ETHNICITY, DEPRIVATION, AND CHILDHOOD MORTALITY IN ENGLAND: A COHORT STUDY

OBJECTIVE: To investigate the relationship between childhood mortality (deaths before 18 years of age) and the ethnicity of the child; and how this is related to local measures of deprivation. POPULATION: All child deaths in England, born at, or over, a gestation of 22 weeks, from April 1, 2019, to March 31, 2023, notified to the NCMD DESIGN: Characteristics and death categories were compared by ethnicity, and the rate of death was calculated using a Poisson distribution. Incident Rate Ratios (IRRs) were derived using White children as a baseline, adjusting for deprivation, age, sex, region of England, and area type. MAIN OUTCOME MEASURES: Rate of death between April 2019 and March 2023. RESULTS: Over the 48 months, a total of 12,142 eligible deaths were reported to the NCMD. After adjusting for confounders, children from Asian (IRR 2.37 (2.26-2.49), Black (IRR 3.20 (2.99-3.43)) and Other ethnicities (IRR 1.74 (1.56-1.94), but not Mixed backgrounds (IRR 1.06 (0.98-1.14)), had a higher rate of death than White children. CONCLUSIONS AND RELEVANCE: In England, children from Asian or Asian British, or Black or Black British backgrounds had the highest rate of death before their 18th birthday, and around 1 in 6 deaths in England would be avoided if all children had the rate of death experienced by White children. However, the relationship between ethnicity and the local environment (esp. deprivation and urban status) was profound, and further work is needed to identify how to best target interventions to reduce the overall inequalities seen.