The Guardian view on rising infant mortality: a warning from data

Since the 19th century, infant mortality has been viewed as a marker of civilisation. In Victorian Britain between a quarter and a third of all babies died. Following a century and a half of progress in health, education and sanitation, the figure today is nearly 100 times better, 3.8 per 1,000. But infant mortality has risen for two years in a row. In 2016, 2,651 babies under one died in England and Wales, an increase of 134 in just two years. In 2016 cot deaths – which account for around a twelfth of the total – also went up. Now a new report from the Royal College of Paediatrics and Child Health is warning that England is likely to fall further behind other wealthy nations over the next decade. It believes a new national strategy for children’s health is needed to halt the slide.

Babies die for a variety of reasons, about two-thirds of them in the first 28 days of life (stillbirths are counted separately). But both the Royal College and the Lullaby Trust, the cot death charity, point to widening inequality as a factor in increased mortality, since infant deaths are far more common in deprived populations. Risk factors associated with poverty include prematurity, smoking, maternal obesity, young maternal age, poor nutrition and lack of antenatal care.

As anyone who has known a family who has lost a baby is aware, infant deaths are desperately sad. In the past they were far more common. This doesn’t mean they didn’t leave parents struggling with grief and sometimes depression. In recent years such bereavements have been discussed much more openly, along with miscarriage and infertility. Baby Loss Awareness Week, which has just ended, provides an annual focus for campaigning for greater awareness, research and support. Such initiatives should resonate all the more loudly with policymakers and the public when the unpalatable fact is that for the first time in a long time, it is becoming more and not less likely that a baby born in England or Wales will die before its first birthday.

In recent years the debate surrounding healthcare has shifted significantly in favour of an understanding that prevention is better than cure; that resources must be shifted from acute hospitals into communities and primary settings – clinics, GP surgeries, counselling sessions. This week the government launched its first loneliness strategy, and the eye-catching promise of prescriptions for activities such as walking clubs. But cuts to council budgets since they were given a statutory responsibility for public health in 2013 have had the opposite effect. In many areas, services such as early intervention and support for families have been almost destroyed. Instead of expanding, public health provision has contracted. Children have been badly affected.

This should not go on, as the infant mortality statistics demonstrate. We know how to improve outcomes in this area, by promoting the safety and wellbeing of our tiniest and most helpless citizens. Now, we must do it.