The chances of survival for a newborn today are around times higher than the past. But in some countries mortality rates are still much higher than the world average. The country with the lowest infant mortality rate today is Iceland at 0. The chances of an infant surviving there are times higher than in the past. A different version of the chart above that is only showing the share of children who died before they reached the end of puberty.
Even on the basis of many dozen studies we only have some snapshots of the long history of our species. Could they all mislead us to believe that mortality rates were higher than they actually were? The fertility rate was commonly higher than 6 children per woman on average, as we discuss here. A fertility rate of 4 children per woman would imply a doubling of the population size each generation; a rate of 6 children per woman would imply a tripling from one generation to the next.
But instead population barely increased: From 10, BCE to the world population grew by only 0. A high number of births without a rapid increase of the population can only be explained by one sad reality: a high share of children died before they could have had children themselves.
A first reason is that death records were often not produced for children, especially if children died soon after birth. And lastly, we find that a large number of independent studies for very different societies, locations, and times come to surprisingly similar assessments: all point to very high mortality rates for children. For societies that lived thousands of kilometers away from each other and were separated by thousands of years of history, mortality in childhood was terribly high in all of them.
The researchers find that on average a quarter of infants died before their first birthday and half of all children died before they reached puberty. How does the historical data compare with the world today? Globally This is a dramatic change from the past. The map shows the mortality up to the age of 15 in every country today. By clicking on any country in this map you see the change over time. You will find that the mortality rate declined in every country around the world.
But you also see that in some parts of the world, youth mortality is still very common. Somalia — on the Horn of Africa — is the country with the highest rate at And the map also shows the regions with the best health. In the richest parts of the world deaths of children became very rare. In Iceland, the country with the lowest youth mortality, the chances a child survives their first 15 years of life are The second metric we studied above was the infant mortality rate in the first year of life.
Across the historical societies this rate was around a quarter; the global rate today is 2. In our map for infant mortality you find the data for every country in the the world.
Our ancestors could have surely not imagined what is reality today. And for me this progress is one of the greatest achievements of humanity. The historical record the authors investigated goes back years. What about prehistory when our ancestors lived as hunter-gatherers? Good evidence here is much harder to come by. To study mortality at a young age in prehistoric societies the researchers need to mostly rely on evidence from modern hunter-gatherers.
Here, one needs to be cautious of how reflective modern societies are of the past. Both of these could matter for mortality levels. Again, the researchers find very similar mortality rates across their sample of 20 different studies on hunter-gatherer societies from very different locations: The average infant mortality rate younger than 1 was Almost exactly the same as the historical sample discussed above.
All but one of these studied societies are modern hunter-gatherers. Going beyond our own species homo sapiens , researchers have also attempted to measure the mortality rates at young ages for our closest relatives.
Atkinson and Volk also compared human child mortality rates across species with other primates. Bringing together many different sources the authors find the mortality rates of young chimpanzees and gorillas to be similar to the mortality rates of humans of the past, while other primates differ: orangutans and bonobos appear to have somewhat lower mortality rates and baboons, macaques, colobus monkeys, vervet monkeys, lemurs and other primates suffer from higher mortality rates.
Since the beginning of the age of the Enlightenment the mortality of children has declined rapidly. This is a very recent development and was only reached after a hundredfold decline in child mortality in these countries.
In early-modern times, child mortality was very high; in 18th century Sweden every third child died, and in 19th century Germany every second child died. We will not learn about this development from the news as such a slow development is never fast enough to make a headline.
Big countries like Brazil and China reduced their child mortality rates fold over the last 4 decades. In Sub-Saharan Africa, child mortality has been continuously falling for the last 50 years 1 in 4 children died in the early 60s — today it is less than 1 in Over the last decade this improvement has been happening faster than ever before.
Rising prosperity, rising education and the spread of health care around the globe are the major drivers of this progress. There are few events more tragic than the loss of a child. The average woman in had between 5 to 7 children. Parents probably lost 2 or 3 of their children in the first few years of life. Such loss was not a rare occurrence but the norm for most people across the world.
For the richest countries at the time — across Europe, Australasia, North America, and some parts of South America — child mortality had fallen to less than 5 percent 1-in The fertility rate across these countries had also fallen to around 2 to 3 children per woman. Major improvements in living standards, medical knowledge and care, nutrition , water and sanitation, and treatment of disease had transformed outcomes for mothers and children.
For the first time in millennia, most parents would not lose a child. Child mortality was still fairly common, but no longer the norm. But was also a divided world. Child mortality rates across the rest of the world were still unimaginably high.
