Authors :
Charlotte Maccarthy; Vinsam Ouko
Volume/Issue :
Volume 10 - 2025, Issue 5 - May
Google Scholar :
https://tinyurl.com/mspucsar
DOI :
https://doi.org/10.38124/ijisrt/25may381
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Introduction
Child mortality, defined as the death of a child before reaching the age of five, reflects the overall health and well-being
of a population. Despite advancements in healthcare, socioeconomic disparities and preventable health conditions continue
to contribute to child deaths. Understanding the multifactorial nature of child mortality was essential for implementing
effective preventive strategies.
Objectives
This study aimed to elucidate the factors contributing to child mortality in Ontario, Canada, and analyze their relative
impacts on mortality rates. Additionally, it seemed to identify high-risk populations and areas for targeted interventions.
Methods
Data from vital statistics and health records spanning a ten-year period (2012-2021) were analyzed to determine the
leading causes of child mortality in Ontario. Statistical techniques, including regression analysis and descriptive
epidemiology, were employed to assess the associations between various factors, such as socioeconomic status, access to
healthcare, and specific health conditions, and child mortality rates.
Findings
The analysis revealed several key findings regarding child mortality in Ontario. Premature birth, congenital anomalies,
respiratory infections, and accidents emerged as leading causes of child mortality. Socioeconomic factors, including income
inequality and access to healthcare services, were identified as significant determinants of child mortality rates.
Furthermore, geographic disparities in mortality rates were observed, with certain regions exhibiting higher mortality rates
than others.
Conclusion
This study underscores the importance of addressing socioeconomic determinants and improving access to healthcare
services to reduce child mortality rates in Ontario, Canada. Targeted interventions aimed at vulnerable populations and
geographical areas with elevated mortality rates are crucial for achieving substantial reductions in child mortality and
advancing child health outcomes.
Keywords :
Child Mortality, Ontario, Canada, Socioeconomic Determinants, Healthcare Access, Leading Causes, Preventive Strategies.
References :
- Acheampong, M., Ejiofor, C., Salinas-Miranda, A., Wall, B., & Yu, Q. (2019). Priority setting towards achieving under-five mortality target in Africa in context of sustainable development goals: an ordinary least squares (OLS) analysis. Global Health Research and Policy, 4(1). https://doi.org/10.1186/s41256-019-0108-0
- Adebowale, A. S., Fagbamigbe, A. F., Morakinyo, O., Obembe, T., Afolabi, R. F., & Palamuleni, M. E. (2020). Parental educational homogamy and under-five mortality in sub-Saharan Africa: Clarifying the association’s intricacy. Scientific African, 7. https://doi.org/10.1016/j.sciaf.2019.e00255
- Aoyama, K., Park, A. L., Davidson, A. J. F., & Ray, J. G. (2020). Severe maternal morbidity and infant mortality in Canada. Pediatrics, 146(3). https://doi.org/10.1542/PEDS.2019-3870
- Aziz, I., & Salim, L. A. (2020). Decreasing and determining child mortality in Indonesia. Indian Journal of Forensic Medicine and Toxicology, 14(4). https://doi.org/10.37506/ijfmt.v14i4.12044
- Babayara, M. N. K., & Addo, B. (2018). Risk Factors for Child Mortality in the Kassena-Nankana District of Northern Ghana: A Cross-Sectional Study Using Population-Based Data. Scientifica, 2018. https://doi.org/10.1155/2018/7692379
