trite little line here. “The world was a different place back then,” I could quip, “when the Russians were threatening Europe and the media followed every moment of a royal princess’s pregnancy and all the music sounded like it was from the ‘80s.” It would be hilarious but tragically wrong, because it really was a different place. A September baby, I was born into the cold and dark of one of the most brutal winters ever seen in Britain. In the Midlands, temperatures plummeted to an astonishing (for England) -25.2C. The River Severn iced over, while commuters were trapped on trains when the doors froze solid. William missed all that because his parents planned better, but he had another big problem to contend with, a problem called ‘being born in the nineteen eighties.’ The ONS have a handy graph that illustrates this vividly. In 2011, 4.2 children out of every thousand died before their first birthdays. In 1981, the year I was born, that figure was over 11. In fact even in 1997, rates were almost 50% higher than they are now. People often talk about medical advances as if they all happened in the 1960s, and we switched overnight from some flea-ridden Victorian hell-hole to the modern world we know today, but even now we’re making astonishing advances. So things are getting better. The small wrinkly proto-Royal that just emerged from the national womb will have thrice the chance of surviving that her father and I did, just through the privilege of being born in 2015. But if that makes you feel all warm and complacent, there are a couple of big problems with this story. While it’s true that things are getting better, they’re still not good enough. Our babies are considerably more likely to die than those born in countries like Spain, Italy, France or basically any other European nation you can think of. By 2010, we’d just about caught up with Japan… in 1985. The picture is just as grim for childhood deaths, where we rank behind just about every Western nation on a level with Serbia and Poland, with twice the rate of Iceland. To the extent that you can ever judge a nation by a single metric, child mortality is the one to pick. The death of a child implies so much else that has to have gone wrong first, from education, welfare and health to alcohol abuse and economic inequality, that it acts as a kind of litmus test for the health of our society. We’re failing that test. Except… that’s not actually true either. There’s a simple statistical adjustment you can do that brings Britain’s infant and child mortality rates back into line with the rest of Europe’s, reducing the rate by a third and putting us level again with countries like France and Germany. Can you guess what it is? Get rid of the poor people. Especially northerners. If you live in the South East, or you’re in the top half of the socio-economic scale, then you’ve won the evolutionary lottery. By sheer accident of birth you can enjoy watching only 3.9 babies die for every 6.1 that depart the West Midlands for the great wet nurse in the sky. If you’re rich, only 3.6 of your babies die for every 4.8 the poor folk lose. If you’re rich and a southerner, then congratulations, you have literally won life. It’s tempting to make this a party political issue, but the causes are complicated and they deserve more than knee-jerk name-calling. So do the children involved, who aren’t abstract numbers but real kids dying at a rate of thousands a year. The National Children’s Bureau made the point in a recent report that: “If the UK had the same all-cause mortality rate for children under 14 years as Sweden we could have nearly 2,000 fewer deaths among children in that age group per year - five fewer children’s deaths per day.” How do we address that? Well there are several things a government can do, and they boil down to this. Protect our strong system of primary health care, and raise standards of mental health treatment. Ensure that poorer families received adequate support. Treat alcohol and drug abuse. Above all, reduce inequality in our society. As the NCB put it, “Poverty kills children. Equity saves lives.” In fact I’ll leave you with their concluding words: “That children in the UK may die unnecessarily should be a matter of national shame. As child health advocates, professionals, and policy makers, we have a duty to act urgently to improve the life chances of our children.” So, on Thursday, do you. @mjrobbins |