Deaths among children under five fell in Greece between 2016 and 2020, but a new study finds most of these deaths trace back to causes tied to birth, not later in childhood.
The study, led by Maria Tzoraki of the Medical Service Department at Hygeia Hospital in Athens, was published in the journal Public Health in Practice. It offers the most detailed look yet at child deaths in Greece, breaking down causes by individual diagnosis codes, age group, and region.
Researchers studied 1,877 deaths of children younger than five recorded nationwide over the five-year period. More than half, 58%, happened within the first 28 days of life.
The under-5 death rate dropped nearly 23%, falling from about 5 deaths per 1,000 live births in 2016 to under 4 by 2020. Infant deaths and overall under-5 deaths showed a statistically meaningful decline, though the drop in newborn deaths alone was not strong enough to rule out chance.
Birth-related causes dominate early child deaths in Greece
Among newborns, extreme prematurity and very low birth weight were the top killers, followed by breathing problems and heart defects present from birth. Once babies passed the newborn stage but were still under one year old, the leading causes shifted slightly.
Heart defects and a lung condition called interstitial pulmonary disease topped the list, with sudden infant death syndrome and pneumonia also contributing.
For children between one and five years old, causes looked different again. Heart defects and brain tumors were common, but so were preventable injuries.
Drowning, multiple traumatic injuries, and head trauma each ranked among the leading causes of death in this older age group, marking a shift from birth-related conditions toward accidents as children got older.
Sex and nationality gaps emerge in mortality data
Boys died at higher rates than girls across every age group, making up 56% of all deaths, a pattern researchers say lines up with known biological differences in newborns rather than gaps in care.
Greek nationals accounted for roughly 80% of deaths in every age category, with children of other nationalities making up the remainder.
Most deaths occurred in and around Athens and Thessaloniki, home to Greece’s major children’s hospitals, though researchers cautioned this likely reflects referral patterns rather than higher actual risk in those regions.
Regional Access and Economic Crisis Shaped Outcomes
The study also noted that progress was not always steady. Mortality had improved significantly by 2008 before stalling during Greece’s 2008-2016 financial crisis, a reminder that economic strain can disrupt newborn care.
By 2020, Greece’s death rate placed it mid-pack among EU nations, ahead of Eastern Europe but behind Italy and Spain.
The authors called for stronger neonatal care, better access in rural and island areas, and closer review of Greece’s cesarean delivery rate, among the highest in Europe.
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