- Baker, M., Currie, J., Miloucheva, B., Schwandt, H., & Thuilliez, J. (2021). Inequality in Mortality: Updated Estimates for the United States, Canada and France*. Fiscal Studies, 42(1). https://doi.org/10.1111/1475-5890.12263
- Baker, M., Currie, J., & Schwandt, H. (2019). Mortality inequality in Canada and the United States: Divergent or convergent trends? Journal of Labor Economics, 37(S2). https://doi.org/10.1086/703259
- Balaj, M., York, H. W., Sripada, K., Besnier, E., Vonen, H. D., Aravkin, A., Friedman, J., Griswold, M., Jensen, M. R., Mohammad, T., Mullany, E. C., Solhaug, S., Sorensen, R., Stonkute, D., Tallaksen, A., Whisnant, J., Zheng, P., Gakidou, E., & Eikemo, T. A. (2021). Parental education and inequalities in child mortality: a global systematic review and meta-analysis. The Lancet, 398(10300). https://doi.org/10.1016/S0140-6736(21)00534-1
- Blackburn, R., Guttmann, A., Amartey, A., Zhou, L., Wijlaars, L., Saunders, N., Harron, K., Chiu, M., & Gilbert, R. (2019). Long-term mortality risk in mothers of infants with neonatal abstinence syndrome: an international cohort study in England and Canada. The Lancet, 394. https://doi.org/10.1016/s0140-6736(19)32823-5
- Cardona, M., Millward, J., Gemmill, A., Yoo, K. J., & Bishai, D. M. (2022). Estimated impact of the 2020 economic downturn on under-5 mortality for 129 countries. PLoS ONE, 17(2 February). https://doi.org/10.1371/journal.pone.0263245
- Conti, J. A., Brant, A. R., Shumaker, H. D., & Reeves, M. F. (2016). Update on abortion policy. In Current Opinion in Obstetrics and Gynecology (Vol. 28, Issue 6). https://doi.org/10.1097/GCO.0000000000000324
- Dandona, R., Kumar, G. A., Henry, N. J., Joshua, V., Ramji, S., Gupta, S. S., Agrawal, D., Kumar, R., Lodha, R., Mathai, M., Kassebaum, N. J., Pandey, A., Wang, H., Sinha, A., Hemalatha, R., Abdulkader, R. S., Agarwal, V., Albert, S., Biswas, A., … Dandona, L. (2020). Subnational mapping of under-5 and neonatal mortality trends in India: the Global Burden of Disease Study 2000–17. The Lancet, 395(10237). https://doi.org/10.1016/S0140-6736(20)30471-2
- Doan, B. T., Yang, Y. B., Romanchych, E., Grewal, S., Monga, S., Pignatiello, T., Bryden, P., & Kulkarni, C. (2021). From Pandemic to Progression: An Educational Framework for the Implementation of Virtual Mental Healthcare for Children and Youth as a Response to COVID-19. Journal of Contemporary Psychotherapy, 51(1). https://doi.org/10.1007/s10879-020-09478-0
- Fell, D. B., Park, A. L., Sprague, A. E., Islam, N., & Ray, J. G. (2020). A new record linkage for assessing infant mortality rates in Ontario, Canada. Canadian Journal of Public Health, 111(2). https://doi.org/10.17269/s41997-019-00265-6
- Fiscella, K. (2004). Racial disparity in infant and maternal mortality: confluence of infection, and microvascular dysfunction. In Maternal and child health journal (Vol. 8, Issue 2). https://doi.org/10.1023/B:MACI.0000025726.53515.65
- Gilbert, N. L., Auger, N., Wilkins, R., & Kramer, M. S. (2013). Neighbourhood income and neonatal, postneonatal and sudden infant death syndrome (SIDS) mortality in Canada, 1991-2005. Canadian Journal of Public Health, 104(3). https://doi.org/10.17269/cjph.104.3739
- Groves, H. E., Papenburg, J., Mehta, K., Bettinger, J. A., Sadarangani, M., Halperin, S. A., Morris, S. K., Bancej, C., Burton, C., Embree, J., Foo, C., Bridger, N., Morris, R., Jadavji, T., Lebel, M., Le Saux, N., Top, K. A., Tan, B., McConnell, A., … Lefebvre, M. A. (2022). The effect of the COVID-19 pandemic on influenza-related hospitalization, intensive care admission and mortality in children in Canada: A population-based study. The Lancet Regional Health - Americas, 7. https://doi.org/10.1016/j.lana.2021.100132
