Converging or diverging trajectories of mortality under one year of age in the Baltic States: a comparison with the European Union

Archives of Public Health

Jerzy Konstantynowicz¹  Anita Villerusa²  Agnieszka Genowska³  Birute Strukcinskiene⁴ 

[1] Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children’s Hospital, Bialystok, Poland;Department of Public Health and Epidemiology, Institute of Public Health, Rīga Stradinš University, Rīga, Latvia;Department of Public Health, Medical University of Bialystok, Bialystok, Poland;Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania;

关键词: Stillbirth;    Neonatal mortality;    Infant mortality;    Health inequalities;    Macroeconomic factors;   

DOI  :  10.1186/s13690-021-00598-0

来源: Springer

【 摘 要 】

BackgroundInformation about trends in perinatal and child health inequalities is scarce, especially in the Eastern Europe. We analyzed how mortality under 1 year of age has been changing in the Baltic States and the European Union (EU) over 25 years, and what associations occurred between changes in macroeconomic factors and mortality.MethodsData on fetal, neonatal, infant mortality, and macroeconomic factors were extracted from WHO database. Joinpoint regression analysis was performed to analyze time trajectories of mortality over 1990–2014. We also investigated how the changes in health expenditures and Gross Domestic Product (GDP) contributed to the changes in mortality.ResultsThe reduction of fetal, neonatal and infant mortality in the Baltic countries led to convergence with the EU. In Estonia this process was the fastest, and then the rates tended to diverge. The strongest effect in reduction of neonatal mortality was related to the annual increase in health expenditure and GDP which had occurred in the same year, and a decrease in fetal mortality associated with an increase in health expenditure and GDP in the 4th and 5th year, respectively, following the initial change.ConclusionsThese findings outlined convergences and divergences in mortality under 1 year of age in the Baltic States compared with the patterns of the EU. Our data highlighted a need to define health policy directions aimed at the implementation of effective intervention modalities addressing reduction of risks in prenatal and early life.

【 授权许可】

CC BY