June 18, 2018
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Lowering of infant death rate

By Edwin Dean

In 1900, more than 11 percent of all newborn babies in the U.S. died before their first birthday. This high infant death rate affected my own family. My father, who was born in 1907, was one of eight children, and one of the eight died before his first birthday. My father, too, was a sickly infant. His parents, fearing he too would die early, took photos of him to help them remember him.

Happily, the U.S. infant mortality rate — deaths among infants who die before their first birthday, per 1,000 newborns — fell rapidly throughout the 20th century. It fell from more than 110 per 1,000 newborns in 1900 to fewer than seven at present — truly a revolutionary change.

In Maine, too, the infant mortality rate dropped dramatically. In 1900, it was a sky-high 270 per 1,000 newborns — that is, 27 percent of newborns died within a year. The rate has dropped drastically to six per thousand.

What led to these dramatic drops? From 1900 to about 1930, state, local and federal governments, building on Louis Pasteur’s germ theory of disease, took decisive action. They built public works to make drinking water safe and to make sewage and refuse disposal sanitary; and they passed milk pasteurization laws. Later in the century, drug companies developed many effective antibiotics and scientists brought progress in fighting many infectious and parasitic diseases.

The news gets better: Impressive drops in both infant and child mortality have been recorded for the entire world.

This progress was recently set forth by University of Washington researchers, who developed improved child mortality data, based on thousands of surveys worldwide. They measured child mortality — deaths among children younger than five, per 1,000 newborns — for 187 countries over the years 1970 to 2010; the data for 2010 are of course estimated. They then grouped the 187 countries into 21 regions.

Their results are striking: Child mortality has fallen in every one of the 21 regions. It fell extremely rapidly in some countries: In Portugal it fell from 74 deaths per thousand in 1970 to just three in 2010, a decline of 96 percent, and in Egypt it fell from 237 per thousand to 25, an 89 percent drop. In Nigeria, by contrast, child mortality fell by a more modest 30 percent.

In 1970, child mortality exceeded 200 per thousand in 40 countries; at present, it is below 200 in all countries, according to the University of Washington study.

Child mortality fell even in countries that have suffered war, natural disasters and a high incidence of HIV and AIDS. For example, it fell in Afghanistan, the Congo and South Africa. It fell in large countries and small, in democracies and in dictatorships. Remarkably, child mortality fell throughout sub-Saharan Africa, a region of halting economic growth, civil wars and high HIV incidence.

The causes of these remarkable declines are not yet entirely clear. The sub-Saharan African progress, according to the Washington researchers, is due to vaccination campaigns, widespread use of insecticide-treated sleeping nets and reduction of mother-to-child transmission of HIV.

Are these data reliable? The general trends in the University of Washington data are not in dispute. Two United Nations agencies, UNICEF and the U.N. Population Division, also show very rapid worldwide declines in child mortality, though not quite as rapid as those computed by the Washington researchers.

Without the slightest doubt, there also is bad news about child mortality. For example, the infant mortality rate among black Americans is more than double the white rate. Further, the U.S. child mortality rate is not among the world’s lowest: 31 countries, including Cuba and Croatia, have lower rates than the U.S. And it is dreadful that a few countries still have child mortality rates above 150 per thousand.

Still, we have never before seen in human history such large, widespread child mortality drops as those set forth by the Washington group and the two U.N. agencies. This amounts to a quiet worldwide revolution in children’s health. Around the world, fewer and fewer parents need to take photos of their infants for fear they soon will die.

Edwin Dean, an economist and seasonal resident of Vinalhaven, writes monthly about economic issues.

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