Infant Mortality Analysis Update 13 th October 2008 Helen Brown Assistant Director – Intelligence & Analysis

Contents Population Births Infant Mortality Trends Deprivation Gender and Cause of Death Social Marketing Future Predications

Mortality Definitions Infant mortality rate – number of deaths under one year per 1000 live births Stillbirth rate – Birth of a dead baby at 24 or more completed weeks of gestation expressed as a rate this is the number per 1000 live and stillbirths Neonatal mortality rate – number of deaths under 4 weeks per 1000 live births Post neonatal mortality rate – number of deaths aged between 4 weeks and under one year per 1000 live births

Population 2006, Bradford and England and Wales

Births & Gestation Age of Mother Ethnicity Birthweight Gestation

Age of Mother, 2005

Percentage of Live Births by Ethnicity

Live Births

Summary Births Since last analysis to 2003: Similar distribution of mothers ages Similar proportions of low birthweight babies The increase in the proportion of births to south Asian mothers seems to be levelling off

Gestation Since 1996 the percentage of pre-term births in Bradford has increased by approximately 20%

Premature Birth Rates by deprivation quintile and ethnicity, No clear difference by ethnic group within deprivation quintiles for preterm births

Smoking in Pregnancy An average of 16.5% of mothers were reported to be smokers at time of delivery in 2006/07

Infant Mortality Infant Mortality Rate Neonatal Mortality Rate Postneonatal Mortality Rate Stillbirth Rate

Annual Infant Mortality Rate in Bradford and England and Wales,

Infant Mortality Rate in 3 year rolling periods

Neonatal mortality rate in 3 year rolling periods

Postneonatal mortality rate in 3 year rolling periods

Stillbirth rate in 3 year rolling periods

Summary Infant, Neonatal, Postneonatal Deaths & Stillbirths Infant Mortality - Rate between Bradford and E&W appears to be reducing Neonatal Mortality - Bradford's recent rates are barely significantly more that E&W Postneonatal Mortality - Recent trends show Bradford rates coming down but still significantly higher than E&W Stillbirth Rate - Bradford's rates are significantly higher than E&W and seem to be increasing

Deprivation and IMD2007 Studies have shown links between infant mortality and deprivation Deprivation is a lack of the resources or environment that are considered to be necessary for well being The Indices of Multiple Deprivation 2007 (IMD2007) provides measures of deprivation and is often grouped into quintiles

Deprivation in Bradford by IMD 2007 Quintiles

Percentage Livebirths by Quintiles of Deprivation in Bradford

Infant Mortality Rate by Quintiles of Deprivation in Bradford

Stillbirth Rate by Quintiles of Deprivation in Bradford

Infant mortality rate by deprivation quintile and ethnicity,

Summary Deprivation Deprived areas have increased levels of infant deaths & stillbirths More robust numbers in the more deprived areas In deprived areas trends show slight reduction in infant deaths but possible increases in stillbirths Decreasing deprivation appears to reduce likelihood of an infant death for white mothers

Preliminary Social Marketing Analysis Live Births Low Birthweight Infant Deaths Stillbirths

Ranked Births, Low Birthweights, Infant Deaths and Stillbirths by Acorn Category More detailed categories ranked on Infant Death (where 1 is worst). ‘Crowded Asian Terraces’ is ranked 1 for infant deaths, Stillbirths, Low Birthweight and proportion of Live Births

Low Income Asian Families Mainly young Asian Families Terraced streets in major towns and cities Areas will often be ethnically divers with a high number of students living in these areas Housing is low cost and ownership is split evenly between mortgages owned outright and those renting from social housing High levels of unemployment Low educational attainment Incomes are low Employment is generally in manufacturing or retail sectors High numbers of single parents More reliant on public transport and walking Large Families and Single Parents Many Children Some of the poorest families in the country Exceptionally high numbers of children coupled with a young age profile Three times more likely to be a single parent Generally council houses Larger families may be overcrowded Unemployment is high – with a significant number of young people never worked High levels of debt Single Parents and Pensioners, Council Terraces High numbers of single pensioners High number of single parents Housing is either council owned or housing associations Small terraced houses and flats found in urban estates High levels of unemployment Very low levels of educational attainment Reliant on public transport Crowded Asian Terraces 70% of the people will be of Asian Origin Older terraced housing in major cities and towns Can be a high number of student shares Housing is some of the highest crowded in the country High unemployment Low levels of qualifications Low Income Employment tends to be in the manual or retail sectors High numbers of children under 5 Religion is a very important to the residents Acorn Category Characteristics

Ranked Births, Low Birthweights, Infant Deaths and Stillbirths by Health Acorn Category

3.5 – Low income families with some smoking Age tends to be young with mixtures of families and single parents Higher than average numbers of smokers Slightly more than average people with weight issues High levels of asthma and depression Diet similar to national picture though there is slightly more fast food and crisps and not enough fruit and veg. 1.3 – Vulnerable disadvantaged smokers with high levels of obesity Mixed age groups High levels of family break-up High levels of single parents High levels of depression High levels of smoking High levels of obesity Generally favour fried or grilled food and a high level of snacks and fatty foods Eat less than one portion of fresh fruit and veg a day 4.1 – Young Mobile population with good health and diet High proportions of students and single people Typically aged Physically active Slight tendency to suffer from migraines or depression May not be taking care of what they are eating, though generally eat well Some smokers 2.5 – Disadvantaged multi-ethnic younger adults, with high levels of smoking Relatively Mobile young population Low cost rented accommodation Higher than normal single parents Some depression and asthma High levels of smoking High consumption of sugary and energy drinks Higher than normal overweight population Health Acorn Category Characteristics 2.2 – Multi-ethnic, high smoking high fast food consumption High levels of single parents Low income areas High consumption of fast food Low levels of fruit and veg High levels of asthma and depression 2.4 Deprived multi-ethnic estates, smokers and overweight Some incidence of depression High proportion of smokers High proportion of overweight people High levels of fried food Low fruit and veg consumption Generally have a low consumption of high fat and high sugar foods 2.3 – Urban estates with sedentary lifestyles and low fruit and vegetable consumption Mainly council estates High levels of smoking Low levels of physical exercise High fat diet with little in take of fruit and veg