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Tackling inequalities from the ground up

DEPARTMENT OF HEALTH News Release issued by COI News Distribution Service on 21 April 2009

A new support team to tackle infant mortality was launched today by Public Health Minister Dawn Primarolo, who said it would help turn the tide on health inequalities.

The new National Support Team will visit 43 areas with the highest rate of infant mortality in the routine and manual group, to deliver intensive four-day programmes of interviews and workshops and tailored support to local areas.

The team will help local health teams to deal with maternal obesity, smoking, teenage pregnancy, housing and child poverty all which have significant roles to play in the life expectancy of an infant. Other related factors include ensuring that all women have a health and social care needs assessment by 12 weeks of pregnancy. Ethnicity, immunisation, management of the unwell infant, and infant nutrition can also have an impact.

A national target to reduce the 'gap' between infant mortality rates in the routine and manual group and the population as whole will be met if recent trends continue. However, this remains a challenging target.

Public Health Minister Dawn Primarolo said:

"The death of a baby or toddler can strike people from all walks of life - regrettably, 3,000 young children die each year before the age of one.

"These personal tragedies, unbearable for those affected, are even more poignant when issues like class, wealth, ethnicity, or preventable factors are involved.

"That is why we have used a systematic, evidence-based approach to design the programme of support that this team will offer the local NHS and partners in the areas most affected."

The National Support Team will work with Primary Care Trusts, local authorities, other NHS trusts and the third sector to reduce infant mortality in their areas.

The team has already visited Milton Keynes, Leeds, Bristol, Kirkless and Brent, and 11 more visits are planned for 2009.

Dr Nicholas Hicks, Chief Executive of Milton Keynes PCT said:

"We were very pleased to be a pilot site for this programme, and found the visit helpful and constructive. I'm sure it will help refocus and re-energise the work of The Children's Trust and many agencies across Milton Keynes on reducing inequalities in infant mortality."

Initial findings include good leadership, data collection and analysis, and working to engage communities that are seldom seen, seldom heard are critical to reducing health inequalities in infant mortality.

Notes to Editors

1. The Infant Mortality National Support Team was showcased at an event for people working across the health care, government, education and third sectors at the Queen Elizabeth II Conference Centre in London.

2. A national health inequalities target was set in 2001 and updated in 2004. The overall target, which includes the infant mortality objective, is:
By 2010 to reduce inequalities in health outcomes by 10 per cent as measured by infant mortality and life expectancy at birth.

The target is underpinned by two more detailed objectives:

* Starting with children under one year, by 2010 to reduce by at least 10 per cent the gap in mortality between routine and manual groups and the population as a whole.

* Starting with local authorities, by 2010 to reduce by at least 10 per cent the gap in life expectancy between the fifth of areas with the worst health and deprivation indicators (the Spearhead Group) and the population as a whole.

The Infant Mortality NST was set up in response to a review and Implementation Plan, in 2007, of the infant mortality objective, which identified interventions, which would help meet this target. It began work in Autumn 2008 with the first visits in November 2008.

3. The Infant Mortality Rate (IMR) in England and Wales in the period 2005-07 was 4.7 per 1,000 live births for those born inside marriage or jointly registered outside marriage by both parents, compared to 5.4 per 1,000 live births in the routine and manual (R&M) group.

4. The IMR among the R&M group was 16% higher than in the total population in 2005-07, compared with 17% higher than in the total population in 2004-06, 18% higher in 2003-05 and 19% higher in 2002-04. This compares with 13% higher in the baseline period of 1997-99.

5. If the gap continues to narrow at the rate observed since 2002-04, the Infant Mortality inequality target will be met.

6. The Infant Mortality National Support Team also examines higher infant mortality rates seen in teenage mothers, single parents, black and minority ethnic groups, the homeless and unemployed.

7. Other National Support Teams address sexual health, tobacco control, teenage pregnancy, health inequalities, childhood obesity, alcohol harm and response to sexual violence.

8. Examples of local initiatives include the development by North Bristol NHS Trust of a DVD around access to maternity services for hard to reach groups, which is being translated into 13 languages and is being produced in a sign language format. In Leeds, a Haamla programme to enable Black and Minority Ethnic women to access antenatal care is resulting in more than 90% of South Asian women accessing antenatal care by 12 weeks. Haamla is funded and nested in the Maternity Services Directorate of Leeds Teaching Hospitals NHS Trust. The Haamla Service offers a befriending and advocacy support service to vulnerable and hard to reach women during their antenatal/postnatal care period, by providing relevant information via interpreters, in group settings, literature in various languages which relates to pregnancy, breastfeeding, birth, labour and healthy eating. 'Haamla' is an Urdu/Arabic word, which means 'pregnant women'.

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