The epidemiology of childhood mortality in the European Union

Europe has one of the lowest rates of child mortality in the world. However, there are still large differences in death rates even among European Union (EU) member states. Examining changes in mortality rates across some European countries can help us understand how death rates might further be reduced. A review of mortality data obtained from the World Health Organisation for the EU member states between 1968 and 2002 shows that childhood mortality rates have currently declined at a rate of 1 per 100 000 per year. Rates in eastern Europe are twice those of Scandinavia and most children die in the countries with moderate rates and a large population (i.e. Germany, Poland, Spain and UK). The highest rates are among the preschool age and among boys. The lowest rates are among girls and the 5-10 age group. Non-infectious/non-cancer disease and injury are the main reasons for death. However, deaths due to injury are more preventable and are falling at a faster rate than infectious disease and cancer. Dividing deaths into specific causes according to International Statistical Classification of Diseases and Related Health Problems, tenth revision codes shows that transport accidents, congenital malformation (i.e. heart malformations) and disorders of the nervous system (epilepsy, cerebral palsy) are currently the leading causes of death. Therefore, childhood mortality rates have declined greatly in Europe over the last 30 years. The countries with the higher levels of mortality are those that are still relatively poor (eastern Europe). Currently, in eastern Europe the main cause of childhood death is injury, while in western Europe it is non-infectious, non-cancer disease (epilepsy, congenital malformations). Traffic accidents are the main single cause of death in children in Europe as a whole.