Campaign to cut cot deaths 'badly targeted' in Scotland

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By Reevel Alderson BBC Scotland's social affairs correspondent

A groundbreaking campaign aimed at cutting cot deaths in Scotland took up to 15 years to be effective in deprived areas, a new study has revealed.

But the study also shows the campaign - Back to Sleep - had an immediate impact in more affluent areas.

Researchers say similar health messages in the future must be tailored to ensure they are received effectively.

In the 1980s cot death - or sudden infant death syndrome (SIDS) - affected about one in 500 babies.

It is now much rarer, with a rate of one in 2,000 liveborn infants.

The report, published by the <a href="http://group.bmj.com/" title="Link to report" >British Medical Journal Online, </a>says rates of SIDS changed dramatically in Scotland around the time of the Back to Sleep campaign in November 1991.

The campaign recommended parents ensure healthy babies sleep on their backs, putting them at reduced risk of cot death.

But the team of researchers led by Cambridge University discovered dramatic differences in the way death rates changed between affluent and deprived areas.

They analysed nationally collected data from Scotland to examine if there was a relationship between socioeconomic deprivation and SIDS from 1985 to 2008.

The decline in SIDS started in 1990 in affluent areas, reaching a stable, low level by 1993.

But the study reveals the impact of Back To Sleep was much slower in areas of high deprivation.

There the rate of SIDS began to decline in 1992 and took more than a decade, and possibly as many as 15 years, to reach a low and stable rate, the researchers said.

They said the most plausible explanation for this was the way research studies were published at the time.

Key results were reported in several national broadsheets after their publication in the British Medical Journal (BMJ) in July 1990.

Professor Gordon Smith, from the Department of Obstetrics and Gynaecology at Cambridge University, said: "Ultimately, Back To Sleep was a huge success and helped to stimulate an abrupt decline in the rate of sudden infant death syndrome all over the world.

"Clearly, however, it was much slower where deprivation was high.

"The importance of this study is that it shows that any future campaigns to modify environmental risk factors for stillbirth and infant death should be carefully designed so that the message is delivered to people living in areas of high deprivation more effectively."