Infant mortality
Overview
Infant mortality is defined as the number of infant
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...

 deaths (one year of age or younger) per 1000 live births. Traditionally, the most common cause worldwide was dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

 from diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

. However, the spreading information about Oral Re-hydration Solution (a mixture of salts, sugar, and water) to mothers around the world has decreased the rate of children dying from dehydration. Currently, the most common cause is pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

.
Encyclopedia
Infant mortality is defined as the number of infant
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...

 deaths (one year of age or younger) per 1000 live births. Traditionally, the most common cause worldwide was dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

 from diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

. However, the spreading information about Oral Re-hydration Solution (a mixture of salts, sugar, and water) to mothers around the world has decreased the rate of children dying from dehydration. Currently, the most common cause is pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

. Other causes of infant mortality include: malnutrition, malaria, congenital malformation, infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 and SIDS
Sudden infant death syndrome
Sudden infant death syndrome is marked by the sudden death of an infant that is unexpected by medical history, and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation. An infant is at the highest risk for SIDS during sleep, which is why it is sometimes...

.

Infanticide
Infanticide
Infanticide or infant homicide is the killing of a human infant. Neonaticide, a killing within 24 hours of a baby's birth, is most commonly done by the mother.In many past societies, certain forms of infanticide were considered permissible...

, child abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...

, child abandonment
Child abandonment
Child abandonment is the practice of relinquishing interests and claims over one's offspring with the intent of never again resuming or reasserting them. Causes include many social and cultural factors as well as mental illness. An abandoned child is called a foundling .-Causes:Poverty is often a...

, and neglect
Child neglect
Child neglect is defined as:# "the failure of a person responsible for a child’s care and upbringing to safeguard the child’s emotional and physical health and general well-being"...

 also contribute to a lesser extent.
Related statistical categories:
  • Perinatal mortality
    Perinatal mortality
    Perinatal mortality , also perinatal death, refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and...

    only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery.
  • Neonatal mortality only includes deaths in the first 28 days of life.
  • Postneonatal mortality only includes deaths after 28 days of life but before one year.
  • Child mortality
    Child mortality
    Child mortality, also known as under-5 mortality, refers to the death of infants and children under the age of five. In 2010, 7.6 million children under five died , down from 8.1 million in 2009, 8.8 million in 2008, and 12.4 million in 1990. About half of child deaths occur in Africa....

    includes deaths within the first five years after birth.

World historical and predicted infant mortality rates per 1,000 births (1950–2050)
UN, medium variant, 2008 rev.
YearsRateYearsRate
1950–1955 152 2000–2005 52
1955–1960 136 2005–2010 47
1960–1965 116 2010–2015 43
1965–1970 100 2015–2020 40
1970–1975 91 2020–2025 37
1975–1980 83 2025–2030 34
1980–1985 74 2030–2035 31
1985–1990 65 2035–2040 28
1990–1995 61 2040–2045 25
1995–2000 57 2045–2050 23



Infant mortality rate

Infant mortality rate (IMR) indicates the number of deaths of babies under one year of age per 1,000 live births. The rate in a given region, therefore, is the total number of newborns dying under one year of age divided by the total number of live births during the year, then all multiplied by 1,000. The infant mortality rate is also called the infant death rate (per 1,000 live births).

Historically, infant mortality claimed a considerable percentage of children born, in the 1850s in America it was estimated to be as 216.8 per 1,000 for whites and 340.0 for African Americans but rates have significantly declined in the West in modern times. This has been mainly due to improvements in basic health care, though high-technology medical advances have also helped. Infant mortality rate is commonly included as a part of standard of living
Standard of living
Standard of living is generally measured by standards such as real income per person and poverty rate. Other measures such as access and quality of health care, income growth inequality and educational standards are also used. Examples are access to certain goods , or measures of health such as...

 evaluations in economics
Economics
Economics is the social science that analyzes the production, distribution, and consumption of goods and services. The term economics comes from the Ancient Greek from + , hence "rules of the house"...

.

Comparing infant mortality rates

The infant mortality rate correlates very strongly with, and is among the best predictors of, state failure. IMR is therefore also a useful indicator of a country's level of health or development, and is a component of the physical quality of life index. However, the method of calculating IMR often varies widely between countries, and is based on how they define a live birth and how many premature infants are born in the country. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and raises their rates of perinatal mortality.

The exclusion of any risk infants from the denominator or numerator in reported IMRs can be problematic for comparisons. Many countries, including the United States, Sweden or Germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation
Gestation
Gestation is the carrying of an embryo or fetus inside a female viviparous animal. Mammals during pregnancy can have one or more gestations at the same time ....

 or the size, but according to United States Centers for Disease Control (CDC) researchers, some other countries differ in these practices. All of the countries named adopted the WHO definitions in the late 1980s or early 1990s, which are used throughout the European Union. However, in 2009, the US CDC issued a report that stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries. It also outlined the differences in reporting requirements between the United States and Europe, noting that France, the Czech Republic, Ireland, the Netherlands, and Poland do not report all live births of babies under 500 g and/or 22 weeks of gestation.
The report concluded, however, that the differences in reporting are unlikely to be the primary explanation for the United States’ relatively low international ranking.

