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Austerity, income inequality, and the unprecedented rise in infant mortality for the poorest in our society

Changes in infant mortality

For the past twenty years I have been researching child mortality both in our country and overseas. One of the most encouraging aspects of this has been the steady decrease in child deaths over this period and for many decades before throughout the world. There have been some particularly positive achievements in this, with deaths from cancer, external causes and violent deaths in children all falling by more than 50% in England and Wales since the 1970s, while Sudden Infant Death Syndrome (SIDS) fell by over 80% (Sidebotham, Fraser, Fleming, Ward-Platt, & Hain, 2014). Globally, under five mortality rates have fallen by more than 50% since 1990 (Unicef, 2019).

Sadly, though, those huge achievements have not been maintained, and a recent paper in the British Medical Journal has shown that, for those in the most deprived areas of our country, infant mortality has actually been rising since 2013 (Taylor-Robinson et al., 2019). The gap between the most wealthy and the most deprived, having been reducing for many years, has now started to increase. While there are some limitations in their research, the overall pattern seems very clear. In this graph from that paper, infant mortality in the most deprived local authorities is in pink at the top of the graph, with the least deprived in brown at the bottom.

Changes in infant mortality rates by local authority deprivation quintile (Taylor-Robinson et al.., 2019)

 

Politics, Poverty and Austerity

In the run up to a general election, with all the political posturing going on, it is hard not to conclude that this reversal in infant mortality is linked to a combination of poverty and austerity, with increasing wealth inequalities, reductions in welfare benefits for families with children, and real-terms cuts to the NHS, local authority children’s services, social care and public health budgets. It is notable that throughout the Labour administration from 1997 to 2010, infant mortality fell, particularly in the most deprived areas of the country. The reversal in this trend seemed to kick in just a few years after the change of government.

It seems to me that we need a clear change in policy (and not just electioneering promises) if we are going to see a reversal of this recent trend and a change in the life-chances of those who are most disadvantaged in our society. Perhaps we should be judging our political parties, not so much on what they promise to do, but on their actual track record in tackling poverty and inequalities, ill-health and child mortality.

 

In the context of increasing health inequalities in England, policies that reduce poverty and social  inequalities and investing in child health and social care are likely to reduce the occurrence of infant  mortality and that of many other adverse child health outcomes.  – Taylor-Robinson et al., 2019

 

 

Sidebotham, P., Fraser, J., Fleming, P., Ward-Platt, M., & Hain, R. (2014). Patterns of child death in England and Wales. Lancet, 384(9946), 904-914. doi:10.1016/S0140-6736(13)61090-9

Taylor-Robinson, D., Lai, E. T. C., Wickham, S., Rose, T., Norman, P., Bambra, C., . . . Barr, B. (2019). Assessing the impact of rising child poverty on the unprecedented rise in infant mortality in England, 2000-2017: time trend analysis. BMJ Open, 9(10), e029424. doi:10.1136/bmjopen-2019-029424

 

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What are your priorities?

Boris’ Priorities

Last week Boris Johnson posted on my Facebook page telling me his priorities for the country and asking me for mine. Apart from wondering who had funded this marketing campaign, I was deeply disturbed by the underlying message: his top priority, highlighted in bold and set apart, way above any other priority was to deliver Brexit by 31st October.

I am disturbed at the thought that a prime minister of our country could put, as his top priority – far above any concern for the health, safety and well-being of our citizens, driving through a controversial political decision that many believe will be deeply damaging to our country, and one to which a substantial proportion of the citizens of the country, and their representatives in parliament are opposed.

These past few weeks it has felt as though dark clouds have gathered over our land. Events in Westminster convey a sense of a few unscrupulous men[1] seeking personal power and wealth regardless of what that might mean for our country and for ordinary people.

So what do I think should be the top priorities for our government at this time?

In no particular order, here are my top five:

  • Ensuring that the most vulnerable members of our society can afford a decent basic standard of living;
  • Reducing the gross inequalities in wealth and privilege that exist in our society;
  • Providing affordable and accessible housing for all;
  • Tackling climate change and environmental damage;
  • Reversing the impact of years of austerity and ensuring that teachers, police officers, social workers, doctors and nurses have the resources they need to do their jobs well.

 

To achieve that will inevitably mean higher taxes for those who are financially well off (and I recognise that includes me); it will mean addressing the tax-avoiding activities of individuals and corporations; it will mean substantial investment in public services and housing; it will mean investing in renewable energy and public transport and putting a halt to environmentally damaging projects such as the expansion of Heathrow and HS2.

And therein lies the rub – all of those threaten the wealth, privilege and comfort of those with the money and power who seem to be influencing our current government.

Having received, unsolicited, a post of Boris Johnson’s priorities for our country, I thought I might take the opportunity presented by his survey to tell him what I thought the government’s priorities should be. But, in order to take part in the survey, I had to agree to the Conservative Party using the information I provide to keep me updated via email, online advertisements and direct mail about the Party’s campaigns and opportunities to get involved. That is not something I want to agree to, nor, I suspect, will most others who do not share Boris Johnson’s views. So when, in a few weeks’ time, the prime minister says that the results of his survey of the nation’s views overwhelmingly support his drive to get us out of the EU at all costs, once again, this will be based on biased and distorted data.

[1] it does seem to be men – white, wealthy and public-school-educated – whoops, that describes me, too.