The contribution of the foreign population to the high level of infant mortality in Switzerland: a demographic analysis

BACKGROUND: In 2011 Switzerland reported the highest infant mortality rate among Western European countries, as well as the highest percentage of foreign population (23%). The comparison of the Swiss and foreign population in terms of reproductive health has received so far insufficient attention. The aim of the present study is to analyze the infant (IMR) and neonatal mortality rates (NMR) of Swiss and foreign children over the last 30 years. METHODS: Vital statistics from the period 1980 to 2011 were used to compute IMR and NMR according to year and/or citizenship. The main analyses were made contrasting Swiss versus foreigners as a single category, as well as by country of origin. Comparisons between groups were done using relative risks. RESULTS: In 1980–1989, IMR was 14% higher among foreign children as compared to Swiss children, and NMR 28% higher. In 2006–2010, IMR was 18% higher among foreign children than among Swiss children, and NMR 29% higher. The highest gap of IMR was observed during the period 1990–1993 (+21%). Looking at single countries, in 2008–2010 children of migrants from Germany, Portugal, Turkey, Italy, France, Kosovo and Spain had a higher level of IMR as compared to Swiss children. CONCLUSIONS: The analysis of vital statistics confirms that over the last 30 years the gap of IMR and NMR between Swiss and foreign children has not decreased. Whatever the combination of mechanisms, which cause the observed difference, this fundamental inequity needs to be investigated and remedied by a large scale, concerted effort.