Another well-documented example also illustrates this problem. Until the 1990s, Russia and the Soviet Union did not count, as a live birth or as an infant death, extremely premature infants (less than 1,000 g, less than 28 weeks gestational age, or less than 35 cm in length) that were born alive (breathed, had a heartbeat, or exhibited voluntary muscle movement) but failed to survive for at least seven days. Although such extremely premature infants typically accounted for only about 0.005% of all live-born children, their exclusion from both the numerator and the denominator in the reported IMR led to an estimated 22%-25% lower reported IMR. In some cases, too, perhaps because hospitals or regional health departments were held accountable for lowering the IMR in their catchment area
Catchment area (human geography)
In human geography, a catchment area is the area and population from which a city or individual service attracts visitors or customers. For example, a school catchment area is the geographic area from which students are eligible to attend a local school...

, infant deaths that occurred in the 12th month were "transferred" statistically to the 13th month (i.e., the second year of life), and thus no longer classified as an infant death.

UNICEF uses a statistical methodology to account for reporting differences among countries:
Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriage
Miscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...

s (spontaneous abortions) or those who die during or immediately after childbirth as stillborn
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...

. Therefore, the quality of a country's documentation of perinatal mortality
Perinatal mortality
Perinatal mortality , also perinatal death, refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and...

 can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the demographer Ansley Coale
Ansley J. Coale
Ansley Johnson Coale , was one of America's foremost demographers. A native of Baltimore, Maryland, he earned his B.A. in 1939, his M.A. in 1941, and his Ph.D. in 1947, all at Princeton University...

, who finds dubiously high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries. It suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths, but also that those countries do not follow WHO recommendations for the reporting of live births and infant deaths.

Another seemingly paradoxical finding is that when countries with poor medical services introduce new medical centers and services, instead of declining the reported IMRs often increase for a time. This is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. Thus, even if the new health services reduce the actual IMR, the reported IMR may increase.

Infant mortality rate in war

In most cases, war-affected areas will experience a significant increase in infant mortality rates. The primary causes of the increase are external factors such as murder and abuse. However, many other significant factors influence infant mortality rates in war-torn areas. Health care systems in developing countries in the midst of war often collapse. Attaining basic medical supplies and care becomes increasingly difficult. During the Yugoslav Wars in the 1990s Bosnia experienced a 60% decrease in child immunizations. Preventable diseases can quickly become epidemic given the medical conditions during war.

Many developing countries rely on foreign aid for basic nutrition. Transport of aid becomes significantly more difficult in times of war. In most situations the average weight of a population will drop substantially. Expecting mothers are affected even more by lack of access to food and water. During the Yugoslav Wars in Bosnia the number of premature babies born increased and the average birth weight decreased.

There have been several instances in recent years of systematic rape as a weapon of war. Women who become pregnant as a result of war rape face even more significant challenges in bearing a healthy child. Studies suggest that women who experience sexual violence before or during pregnancy are more likely to experience infant death in their children.
Causes of infant mortality in abused women range from physical side effects of the initial trauma to psychological effects that lead to poor adjustment to society. Many women who became pregnant by rape in Bosnia were isolated from their hometowns making life after childbirth exponentially more difficult.

Global infant mortality trends

For the world, and for both Less Developed Countries (LDCs) and More Developed Countries (MDCs), IMR declined significantly between 1960 and 2001. According to the Save the Children
Save the Children
Save the Children is an internationally active non-governmental organization that enforces children's rights, provides relief and helps support children in developing countries...

 State of the World's Mothers report
Save the Children State of the World's Mothers report
The Save the Children State of the World's Mothers report is an annual report by the International Save the Children Alliance, which compiles statistics on the health of mothers and children and uses them to produce rankings of nations within three groupings corresponding to varying levels of...

, the world infant mortality rate declined from 126 in 1960 to 57 in 2001.

However, IMR was, and remains, higher in LDCs. In 2001, the Infant Mortality Rate for Less Developed Countries (91) was about 10 times as large as it was for More Developed Countries (8). For Least Developed Countries, the Infant Mortality Rate is 17 times as high as it is for More Developed Countries. Also, while both LDCs and MDCs made dramatic reductions in infant mortality rates, reductions among less developed countries are, on average, much less than those among the more developed countries.

