Does Northern Ireland have the highest rate of infant mortality in Europe?

• NI has higher infant mortality than the rest of the UK.

• Several European countries have higher rates.

• Nevertheless, NI does have a relatively high rate of infant mortality compared with wealthy Euro nations.

On August 10, Alliance Party MLA Peter McReynolds tweeted:

“We’ve the highest rate of infant mortality in the U.K. and therefore Europe.”

This is inaccurate.

While Northern Ireland does have higher rates of infant mortality than Scotland, and England and Wales, several European countries’ rates are higher still.

GB and NI

Infant mortality rates refer to the number of children who die before their first birthday.

According to the Northern Ireland Statistics and Research Agency (NISRA), in 2020 the infant mortality rate in NI was 4.4 per 1,000 live births. This compares with 3.8 per 1,000 live births in 2017, 4.2 per 1,000 in 2018, and 5.0 per 1,000 in 2019.

For England and Wales, that figure was 3.6 per 1,000 live births, according to the Office of National Statistics (ONS), with the ONS describing the rate as “fairly stable” since 2014.

Over the same period, the rate in Scotland was 3.1 per 1,000 live births. According to the National Records of Scotland, the rate has been under 4.0 per 1,000 every year since 2012.

Europe

Neither the UK overall nor Northern Ireland on its own have the highest rates of infant mortality in Europe.

According to the latest data from the OECD, EU members Romania (5.6 deaths per 1,000 live births). Slovakia (5.1 per 1,000) and Bulgaria (5.1 per 1,000) among others all have higher infant mortality rates than NI has seen in the past four years.

Context

Infant mortality is a metric used to indicate the overall health and wellbeing of the wider population in a nation or region. Many factors that contribute to high rates of infant mortality also relate to poor health overall, such as low nutrition or inadequate access to healthcare.

Data from the World Bank shows how the relative wealth of individual nations tends to affect infant mortality rates. Its figures show that low-income nations have an overall rate of 26 deaths per 1,000 live births, lower middle-income nations have a rate of 22 deaths per 1,000 – while higher middle-income nations have a rate of 6 per 1,000 while, for high-income countries, the figure is 3 per 1,000. All of these rates decreased significantly between 1990 and 2020.

The UK does have a fairly high rate of infant mortality compared with other wealthy countries.

Both France (3.4 per 1,000) and Germany (3.1 per 1,000) have lower rates than the UK, while a string of European nations have rates that are below 3 deaths per 1,000 live births, including Austria, Portugal, Spain, Lithuania, Italy, Czech Republic and more – and the Republic of Ireland (2.62 per 1,000).

A handful European countries – including Finland, Norway and Estonia – have rates lower than 2 deaths per 1,000 live births.

Methodologies

It is important to note that some of the variation in the international rates of infant mortality are a result of different approaches to registering premature babies. In the US and Canada for example, a much higher proportion of very low weight infants with small chances of survival are registered as live births resulting in higher reported infant mortality. Other countries in Europe apply a minimum gestational age of 22 weeks or a birthweight threshold to register live births.

Given the challenges in collecting robust and comparable data on child and infant mortality, a dedicated UN Inter-agency Group for Child Mortality Estimation – consisting of UNICEF, the World Health Organization, the World Bank and the UN Department of Economic and Social Affairs) – collects and publishes global data including on infant mortality.