- Guttmann, A., Blackburn, R., Amartey, A., Zhou, L., Wijlaars, L., Saunders, N., Harron, K., Chiu, M., & Gilbert, R. (2019). Long-term mortality in mothers of infants with neonatal abstinence syndrome: A population-based parallel-cohort study in England and Ontario, Canada. PLoS Medicine, 16(11). https://doi.org/10.1371/journal.pmed.1002974
- Iddrisu, A. K., Alhassan, A., & Amidu, N. (2019). Survival Analysis of Birth Defect Infants and Children with Pneumonia Mortality in Ghana. Advances in Public Health, 2019. https://doi.org/10.1155/2019/2856510
- Iddrisu, A. K., Tawiah, K., Bukari, F. K., & Kumi, W. (2020). Frequentist and Bayesian Regression Approaches for Determining Risk Factors of Child Mortality in Ghana. BioMed Research International, 2020. https://doi.org/10.1155/2020/8168479
- Jana, A., Saha, U. R., Reshmi, R. S., & Muhammad, T. (2023). Relationship between low birth weight and infant mortality: evidence from National Family Health Survey 2019-21, India. Archives of Public Health, 81(1). https://doi.org/10.1186/s13690-023-01037-y
- Karyani, A. K., Kazemi, Z., Shaahmadi, F., Arefi, Z., & Meshkani, Z. (2015). The main determinants of under 5 mortality rate (U5MR) in OECD countries: A cross-sectional study. International Journal of Pediatrics, 3(1–2).
- King, J. P., Gazmararian, J. A., & Shapiro-Mendoza, C. K. (2014). Disparities in mortality rates among US infants born late preterm or early term, 2003-2005. Maternal and Child Health Journal, 18(1). https://doi.org/10.1007/s10995-013-1259-0
- Laillou, A., Baye, K., Zelalem, M., & Chitekwe, S. (2021). Vitamin A supplementation and estimated number of averted child deaths in Ethiopia: 15 years in practice (2005–2019). Maternal and Child Nutrition, 17(3). https://doi.org/10.1111/mcn.13132
- Landrigan, P. J. (2016). Children’s health and the environment: A global perspective. Toxicology Letters, 259. https://doi.org/10.1016/j.toxlet.2016.07.030
- Li, M. K., Regina, A., Strom, M., Kim, M. S., Philipp-Muller, N., & Hamilton, J. K. (2021). “It’s a tool, not a cure”: the preoperative teen perspective on bariatric surgery. Surgery for Obesity and Related Diseases, 17(6). https://doi.org/10.1016/j.soard.2021.02.004
- Li, Y., Zhang, Y., Fang, S., Liu, S., Liu, X., Li, M., Liang, H., & Fu, H. (2017). Analysis of inequality in maternal and child health outcomes and mortality from 2000 to 2013 in China. International Journal for Equity in Health, 16(1). https://doi.org/10.1186/s12939-017-0558-2
- Malic, C. C., Lam, M., Donelle, J., Richard, L., Vigod, S. N., & Benchimol, E. I. (2020). Incidence, Risk Factors, and Mortality Associated with Orofacial Cleft among Children in Ontario, Canada. JAMA Network Open, 3(2). https://doi.org/10.1001/jamanetworkopen.2019.21036
- Moore, M. D., Brisendine, A. E., & Wingate, M. S. (2022). Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities. American Journal of Perinatology, 39(2). https://doi.org/10.1055/s-0040-1714678
- Munodawafa, D., Onya, H., Amuyunzu-Nyamongo, M., Mweemba, O., Phori, P., & Kobie, A. G. (2021). Achieving SDGs and addressing health emergencies in Africa: strengthening health promotion. Global Health Promotion, 28(4). https://doi.org/10.1177/17579759211064296
- Noori, N., Proctor, J. L., Efevbera, Y., & Oron, A. P. (2022). Effect of adolescent pregnancy on child mortality in 46 countries. BMJ Global Health, 7(5). https://doi.org/10.1136/bmjgh-2021-007681
- Nzioki, J. M., Onyango, R. O., Ouma, J., & Ombaka, J. H. (2016). Effect of Community Health Strategy on Focused Antenatal Care Coverage: A Pretest-Posttest Experimental Study in Rural Mwingi West Sub-County; Kenya. American Journal of Public Health Research, 4(6).