With one-in-three children sometimes higher dying in their first few years, most parents across Africa, Asia and much of South America were probably still losing several children. Child mortality continued to fall across Europe, North America and Australasia; in around 1-in children died before their 5th birthday.
But the rest of the world has also seen dramatic improvements. Many countries across South America, Asia and Africa have reduced child mortality to 1 to 2 percent between 1-in and 1-in China reduced child deaths from 1-in-3 to 1-in; India from 1-in-4 to 1-in; Kenya from 1-in-3 to 1-in; and Tanzania from greater than 1-in-3 40 percent to 1-in The countries where child mortality is highest today have comparable rates to many countries across Europe in Many of us are not aware that child mortality has declined substantially everywhere and still imagine the divided world as it was in A divided world where progress in the richest countries was dynamic, but static and persistently bad elsewhere.
As the chart shows, substantial declines in child mortality have occurred across all regions. Average rates in Africa are now lower than the European average in The frequency of child deaths today as high as 1-in-7 in the handful of poorest cases is still tragically high. We must do better. But we also know that we can do better.
History has shown that no country is an exception to this. Mary and John Evelyn continued to have children together. They had another son, also named Richard, who died at an even younger age, as a newborn. Of their eight children, seven died. The diary records of other parents tell us of similar hardship. The English politician and barrister William Brownlow and his wife Elizabeth Duncombe had 19 children together.
Thirteen of them died. Some periods of their life were particularly tragic: in just eight years between and they had seven children. The death of a child has always been the most tragic calamity mothers and fathers could experience. The visualization presents the best estimates available.
I am showing Sweden because it is a country for which we have particularly good long-run demographic data. Sweden was the first country to establish an office for population statistics: the Tabellverket , which was founded in The total height of the orange and purple area shows the average number of children born per woman — the fertility rate — up to the present. The area in purple shows the answer to our question; it is the average number of children who died within the first five years of life, per woman.
I calculated this by multiplying the number of children per woman by the mortality rate of children under five. Throughout most of the 19th century Swedish women gave, on average, birth to more than four children. Child mortality in this period was around one-in-four , and at times much higher, so that on average every woman lost one child under the age of five. In Sweden, in the mid 18th century, the fertility rate for married women was 7.
For other countries the estimates for the 18th century are similar. In France the average married woman had 8 children and saw around 3. With the decline of child mortality and fertility over the last couple of centuries this has changed dramatically, and in rich countries like Sweden these tragic events have become very rare.
As the data in the chart shows, for Sweden the average has gone down to 0. An experience that just a few generations ago was so common, and that almost every woman suffered through it, is now so rare that today it is only a reality for 1-in Swedish women.
In this visualization you can change the country for which this data is shown and explore the trends in countries around the world. To compare the number of children lost per woman for several countries — and see the data on a world map — you can use this visualisation. In most world regions it has become rare for parents to lose a child, but this is unfortunately not true everywhere.
When I write about child mortality some commentators respond by speculating that in times and places where many children die the loss of a child does not hurt parents as much. The mortality that these two couples experienced was higher than the average — which was likely between two and four dead children — and show that parents did not, in any circumstances, find it bearable to lose a child.
There is no reason to suppose — no evidence anywhere, including that of common sense — that parents were ever, at any point in the past, indifferent to the happiness and well-being of their children. Losing a child has always been terrible for parents, whether it was as common as it was in the past or much rarer as it is today. The chart shows the child mortality rate for the entire world population at 4 different points in time.
How to read the following graph: On the x-axis you find the cumulative share of the world population. This makes it possible to see the child mortality rate for each country. Some countries are labelled, but not all. It is also possible to see which share of the world population had a child mortality rate lower than a given level. Every second child died before the age of 5. The world was clearly divided into developed and developing countries. The rapid progress of the industrialized countries had the consequence that the distribution of global health was hugely unequal.
The latest data refers to Global health has improved hugely. Particularly those countries that had the worst health in the s experienced the most dramatic improvements. China for example reduced its child mortality from The consequence of the faster progress in former developing countries is that global health inequality has fallen since the s.
The global average child mortality rate weighted population was Focusing at global inequality we see that in health was bad around the world, in the s the world became unequal, and today we are back to higher equality but on a much higher level. Also noted here is the start and end date by which this was achieved. Here we see that countries which industrialized rapidly during the 19th century many countries across Europe , it took more than century as high as years in the case of the UK for child mortality to fall from 1-in-3 to 1-in If we look at countries who achieved this in the late 20th or early 21st century, we see that this reduction was much faster.
