This indicator was published in March 2020.

In May 2021 we updated our graphs and charts where new data had been published, and we reviewed our policy recommendations by nation.

Background

• Factors that contribute to death during early childhood are different to those which contribute to death during infancy or adolescence, with cancer being the biggest cause of death in this age group.
• There is a strong association between deprivation and the risk of death throughout childhood, with children in deprived areas more likely to die.¹

Key findings

• Mortality rates among one to nine year olds in the UK have declined in the previous five years, from 11.8 to 10.0 deaths per 100,000 children in 2014 and 2018 respectively, although the rate of decline in recent years has slowed.
  • There were a total of 722 registered deaths for children aged one to nine years in the UK in 2018.
• Falling trends have been mirrored in England and Wales, where the rate in 2018 was 9.9 per 100,000 children.²
• The mortality rate is higher in Northern Ireland, but low numbers of deaths in there makes it difficult to interpret trends. The rate in Northern Ireland was 10.0 per 100,000 children³ and in Scotland the rate was 9.7 per 100,000 in 2018.⁴
• The top three causes of death in the 1-4 age group in England and Wales are:
  • Cancer
  • Accidents (including injuries / poisonings)
  • Congenital conditions.²

• The top three causes of death in the 5-9 age-group in England and Wales are:
  • Cancer
  • Respiratory causes
  • Accidents (including injuries / poisonings).²

What does good look like?

Focus on environmental and social factors to reduce inequalities. Across all age groups, children who live in poverty and deprivation are less likely to survive than their more privileged peers.¹ Efforts to reduce child poverty remain crucial to child survival.⁶ Universal health visiting services play a vital role in this for pre-school children, particularly for accident prevention guidance.

Better access to high quality healthcare services to support children with long term conditions. The incidence of death during childhood due to non-communicable diseases is higher in the UK than in similar wealthy countries,⁷ although many children with congenital conditions are living longer. To improve outcomes for both common and rare long-term conditions in childhood, efforts should focus on both advances in clinical knowledge (including improved national data collection) and ensuring the uniform adoption of best practice across the UK, including access to the full range of multidisciplinary child health services.

Policy recommendations

What can health professionals do about this?

• Improve maternal health. Professionals should support efforts to maximise maternal health during pre-conception and pregnancy, including smoking cessation programmes, promoting breastfeeding, and promoting healthy weight in women of childbearing age.
• Make every contact count. Health professionals in emergency care settings should take advantage of healthcare contacts to offer health promotion advice on injuries and poisonings. Clinical guidance is available from the National Institute for Health and Care Excellence (NICE).⁸
• Recognise impact of social determinants of health, and support families in need. Professionals should recognise that families living in difficult circumstances are at higher risk of death in childhood, as well as other poor outcomes. They can support and act as advocates for vulnerable families, signposting referrals to other agencies for help with poverty and adversity if appropriate.

Contributing authors

• Dr Ronny Cheung, RCPCH State of Child Health Clinical Lead
• Rachael McKeown, RCPCH State of Child Health Project Manager
• Dr Rakhee Shah, RCPCH State of Child Health Clinical Advisor