TY - JOUR
T1 - Converging or diverging trajectories of mortality under one year of age in the Baltic States
T2 - a comparison with the European Union
AU - Genowska, Agnieszka
AU - Strukcinskiene, Birute
AU - Villerusa, Anita
AU - Konstantynowicz, Jerzy
N1 - Funding Information:
The present study was supported by the Medical University of Bialystok, Poland (Grant No. N/ST/ZB/18/002/3303).
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/5/13
Y1 - 2021/5/13
N2 - Background: Information 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. Methods: Data 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. Results: The 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. Conclusions: These 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.
AB - Background: Information 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. Methods: Data 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. Results: The 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. Conclusions: These 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.
KW - Health inequalities
KW - Infant mortality
KW - Macroeconomic factors
KW - Neonatal mortality
KW - Stillbirth
UR - http://www.scopus.com/inward/record.url?scp=85105876750&partnerID=8YFLogxK
U2 - 10.1186/s13690-021-00598-0
DO - 10.1186/s13690-021-00598-0
M3 - Article
AN - SCOPUS:85105876750
SN - 0778-7367
VL - 79
JO - Archives of Public Health
JF - Archives of Public Health
IS - 1
M1 - 76
ER -