Perspective and Patterns

In childhood the pattern of disease has changed, the infectious diseases have become increasingly less important and the noncommunicable diseases now predominate. Trends in mortality rates of infancy and childhood have shown different patterns. In particular, perinatal mortality has shown a steep decline in recent years whereas the postneonatal mortality rate has been relatively stable. These changes have been associated with demographic changes in the maternal age, parity and social class distribution of births, analysis of which has been made possible by record linkage of infant birth and death registrations. Special and intensive care for neonates has seen major advances and service provision has changed dramatically. Interest is now focussing on the long-term disabilities of the survivors. Recent patterns of morbidity in childhood have been altered by changes in incidence and duration of many diseases, both of which have profoundly affected the prevalence of these conditions.