title: Understanding why children die in high-income countries.
abstract: Many factors affect child and adolescent mortality in high-income countries. These factors can be conceptualised within four domains-intrinsic (biological and psychological) factors, the physical environment, the social environment, and service delivery. The most prominent factors are socioeconomic gradients, although the mechanisms through which they exert their effects are complex, affect all four domains, and are often poorly understood. Although some contributing factors are relatively fixed--including a child's sex, age, ethnic origin, and genetics, some parental characteristics, and environmental conditions--others might be amenable to interventions that could lessen risks and help to prevent future child deaths. We give several examples of health service features that could affect child survival, along with interventions, such as changes to the physical or social environment, which could affect upstream (distal) factors.
authors.affiliation: Division of Mental Health and Well Being, University of Warwick, Coventry, UK. Electronic address: p.sidebotham@warwick.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Sidebotham
authors.affiliation: Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: James
authors.initials: J
authors.lastname: Fraser
authors.affiliation: National Center for the Review and Prevention of Child Deaths, Michigan Public Health Institute, Okemos, MI, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Covington
authors.affiliation: Centre for Health and Society, The Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Freemantle
authors.affiliation: Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.
authors.forename: Stavros
authors.initials: S
authors.lastname: Petrou
authors.affiliation: Warwick Evidence, University of Warwick, Coventry, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Pulikottil-Jacob
authors.affiliation: Centre for Epidemiology and Biostatistics, The Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Tessa
authors.initials: T
authors.lastname: Cutler
authors.affiliation: Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ellis
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D001315:Australia; D002423:Cause of Death; D002648:Child; D002649:Child Abuse / Q000401:mortality; D046688:Child Mortality; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D019049:Developed Countries / Q000706:statistics & numerical data*; D019988:Children with Disabilities / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D004777:Environment; D005865:Gestational Age; D006128:Growth / Q000502:physiology; D006801:Humans; D007182:Income; D007223:Infant; D007226:Infant Mortality; D009520:New Zealand / Q000453:epidemiology; D011041:Poisoning / Q000401:mortality; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000401:mortality; D055815:Young Adult