- Paulson, K. R., Kamath, A. M., Alam, T., Bienhoff, K., Abady, G. G., Abbas, J., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abd-Elsalam, S. M., Abdoli, A., Abedi, A., Abolhassani, H., Abreu, L. G., Abu-Gharbieh, E., Abu-Rmeileh, N. M. E., Abushouk, A. I., Adamu, A. L., Adebayo, O. M., … Kassebaum, N. J. (2021). Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. The Lancet, 398(10303). https://doi.org/10.1016/S0140-6736(21)01207-1
- Perry, S. E. (2021). Fifty Years of Progress in Neonatal and Maternal Transport for Specialty Care. JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 50(6). https://doi.org/10.1016/j.jogn.2021.04.013
- Persaud-Sharma, V. (2020). Rethinking maternal healthcare for the 21st century in the United States. Journal of Health and Social Sciences, 5(3). https://doi.org/10.19204/2020/rthn1
- Pham, B. N., Emori, R. B., Ha, T., Parrish, A. M., & Okely, A. D. (2022). Estimating Child Mortality at the Sub-national Level in Papua New Guinea: Evidence From the Integrated Health and Demographic Surveillance System. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.723252
- Reduce child mortality. (2021). https://doi.org/10.18356/9789210550307c012
- Roberton, T., Carter, E. D., Chou, V. B., Stegmuller, A. R., Jackson, B. D., Tam, Y., Sawadogo-Lewis, T., & Walker, N. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. The Lancet Global Health, 8(7). https://doi.org/10.1016/S2214-109X(20)30229-1
- Robinson, E., Lee, L., Roberts, L. F., Poelhekke, A., Charles, X., Ouabo, A., Vyncke, J., Ariti, C., Gbanzi, M. C. A., Ouakouma, M. T., Gray, N., Daly, M., White, K., Templeman, S., Hejdenberg, M., Hersevoort, M., Pena, S. J., & Kuehne, A. (2021). Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020. Conflict and Health, 15(1). https://doi.org/10.1186/s13031-021-00385-2
- Shahid Ali, S. (2015). Maternal Mortality Rate. Journal of Pregnancy and Child Health, 02(03). https://doi.org/10.4172/2376-127x.1000e112
- Sharrow, D., Hug, L., You, D., Alkema, L., Black, R., Cousens, S., Croft, T., Gaigbe-Togbe, V., Gerland, P., Guillot, M., Hill, K., Masquelier, B., Mathers, C., Pedersen, J., Strong, K. L., Suzuki, E., Wakefield, J., & Walker, N. (2022). Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. The Lancet Global Health, 10(2). https://doi.org/10.1016/S2214-109X(21)00515-5
- Sheffield, P. E., & Landrigan, P. J. (2011). Global climate change and children’s health: Threats and strategies for prevention. In Environmental Health Perspectives (Vol. 119, Issue 3). https://doi.org/10.1289/ehp.1002233
- Sidhu, N., Wang, Y., Barrett, E., & Casas, M. (2020). Prevalence and presentation patterns of enamel hypomineralisation (MIH and HSPM) among paediatric hospital dental patients in Toronto, Canada: a cross-sectional study. European Archives of Paediatric Dentistry, 21(2). https://doi.org/10.1007/s40368-019-00477-x
- Sly, P. D., Arphacharus, N., Aung, W. P., Coleman, G. W., Gamble, M. V, Graziano, J., Hai, D. N., Henshaw, D. L., Navasumrit, P., Ravichandran, B., Ruchirawat, M., Suk, W. A., & Tshering, U. (2017). South-East Asian Children’s Environmental Health: networking to improve health outcomes. Bhutan Health Journal, 3(2). https://doi.org/10.47811/bhj.48
- Tam, J., Papenburg, J., Fanella, S., Asner, S., Barton, M., Bergeron, C., Desai, S., Hui, C., Foo, C., Langley, J. M., Leifso, K., Ma, M. L., Pernica, J., Robinson, J., Singh, R., Tapiero, B., & Allen, U. (2019). Pediatric investigators collaborative network on infections in Canada study of respiratory syncytial virus-associated deaths in pediatric patients in Canada, 2003-2013. Clinical Infectious Diseases, 68(1). https://doi.org/10.1093/cid/ciy413
- UN-IGME. (2018). Levels and Trends in Child Mortality Report 2018 | United Nations Population Division | Department of Economic and Social Affairs. In United Nations.
