Child deaths in England rising above pre-pandemic levels, study finds

Child deaths in England have risen to new levels after a temporary fall during the Covid-19 pandemic, a study has found.

The study, published in the PLOS Medicine journal, shows children were less likely to die between April 2020 and March 2021, a period when lockdowns were in place, than at any time before or since. There were 377 fewer deaths than expected from the previous 12-month period.

However, while the number of deaths in the following year, 2021-22, was similar to before the pandemic, in 2022-23, there were 258 more deaths than expected from 2020-21 period, researchers at the University of Bristol found using the National Child Mortality Database (NCMD).

The study also found that the relative rate of dying for children from non-white backgrounds, compared with white children, was now higher than before or during the pandemic.

The increase could be down to a range of changes including circulating diseases returning to pre-pandemic levels, end of enhanced health-related behaviour changes such as enhanced hand washing, or withdrawal of wider, state-based enhanced social support, which benefited the most socially vulnerable families.

Karen Luyt, programme director for the NCMD and professor of neonatal medicine at the University of Bristol, said: “These stark findings demonstrate that, for most children and most causes of death, the reduction in mortality that was seen during the pandemic was only temporary.

“The NCMD’s unique data also tells us that existing inequalities have widened, with outcomes deteriorating for children from poor and non-white backgrounds compared with their peers. But it also shows that change is possible; more must be done to change these trends in the long term, and improve and save children’s lives.”

The study confirms deaths were higher in the years after the lockdown period. However, one category, deaths from birth events, showed a clear increase going into and during the lockdowns, but then a reduction to pre-pandemic levels afterwards.

Other categories, including death from substance misuse, infections, sudden unexpected death in childhood and underlying conditions, all increased after the pandemic.

There was also a rise in death caused by “trauma” which the researchers said was striking, though they added that it did not exclusively cover non-accidental injury – it also included road traffic accidents and drownings.

Ethnicity data shows that in the most recent year, 61% of child deaths accounted for white children – a decline from the share in 2019-20 – compared with 20% accounting for Asian child deaths and 9.7% for Black or Black British children’s deaths, which were both an increase.

The researchers identified all the children in England who died between April 2019 and March 2023, and calculated the annual rate of death for each group of children and cause of death. Using a mathematical model, the research team then tested whether the rate of death was going up or down across the four years.