Inequality in Neonatal Care: A Shocking Reality
A recent study has uncovered a disturbing truth about neonatal units in England and Wales, revealing a stark contrast in mortality rates among babies based on their socio-economic background and ethnicity. This eye-opening research, led by the University of Liverpool and published in The Lancet Child & Adolescent Health, analyzed data from over 700,000 babies admitted to NHS neonatal units between 2012 and 2022. The findings are a wake-up call, highlighting the urgent need for action to address these inequalities.
The Disparity in Survival Rates
The study's results paint a grim picture. Babies born to mothers from the most deprived areas face a 63% higher risk of death before discharge compared to those from the least deprived areas. This disparity persists even when considering other factors like deprivation and maternal/birth complications. Furthermore, the study found that babies of Black mothers had the highest mortality rates throughout most of the study period, with an 81% higher risk of death compared to babies of White mothers. Babies of Asian mothers also had a significantly higher risk of death (36%) than those of White mothers.
Inequality's Dual Impact
Here's where it gets controversial: the study suggests that deprivation and ethnicity each play a unique role in newborn survival within neonatal units. In simpler terms, one factor doesn't cancel out the other. This means that addressing just one aspect won't solve the problem; both need to be tackled simultaneously.
Implications and Action Points
The authors emphasize that these findings have far-reaching implications for policy and practice. They call for urgent action to address the social determinants of health and clinical care pathways. Recommended strategies include improving socio-economic conditions for women during the perinatal period, supporting pregnant women to quit smoking, strengthening the maternity and neonatal workforce, and implementing culturally sensitive interventions for high-risk groups.
Lead author Samira Saberian, a PhD student at the University of Liverpool's Health Inequalities Policy Research Group, said: "Our analysis shows that socio-economic and ethnic inequalities independently influence survival in neonatal units. To reduce these disparities, we need a holistic approach that strengthens clinical care and addresses the broader social conditions affecting families. By improving services and tackling the root causes of inequality, we can give vulnerable babies a fighting chance."
Professor David Taylor-Robinson, an expert in public health and policy, added: "Our government has committed to creating the healthiest generation of children. Yet, this study reveals that even in 2025, many children face significant health challenges from birth, and for some, even before birth. I hope this evidence spurs real action to address the societal factors that shape health outcomes. Our research also highlights how existing biases and injustices in society are reflected in healthcare settings, disproportionately impacting women and babies. These are inequalities that demand our attention and action."
This research was funded by the Hugh Greenwood Legacy Fund, the University of Liverpool, and the National Institute for Health and Care Research (NIHR).
The full paper, 'Inequalities in neonatal unit mortality in England and Wales: A retrospective cohort study, 2012-2022', is available in The Lancet Child & Adolescent Health.