- UNICEF. (2015a). Levels and trends in child mortality: United Nations Inter-agency Group for Child Mortality Estimation (UN-IGME), 2015 report. Report 2015.
- UNICEF. (2015b). United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & Trends in Child Mortality. Report 2015’, United Nations Children’s Fund, New York, 2015, available from . UNICEF WHO World Bank Group United Nations.
- United Nations. (2015). Levels and Trends in Child Mortality Report 2015 | United Nations Population Division | Department of Economic and Social Affairs. In United Nations.
- Van Malderen, C., Amouzou, A., Barros, A. J. D., Masquelier, B., Van Oyen, H., & Speybroeck, N. (2019). Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa: A decomposition analysis. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7111-8
- WHO, UNICEF, UNFPA, W. B. (2015). Trends in maternal mortality 2010 - 2015, WHO. World Health Organization.
- WHO, U. U. T. W. B. (2015). WHO_2015_Trends in maternal mortality. Bulletin of the World Health Organization (WHO).
- World Health Organization. (2006). Taking stock : HIV in children. Who.
- World Health Organization (WHO). (2022). Child mortality (under 5 years). Fact Sheets, January.
- Yu, Y., Liew, Z., Wang, A., Arah, O. A., Li, J., Olsen, J., Cnattingius, S., Qin, G., Obel, C., Fu, B., & Li, J. (2019). Mediating roles of preterm birth and restricted fetal growth in the relationship between maternal education and infant mortality: A danish population-based cohort study. PLoS Medicine, 16(6). https://doi.org/10.1371/journal.pmed.1002831
Introduction
Child mortality, defined as the death of a child before reaching the age of five, reflects the overall health and well-being
of a population. Despite advancements in healthcare, socioeconomic disparities and preventable health conditions continue
to contribute to child deaths. Understanding the multifactorial nature of child mortality was essential for implementing
effective preventive strategies.
Objectives
This study aimed to elucidate the factors contributing to child mortality in Ontario, Canada, and analyze their relative
impacts on mortality rates. Additionally, it seemed to identify high-risk populations and areas for targeted interventions.
Methods
Data from vital statistics and health records spanning a ten-year period (2012-2021) were analyzed to determine the
leading causes of child mortality in Ontario. Statistical techniques, including regression analysis and descriptive
epidemiology, were employed to assess the associations between various factors, such as socioeconomic status, access to
healthcare, and specific health conditions, and child mortality rates.
Findings
The analysis revealed several key findings regarding child mortality in Ontario. Premature birth, congenital anomalies,
respiratory infections, and accidents emerged as leading causes of child mortality. Socioeconomic factors, including income
inequality and access to healthcare services, were identified as significant determinants of child mortality rates.
Furthermore, geographic disparities in mortality rates were observed, with certain regions exhibiting higher mortality rates
than others.
Conclusion
This study underscores the importance of addressing socioeconomic determinants and improving access to healthcare
services to reduce child mortality rates in Ontario, Canada. Targeted interventions aimed at vulnerable populations and
geographical areas with elevated mortality rates are crucial for achieving substantial reductions in child mortality and
advancing child health outcomes.
Keywords :
Child Mortality, Ontario, Canada, Socioeconomic Determinants, Healthcare Access, Leading Causes, Preventive Strategies.