1. Total numbers
2. Gender breakdown
3. Geographical breakdown
4. Millennium Development Goals
5. Reasons for reductions in rates
6. Causes of child mortality
7. Under one mortality rates
8. Adolescent mortality rates
Child mortality rates are the numbers of children under the age of 5 or 1 who die from preventable causes. “There is not a single country in the world where infant or child mortality today is not lower than it was in 1950,” writes Angus Deaton.
Let’s focus first on under-5 mortality. Between 1990 and 2010, the percentage of children who died before their fifth birthday dropped by almost half. In 1960, 25% of kids died before the age of 5. Now we’re down below 6% of kids dying before the age of 5. In 2012, child mortality in the world is down to the US-level of 1945, namely 48 deaths per 1000 born.
In real numbers: in 1970, 17 million children under the age of 5 died from preventable diseases. In 1990, around 12 million; in 2000, around 10 million; in 2011, this number dropped to 7 million. In 2012, approximately 6.6 million children worldwide – 18,000 children per day – died before reaching their fifth birthday. This is roughly half the number of under-fives who died in 1990. However, we’re still at more than 10 children dying every minute. Almost half of under-5 deaths in developing countries are babies younger than 1 month.
In relative numbers as well there has been a remarkable decline, especially in view of global population growth. Indeed, over the last centuries and decades, there have been tremendous improvements and child mortality rates have dropped substantially:
Childhood mortality rates differ for boys and girls. In Africa childhood mortality among boys is far higher than among girls, according to new figures from UNICEF that break down mortality by sex.
This reflects biology: in all societies, boys tend to be more vulnerable to childhood diseases. That is also the reason why in almost all countries more boys are born than girls: nature’s ratio is about 105 to 100. But India is highly unusual: it is the only country (bar the Solomon Islands) where more girls die an early death than boys (64 to 59). It is also a country that practices sex-selective abortion—of female fetuses—and it is possible that some abortions may be counted as infant deaths. China also practices sex-selective abortion and its child-mortality numbers are unusual, too. They are roughly balanced (14.8 for boys; 14.4 for girls). That is very different from the pattern in Africa, Latin America and eastern Europe, where male mortality is higher. The other parts of the world where there is no big discrepancy between the mortality rates of boys and girls are all rich ones in Europe, America and Japan. They have hardly any child mortality, so the rates for both sexes are close to zero. (source)
One third of deaths in children younger than 5 years occur in south Asia and half occur in sub-Saharan Africa. Less than 1% of deaths occurring in high-income countries. About half of under-five deaths occur in only five countries: China, Democratic Republic of the Congo, India, Nigeria, and Pakistan. India (22 per cent) and Nigeria (13 per cent) together account for more than one-third of all deaths of children under the age of five.
However, childhood mortality are declining in all regions of the world:
In the U.S., the death rate for children younger than 5 is 7 per 1,000 births, on a par with Bosnia and Herzegovina. A child in the U.S. is 3 times as likely as a child in Iceland, Japan, Sweden or Norway to die before the age of 5. Forty countries perform better than the U.S. There has been an improvement in the U.S. recently: infant mortality has declined 12% since 2005 after holding steady for many years, according to data released Wednesday by the Centers for Disease Control and Prevention. The infant mortality rate in 2011 was 6.05 deaths per every 1,000 live births, down from 6.87 in 2005, according to the report from the National Center for Health Statistics. Some numbers for the US broken down by race:
The child mortality rate in Niger is one in 8, vs. one in 333 in Norway. However, in Africa as a whole rates have gone down dramatically:
For example, in 1970s Mali, 37% of children born did not reach their fifth birthday. In 2010, that rate stood at a markedly lower 18%. (source)
The rate of child death across sub-Saharan Africa is not just in decline:
that decline has massively accelerated, just in the last few years. From the middle to the end of the last decade, declines in child mortality across the continent plummeted much faster than they ever had before. (source)
This is a stunningly rapid decline, and nothing like it was occurring even as recently as the first half of the decade. For comparison, the Millennium Development Goal of a 2/3 decline in child mortality between 1990 and 2015 translates into a 1.6 percent annual decline in child mortality. In other words, the above countries are successfully reducing child mortality at an annual rate quadruple the rate called for by the Millennium Development Goals. (source)
Here are some global rates of decline:
(source, click image to enlarge)
Unfortunately, the rates are still high in most developing countries and haven’t gone down fast enough to reach the 2015 Millennium Development Goals (reduce under-five mortality rate to one-third of where it stood in 1990):
Just 17 countries had met that target in 2010; notable among them were Brazil, Egypt and Turkey. While China, with 13% of the world’s 636m children under five, is on course to meet the goal by 2015, it will be among only an additional 23 countries to do so, leaving 101 countries set to miss the target. (source)
Not surprisingly, wealthy countries – wealthy in the commonly accepted sense of high GDP per capita – have a lower IMR because they have the means to invest in healthcare, sanitation, drugs etc. You can see from the two graphs below that the progress of GDP is correlated with declining rates of infant mortality:
Another reason for the decline in child mortality: the percentage of children fully vaccinated against childhood disease worldwide climbed from 5 percent to 80 percent between 1974 and 2000. As a result, child mortality in developing countries has dropped by a third since 1990. A lot also depends on the quality of the available healthcare, for instance the availability of professional help for mothers during child birth:
What also makes a difference is economic growth. Growth allows governments to invest in public health. For example, the increase in the use of insecticide-treated bednets (ITNs) reduces the number of malaria cases.
Malnutrition is a major cause of child mortality, together with insufficient vaccination and unprofessional delivery. Malnutrition is the underlying cause of 6 million deaths under the age of five each year. That’s 16.000 every day and this cause of death explains 60% of under 5 mortality. Other causes of death among children aged less than five years include pneumonia, prematurity, birth asphyxia, diarrhea and malaria.
This is an interesting case study, citing some other causes such as wars and epidemics:
Racism may also be a cause, given that there’s a racial discrepancy in infant mortality rates in the US:
The profession of the parents also has something to do with it. Here are the infant mortality rates for the UK by profession of the father:
More than a million babies die on the day of their birth every year, most in developing countries. Many more die during their first year of life. And yet, from Gapminder: infant mortality rates – or under-1 mortality rates – dropping spectacularly over the last decades:
(blue = Africa, orange = Europe and Central Asia, yellow = America, red = Eastern Asia and Oceania, green = Middle East and North Africa, light blue = Southern Asia)
Without this decrease, millions of children would have died before reaching the age of one. Instead, many of them are now alive and well into adulthood.
These numbers as well are going down, but there’s still a long way to go, especially in developing countries. In the following map we can see that in several African countries as well as in South Asia, 1 in 10 babies die before they reach the age of 1. That’s horrendous.
Some data for the U.S.: