Trends and Spatial Patterns in Infant, Child and Adolescent Mortality across 285 European Regions, 1993-2023

Helena Ludwig-Walz , Federal Institute for Population Research
michael muehlichen, Federal Institute for Population Research (BiB),
Ina Alliger, Federal Institute for Population Research (BiB)
Martin Bujard, Federal Institute for Population Research
Pavel Grigoriev, Federal Institute for Population Research

Child mortality remains a key indicator of population health and social development. Although Europe has achieved substantial reductions in infant, child, and adolescent mortality over recent decades, progress has been uneven, and recent data suggest stagnation or even reversal. Most existing research has relied on national aggregates, masking regional heterogeneity. Examining subnational patterns is essential to identify structural inequalities and their determinants. Using official mortality data from 285 regions across 30 European countries (1993-2022), we calculated mortality rates for infants (<1 year) and for children and early adolescents (1-14 years). Temporal trends, spatial variation, and associations between mortality and regional gross domestic product (GDP) were assessed using linear regression models for the periods 1993-1995, 2017-2019, and 2020-2022. Between 1993 and 2022, infant mortality declined by 57.6% (from 4.8 to 2.0 per 1,000) and child/adolescent mortality by 60.1% (from 27 to 10.8 per 100,000). Regional disparities narrowed markedly until 2019 but have since plateaued, and in several European countries, mortality rates among infants and children/adolescents have started to rise again. The negative association between GDP and mortality persisted but weakened over time, suggesting that economic development has become a less dominant determinant of survival as social and healthcare factors may gain greater importance. We will present analyses including additional socioeconomic and healthcare indicators, sex-stratified results, and estimates for older adolescents (15-19 years) based on updated data through 2023.

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 Presented in Session 35. International and Cross-Country Health Comparisons