Child Mortality

Since the beginning of the age of the Enlightenment and over the course of modernisation the mortality of children below 5 years of age declined rapidly. Child mortality in rich countries today is much lower than 1%. 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 3rd child died, in 19th century Germany every 2nd child died. With declining poverty and increasing knowledge and service in the health sector child mortality around the world is declining very rapidly. Big countries like Brazil and China reduced their child mortality rates 10-fold over the last 4 decades. Other countries – especially in Africa – are still having high child mortality rates but its not true that these countries are not making progress. In Sub-Saharan Africa child mortality is continuously falling for the last 50 years (1 in 4 children died in the early 60s – today it is less than 1 in 10). Over the last decade this improvement is 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.

# Empirical View

The child mortality rate is the number of children before reaching five years of age expressed per 1,000 live births per year.

In the time-series plot below I show child mortality over the long run. Today child mortality in industrialised countries is below 5 per 1,000 live births. The time series plot shows that these low mortality rates are a very recent development and that in pre-modern countries child mortality rates were between 300 and 500. In the late 19th century every second child in Germany died before its fifth birthday. In developing countries the health of children is quickly improving – but child mortality is still much higher.

A second interesting characteristic that is immediately noticeable is that the series are very ‘spikey’ in the 19th century and are then becoming much smoother in the 20th century. This is partly because the data quality is improving over time but it also shows how frequent crises were in pre-modern times. The decline of crises is an important aspect of improving ‘living standards’. In the ‘Our World in Data’ entry on food price volatility you find a long-run series of food price volatility in Pisa by Cormac O Grada that shows how frequent food crises were. In the following plot you can see what these and other crises – epidemics or wars for example – meant for the health of the population.

# Child Mortality from 1751 to 2011 in 13 countries around the world – Max Roser1

Full screen view       Download Data

# Child Mortality in pre-modern cultures

In ‘Longevity Among Hunter‐Gatherers’ the authors – Gurven and Kaplan – compare mortality patterns of hunter gatherers and modern societies and state that “infant mortality is over 30 times greater among hunter-gatherers, and early child mortality is over 100 times greater than encountered in the United States”.2

# Proportions of subadults (defined as individuals with incomplete skeletal or dental development) in samples of fossil hominids – Chamberlain (2006)3
Site and species
Subadults
Adults
Share of Subadults
Surface collected sites
Koobi Fora (Homo)
72820%
Koobi Fora (Paranthropus boisei)102926%
Hadar (Australopithecus afarensis)174129%
Excavated sites
Sterkfontein (Australopithecus africanus)
225628%
Swartkrans (Paranthropus robustus)798050%
Zhoukoudian (Homo erectus)152339%
Neanderthals (Homo neanderthalensis)10610052%
Olduvai Gorge (Homo habilis)13668%
Atapuerca (Homo heidelbergensis)19968%

# Child Mortality Globally Post 1950

# Child Mortality rate, (per 1,000 live births) by World Region – Max Roser4

Full screen view

Mortality Data around the World (1970-2010) can be studied with an interactive data visualisation at HealthIntelligence.org here.

# World Maps of Child Mortality between 1950 and 2012 – Max Roser 5

# Annual rates of reduction (ARR) in the under-five mortality rate, %, by region, since 1990 – UNICEF (2013)6 Annual rates of reduction in the under-five mortality rate, per cent by region, since 1990 – UNICEF (2013)

# Child Mortality by Cause of Death

# Global distribution of deaths among children under age 5, by cause, 2012 – UNICEF (2013)7 Global distribution of deaths among children under age 5, by cause, 2012 – UNICEF (2013)0

# Global under-five deaths from five infectious diseases, 2000 and 2012 – UNICEF (2013)8 Global under-five deaths from five infectious diseases, 2000 and 2012 – UNICEF (2013)0

# Correlates, Determinants, & Consequences

# Child Mortality rate, (per 1,000 live births) by Country’s Income Level – Max Roser9

Full screen view
# Under five mortality rate (per 1,000 live births) and Total fertility rate (births per woman), 1970 to 2010 – World Development Indicators (2013)10 Under five mortality rate (per 1,000 live births) and Total fertility rate (births per woman), 1970 to 2010 – World Development Indicators (2013)0

# Education and Child Mortality

The effect of education on child mortality for a sample of 175 countries was analysed in a research paper published in The Lancet. The authors found that around half (51.2 %) of the reduction in child mortality between 1970 and 2009 could be attributed to increased educational attainment in women of reproductive age.11

# Under-5 mortality rate, by mother’s education and wealth, selected countries, 2003—2009 – UNESCO (2011)12 Under-5 mortality rate, by mother’s education and wealth, selected countries, 2003—2009 – UNESCO (2011)0

The effect of education on child mortality is huge and especially in places with relatively little education the prospects for extending education are promising. In 2008 4.4 million children younger than 5 years died in sub-Sahran Africa. The UNESCO estimates that an extension of secondary education for all women would save 1.8 million children per year.13

# Health Care and Child Mortality

In a publication in the American Economic Journal the authors report that Thailand’s 2001 healthcare reform led to significant reductions in child mortality, especially among the poor.14 The following graph shows for a large cross-section of countries that high expenditure on health more generally comes along with lower levels of child mortality.

# Under-five mortality rate by per capita total expenditure on health, countries by WHO Region, 2002–2003 – WHO15 Under-five mortality rate by per capita total expenditure on health, countries by WHO Region, 2002–2003 – WHO

# Measurement, Data Quality & Definitions

Child mortality is the probability per 1,000 live births that a newborn baby will die before reaching age five under current age-specific mortality patterns. The uncertainty associated with the estimates of child mortality can be understood if one compares different data sources. The UN Inter-agency Group for Child Mortality Estimation does this for each country of the world. Here is the chart on the child mortality of Brazil as one example. On the same website the differences of different data sources can be studied for a large number of countries.

# Data

# Data on child mortality in early cultures and hunter gatherers

A still often cited early text is Acsádi and J. Nemeskéri (1970) – History of human life span and mortality.16 Other texts on early cultures and hunter gatherers are:

  • Andrew T. Chamberlain (2006) – Demography in Archaeology-Cambridge University Press (Cambridge Manuals in Archaeology)
  • Gurven, H Kaplan (2007) – Longevity Among Hunter‐Gatherers: A Cross‐Cultural Examination. Population and Development Review. Volume 33, Issue 2, pages 321–365, June 2007. Online here.
  • Preston (1995) – Human mortality throughout history and prehistory. In Simon (1995) – The State of Humanity. Wiley.
  • Johnston, F. E., and C. E. Snow (1961) – The Reassessment of the Age and Sex of the Indian Knoll Skeletal Population:  Demographic and Methodological Aspects, American Journal of Physical Anthropology, vol. 19.
  • Brothwell, D. (1975) – Paleodemography, in Biological Aspects of Demography, ed. W. Brass. London: Taylor and Francis.
  • Hopkins, M. K. (1966) – On the Probable Age Structure of the Roman Population, Population Studies, 20, 2.
  • Howell, N. (1979) – The Demography of the Dobe !Kung. New York: Academic Press.

# Long-Run Data

The Human Mortality Database
  • Data: Child mortality estimates and more mortality data
  • Geographical coverage: More than 35 countries. Mostly European but also Taiwan and USA.
  • Time span: For some countries data is available since the 19th century. Few data available for the 18th century.
  • Available at: Online at www.mortality.org.
  •  This very  comprehensive source is maintained by the University of California, Berkeley (USA), and the Max Planck Institute for Demographic Research (Germany).

Gapminder.org
  • Data: Child mortality estimates
  • Geographical coverage: Global – by country
  • Time span: From 1800 onwards (data on Sweden go back to 1751)
  • Available at: Online at Gapminder.org
  • The sources of Gapminder are the Human Mortality Database and Child Mortality Estimates Info. Some of the data on child mortality is estimated from data on infant mortality (see the documentation which is online here).

# Post 1950 Data

‘Child Mortality Estimates Info’ (CME Info)
  • Data: The latest estimates based on the research of the UN Inter-agency Group for Child Mortality Estimation
    • List of available data: Under-five mortality estimates, Infant mortality estimates, Neonatal mortality estimates (for all three rates and deaths) Estimates of: Sex-specific under-five mortality rate, Sex-specific infant mortality rate, Annual rate of reduction of under-five mortality.
  • Geographical coverage: Global – by country.
  • Time span: Data availability varies but for some countries it goes as far back as the 1930s.
  • Available at: Online at www.childmortality.org
  • This very good source is published by UNICEF. It is possible to explore the trends country by country and to visualise the data on a map.

World Development Indicators (WDI) published by the World Bank
  • Data: ‘Mortality rate, under-5 (per 1,000 live births)’
  • Geographical coverage: Global – by country and world region
  • Time span: Annual data since 1960
  • Available at: Online here
  • The Worl Bank data is based on the estimates developed by the UN Inter-agency Group for Child Mortality Estimation (UNICEF, WHO, World Bank, UN DESA Population Division) at childmortality.org.

 

This website presents the long-term data on how we are changing our world – based on empirical evidence and visualised in graphs. Topic by topic, the empirical view of our world shows how the Enlightenment continues to make our world a better place. It chronicles how we are becoming less violent and increasingly more tolerant. The data displays how new ideas continue to improve living standards, allowing us to live a healthier, richer and happier life. It is the story of declining poverty and better food provision in a world we care about.

Written by Max Roser

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