Is the period of austerity in the UK associated with increased rates of adverse birth outcomes?

IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH European Journal of Public Health Pub Date : 2024-11-01 DOI:10.1093/eurpub/ckae154
Rachael Watson, David Walsh, Sonya Scott, Jade Carruthers, Lynda Fenton, Gerry McCartney, Emily Moore
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Abstract

Hugely concerning changes to health outcomes have been observed in the UK since the early 2010s, including reductions in life expectancy and widening of inequalities. These have been attributed to UK Government 'austerity' policies which have profoundly affected poorer populations. Studies in mainland Europe have shown associations between austerity and increases in adverse birth outcomes such as low birthweight (LBW). The aim here was to establish whether the period of UK austerity was also associated with higher risks of such outcomes. We analysed all live births in Scotland between 1981 and 2019 (n = 2.3 million), examining outcomes of LBW, preterm birth (PB) and small-for-gestational-age (SGA). Descriptive trend analyses, segmented regression (to identify changes in trends) and logistic regression modelling (to compare risk of outcomes between time periods) were undertaken, stratified by infant sex and quintiles of socioeconomic deprivation. There were marked increases in LBW and PB rates in the austerity period, particularly in the most deprived areas. However, rates of SGA decreased, suggesting prematurity as the main driver of LBW rather than intrauterine growth restriction. The regression analyses confirmed these results: trends in LBW and PB changed within 1-3 years of the period in which austerity was first implemented, and that period was associated with higher risk of such outcomes in adjusted models. The results add to the European evidence base of worsening birth outcomes associated with austerity-related economic adversity. The newly elected UK government needs to understand the causes of these changes, and the future implications for child and adult health.

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英国的财政紧缩时期是否与不良出生结果率上升有关?
自 2010 年代初以来,英国的健康状况发生了令人担忧的巨大变化,包括预期寿命缩短和不平等现象扩大。这些都归咎于英国政府的 "紧缩 "政策,这些政策对贫困人口产生了深远的影响。欧洲大陆的研究表明,紧缩政策与出生体重不足(LBW)等不良出生结果的增加有关。本文旨在确定英国的财政紧缩时期是否也与此类结果的高风险有关。我们分析了 1981 年至 2019 年期间苏格兰的所有活产婴儿(n = 230 万),研究了低出生体重儿、早产儿 (PB) 和小于胎龄儿 (SGA) 的结果。按照婴儿性别和社会经济贫困程度的五分位数进行了描述性趋势分析、分段回归(以确定趋势的变化)和逻辑回归建模(以比较不同时期的结果风险)。在紧缩时期,低体重儿和早产儿的比率明显上升,尤其是在最贫困地区。然而,SGA 的比率却有所下降,这表明早产是造成低体重儿的主要原因,而不是宫内生长受限。回归分析证实了这些结果:在开始实施紧缩政策的 1-3 年内,低体重儿和早产儿的趋势发生了变化,在调整后的模型中,这一时期发生此类结果的风险较高。这些结果增加了欧洲的证据基础,即与紧缩相关的经济逆境会导致出生结果恶化。新当选的英国政府需要了解这些变化的原因,以及未来对儿童和成人健康的影响。
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来源期刊
European Journal of Public Health
European Journal of Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
2.30%
发文量
2039
审稿时长
3-8 weeks
期刊介绍: The European Journal of Public Health (EJPH) is a multidisciplinary journal aimed at attracting contributions from epidemiology, health services research, health economics, social sciences, management sciences, ethics and law, environmental health sciences, and other disciplines of relevance to public health. The journal provides a forum for discussion and debate of current international public health issues, with a focus on the European Region. Bi-monthly issues contain peer-reviewed original articles, editorials, commentaries, book reviews, news, letters to the editor, announcements of events, and various other features.
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