Many across all regions achieved this in under 50 years. South Korea achieved it in only 25 years. Whilst progress may at times seem persistently slow, we see that fast catch-up improvements are possible. The fact that in those countries with the best health, child mortality rates are times lower than the global average suggests that most of these child deaths are preventable.
Here we take a look at the first question: where in the world are children dying? We mapped the global distribution of child deaths in the somewhat unusual visualization. This type of visualization is called a treemap.
At a time during which the number of births increased globally, the number of child deaths fell. In , Every world region also saw a decline. But, some of the countries which have seen the greatest progress are still those where most children are dying today. India has suffered the most child deaths: one million in This was followed by Nigeria , ; Pakistan , ; the Democratic Republic of Congo , ; Ethiopia , ; and China , The total number of children dying depends on two factors: the likelihood a newborn will die in the first years of life and the number of children born.
Here is the map of the mortality rate of children. But it has, by far, the largest number of children under five years old. This matters for the possibility to make progress in the future. The number of children under five years old has already peaked and is now falling: in the coming decades, its under-5 population will decline.
Our concern will then turn towards countries where the chances of child mortality is high, and the number of births increasing. Countries where children are most likely to die — Somalia, Chad, Central African Republic, Sierra Leone, Nigeria, and Mali — will all have an increasing number of children in the coming decades.
Progress on reducing child deaths will here therefore become a race between declining child mortality rates and an increasing number of children. But the two runners in the race are not independent: one of the reasons couples have many children is because they do — or expect to — lose some of them early in life. Our progress on reducing child deaths can therefore be amplified if falling child mortality leads to falling fertility rates. We know that most child deaths today are preventable.
They result from causes we know we can tackle. How do we know this? Because we already averted many millions of child deaths in the past few decades. Between and the number of children dying each year fell by 7. By stopping those we know are preventable, we could save at least another 5 million children every year.
We can reach a world with many fewer child deaths than ever before. In the chart presented here we see the major causes of death of children under 5 in compared to This type of chart is called a treemap, where the area of each box represents the total number of child deaths for each specific cause. The total colored area represents the total number of child deaths in As the treemap shows, the boxes representing the numbers for child deaths in are almost always smaller — reflecting the fact that deaths from almost all causes have fallen significantly.
There are two major exceptions: the number of deaths from AIDS and the deaths caused by invasive non-typhoidal salmonella iNTS has increased. Although those numbers were higher in than , the deaths from both causes have been decreasing since their peak in While the total number of child deaths has more than halved from Almost every seventh child who died in died of a lower respiratory infection LRI , which has remained the leading cause of mortality over the past three decades.
Pneumonia is the leading LRI. It is caused primarily by bacterial infections. When we talk about child mortality we usually refer to mortality of children under the age of 5. But of all children who die, most do not come close to their fifth birthday: the younger a child is, the higher the risk of mortality. Three times as many children die in the first year of their lives than in the next four years.
And the majority of children who die in their first year die in the neonatal period , the first 27 days after birth.
Premature birth being born before the 37th week of gestation is one of the major determinants of neonatal mortality and therefore complications arising from preterm birth are usually grouped with the neonatal disorders, as we did in our chart. Children born prematurely are at high risk of having birth injuries, underdeveloped organ failures, and attracting infectious diseases. Every tenth child that died in died because of some diarrheal disease — rotavirus infection, cholera, shigellosis and other infectious diseases that result in diarrhea.
Clearly, the fact that diarrheal diseases are the third leading cause of child mortality is simply inexcusable. As we will discuss in another post in this series, an increased coverage of oral rehydration therapy — an incredibly simple treatment for diarrhea — could help to prevent many of these deaths. While classed separately from neonatal disorders, congenital birth defects are significant contributors to infant mortality as well.
Infectious diseases have always been one of the major causes of child deaths, but the success of vaccination campaigns and antibiotic availability has done a great deal to reduce mortality from infectious diseases.
The WHO has estimated that between and measles vaccination has prevented Today we also have vaccines available for tuberculosis, meningitis, hepatitis, and whooping cough. The best way to protect children against malaria today is to provide insecticide treated bednets , but a new malaria vaccine implementation program is also underway.
The chart shows the annual change in the number of child deaths from leading causes from onwards. Here we see a dramatic decline in deaths from several causes: lower respiratory infections pneumonia ; preterm birth complications; and diarrheal diseases saw dramatic declines globally in recent decades. Vaccine coverage also saw a dramatic decline in deaths from measles. However, more effective prevention for malaria in the form of bednets; and progress on prevention of mother-to-child transmission of HIV PMCT means these are now also in decline.
