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Infant mortality: why is France so poorly placed?



In Europe, infant mortality stood at 3.3 deaths per 1,000 births in 2020. In France, the figure climbs to 3.7 while the infant mortality rate is no longer falling. Explanations.

2,700 children under the age of 1 died in France in 2021, i.e. 3.7 deaths per 1,000 children born alive. Alarming figures that make France a country where infant mortality is higher than the European average. According to data published by INSEE on Wednesday June 14, the infant mortality rate, although historically low, has stopped falling over the past 15 years and has even tended to increase between 2014 and 2017.

In 2021, almost half of children who died before the age of 1 year were less than a week old. A quarter of them died between 7 and 27 days. Mortality over this neonatal period – up to and including 27 days – concerned 74% of infant mortality in 2021, compared to 65% in 2005. That year, neonatal mortality before 7 days of life was 1.6 deaths per 1,000 live births. The figure jumped to 2 in 2017 before dropping slightly to 1.9 in 2021.

Why is neonatal mortality increasing?

The National Institute of Statistics advances several factors which partly explain the lower survival rate in France of very premature babies compared to other European countries:

  • Advances in medicine allow very premature babies to be born alive and not stillborn;
  • the higher age of women at childbearing leads to more high-risk births;
  • multiple births, on the rise, then on a high plateau until 2018 before decreasing slightly, also increasing the number of births at risk;
  • perinatal health was changing “worrying” certain indicators overseas according to a report by Public Health France, published in September 2022;
  • social insecurity is on the rise as the proportion of births covered by Medicare is declining and that covered by State Medical Aid is increasing;
  • the proportion of homeless women giving birth is on the rise, as is the proportion of overweight women;
  • maternal smoking remains high in France.

Finally, INSEE offers a final explanation: in France, more women decided, between 2014 and 2018, to keep a fetus when a serious pathology had been diagnosed.

National disparities

The infant mortality rate is higher in the overseas departments, and, in France, in the department of Seine-Saint-Denis in particular. In the overseas departments, they amount to 7.7 deaths per 1,000 live births, well above the average infant mortality rate.

In Seine-Saint-Denis, this figure reaches 5.4. Elsewhere in France, the departments with the highest infant mortality rate are Indre-et-Loire (5.2‰), Jura (5.2‰) and Lot (5.1‰). These four departments in France are the only ones with an infant mortality rate above 5‰. Concerning Seine-Saint-Denis, we know that mothers are in poorer health and the use of care is lower than the national average.

What about elsewhere in Europe?

On a European scale, the infant mortality rate is 3.3‰, ie 0.4 points lower than in France. “Contrary to France, the infant mortality rate in Europe continues to decrease on average, although at a very low rate since 2012”, specifies INSEE. Thus, while France was in third position among the countries with the lowest infant mortality rate between 1996 and 2000, it is now in 20e position.

Logically, the most marked declines in this rate were observed in the countries where it was highest. Between the periods 1996-2000 and 2016-2020, the figures fell by more than 60% in many Eastern European countries (Hungary, Bulgaria, Poland, Cyprus, etc.).

Over the same periods, infant mortality fell by 49% in Finland, 36% in Sweden to respectively reach 2‰ in 2016 and 2.3‰ in 2020. In France, “with a drop of only 20% in infant mortality in two decades, this is one of the lowest declines in Europe over the period”, confirms the statistics institute.

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