In the following sections we take a closer look at the leading causes of child mortality one-by-one. In doing so, we also try to understand how can we reduce the number of children dying from each cause using treatments and interventions which are already available at our disposal.
The section below only discusses pneumonia in the context of child mortality. You can find a more in-depth look at the global burden of pneumonia, its causes and treatments in our pneumonia entry. In the visualization here we see the global number of deaths from pneumonia 34 by age group.
The number of children dying from pneumonia has decreased substantially over the past three decades. In , more than two million children died from pneumonia every year. By , this number had fallen by almost two-thirds. Improvements in the major risk factors such as childhood wasting , air pollution , and poor sanitation , falling global poverty , and a better availability of health technology such as pneumococcal vaccines and antibiotics have all contributed to this decline.
While the death rate for old people fell slightly, the number of deaths of people who are 70 years and older increased. This is because the number of people who reached the age of 70 increased very strongly globally as we show in our entry on the changing global age structure.
It shows that children are most likely to die from pneumonia across Sub-Saharan Africa and South Asia. The deaths in just 5 countries — India, Nigeria, Pakistan, the Democratic Republic of Congo, and Ethiopia — accounted for more than half of all deaths from childhood pneumonia in Pneumonia is not a disease that easily spreads across borders, its transmission is generally restricted to local communities and it can be controlled if basic health measures are available.
The disease is therefore most common in poor places where healthcare infrastructure is lacking and people are least able to afford the treatment.
To understand how we can reduce the number of children dying from pneumonia we need to understand both prevention and treatment. In the chart we show the number of child deaths from pneumonia which are attributed to various risk factors. Without sufficient energy intake the body cannot cope with increased energy demands required to fight off the infection.
A literature review of pneumonia in malnourished children by Mohammod Jobayer Chisti and colleagues found that undernourished children are between two and four times more likely to be admitted to hospital due to pneumonia and up to 15 times more likely to die from it.
Studies have shown that high indoor air pollution in households can double the chances a child develops pneumonia and makes recovery less successful.
Laura Jones et al. Exposure to other pathogens such as measles and HIV also increases the risk of pneumonia in children. When children who are infected with HIV develop AIDS — which weakens their immune system — their chances of dying from pneumonia increase significantly.
A study by Evropi Theodoratou et al. These regional differences are important to know so that interventions that can save most lives can be prioritized.
Pneumonia is not an easily transmittable disease, it requires close contact for the pathogens to be transmitted to another person via air droplets. Therefore overcrowding — too many people living in one space — also increases the risks of pneumonia. Despite progress against it, more than , children still die from pneumonia each year. We know where children are dying, and the factors that make them vulnerable to the disease.
The key question is how we continue to make progress against it. When we understand what risks can lead to pneumonia, we can find ways to reduce them. Furthermore, because a number of risks factors for pneumonia overlap with risk factors for other diseases, especially diarrheal diseases , interventions that target pneumonia have the additional benefit of helping to limit other diseases and saving more lives.
There are several versions of pneumococcal conjugate vaccine PCV , which target different serotypes of S. The PCV vaccine is given to children younger than 24 months. According to a study by Cheryl Cohen et al. It has been estimated that if PCV13 coverage in low income countries would reach the coverage of the DTP3 vaccine , then PCV13 could prevent , child deaths and In Europe, several countries apply a minimum gestational age of 22 weeks or a birth weight threshold of g for babies to be registered as live births.
This indicator is measured in terms of deaths per 1 live births. Find a country by name. Width: px Preview Embedding. Infant mortality rates Related topics Health. Latest publication Health at a Glance Publication Indicators Life expectancy at birth Life expectancy at 65 Infant mortality rates Potential years of life lost Deaths from cancer Suicide rates. My pinboard Add this view Go to pinboard. However, deaths from certain causes dropped dramatically in those 20 years. In particular, many fewer babies died of lower respiratory infections and diarrheal diseases in than did in Causes of Infant Mortality Worldwide Globally, the top five causes of infant death in the most recent year for which data were available were the following: 3 , 4 Neonatal encephalopathy, or problems with brain function after birth.
Neonatal encephalopathy usually results from birth trauma or a lack of oxygen to the baby during birth. Infections, especially blood infections Complications of preterm birth Lower respiratory infections such as flu and pneumonia Diarrheal diseases This ranking is an average for all infant mortality from birth to age 1 year. Deaths: preliminary data for National Vital Statistics Reports, 61 6.
Table Infant mortality rates, fetal mortality rates, and perinatal mortality rates by race: United States, selected years — Health, United States — ed.
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