Infant mortality rate in countries

Nearly two orders of magnitude separate countries with the highest and lowest reported infant mortality rates. The top and bottom five countries by this measure (taken from The World Factbook
The World Factbook
The World Factbook is a reference resource produced by the Central Intelligence Agency of the United States with almanac-style information about the countries of the world. The official paper copy version is available from the National Technical Information Service and the Government Printing Office...

's 2009 estimates) are shown below.
Rank Country Infant mortality rate
(deaths/1,000 live births)
1 Angola
Angola
Angola, officially the Republic of Angola , is a country in south-central Africa bordered by Namibia on the south, the Democratic Republic of the Congo on the north, and Zambia on the east; its west coast is on the Atlantic Ocean with Luanda as its capital city...

 
180.21
2 Sierra Leone
Sierra Leone
Sierra Leone , officially the Republic of Sierra Leone, is a country in West Africa. It is bordered by Guinea to the north and east, Liberia to the southeast, and the Atlantic Ocean to the west and southwest. Sierra Leone covers a total area of and has an estimated population between 5.4 and 6.4...

 
154.43
3 Afghanistan
Afghanistan
Afghanistan , officially the Islamic Republic of Afghanistan, is a landlocked country located in the centre of Asia, forming South Asia, Central Asia and the Middle East. With a population of about 29 million, it has an area of , making it the 42nd most populous and 41st largest nation in the world...

 
151.95
4 Liberia
Liberia
Liberia , officially the Republic of Liberia, is a country in West Africa. It is bordered by Sierra Leone on the west, Guinea on the north and Côte d'Ivoire on the east. Liberia's coastline is composed of mostly mangrove forests while the more sparsely populated inland consists of forests that open...

 
138.24
5 Niger
Niger
Niger , officially named the Republic of Niger, is a landlocked country in Western Africa, named after the Niger River. It borders Nigeria and Benin to the south, Burkina Faso and Mali to the west, Algeria and Libya to the north and Chad to the east...

 
116.66
219 Hong Kong
Hong Kong
Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...

 
2.92
220 Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...

 
2.79
221 Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....

 
2.75
222 Bermuda
Bermuda
Bermuda is a British overseas territory in the North Atlantic Ocean. Located off the east coast of the United States, its nearest landmass is Cape Hatteras, North Carolina, about to the west-northwest. It is about south of Halifax, Nova Scotia, Canada, and northeast of Miami, Florida...

 
2.46
223 Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

 
2.31


Afghanistan's infant mortality rate is expected to improved by at least 60% in the next ten years due to billions of dollars of international aid.

United States

In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, infant mortality is 629 per 100,000 live births or 6.3 per 1000 live births.
The infant mortality rate for European Americans was 5.7 per 1000 births in 2003-05. For African Americans it was 13.6 per 1000, and for Hispanic Americans it was 5.6 per 1000. Overall, the infant mortality rate for the United States was 6.9 per 1000 in 2003-05. Source from Statehealthfacts.org

Infant Mortality Rate by State (2005)

State Infant mortality Rate per 1000 births
Alabama 8.96
Alaska 6.45
Arizona 6.69
Arkansas 8.29
California 5.22
Colorado 6.27
Connecticut 5.53
Delaware 9.03
District of Columbia 14.1
Florida 7.24
Georgia 8.35
Hawaii 6.67
Idaho 6.12
Illinois 7.53
Indiana 7.87
Iowa 5.40
Kansas 7.12
Kentucky 6.79
Louisiana 9.79
Maine 5.87
Maryland 8.00
Massachusetts 4.89
Michigan 8.02
Minnesota 4.78
Mississippi 10.74
Missouri 7.63
Montana 6.35
Nebraska 5.89
Nevada 5.86
New Hampshire 5.05
New Jersey 5.44
New Mexico 6.13
New York 6.02
North Carolina 8.85
North Dakota 6.35
Ohio 7.82
Oklahoma 7.86
Oregon 5.68
Pennsylvania 7.30
Rhode Island 6.20
South Carolina 9.03
South Dakota 7.18
Tennessee 8.87
Texas 6.45
Utah 4.92
Vermont 5.37
Virginia 7.50
Washington 5.39
West Virginia 8.1
Wisconsin 6.34
Wyoming 6.95

Infant Mortality as a Historical Economic Indicator

In the United States, historically there has been a negative relationship between infant mortality rates and economic factors such as average wage. This relationship is likely caused indirectly by several variables, both exogenous and endogenous.

Research into the era between 1900 and 1920 by Karen Clay, Warner Troeskin and Michael R. Haines reveals that infant mortality is a reliable indicator of median wages in an urban population. They found that cities that had an infant mortality rate that was one standard deviation above the mean, had wages that were 4.0 -5.4% lower than average. They attributed most of this effect to the prevalence of lead pipes in some American cities during this time period. For reference, in 1897 approximately 67% of US cities were partially using lead in their piping systems. Clay, Troeskin and Haines found a positive relationship between lead pipes and infant mortality rates in early American cities. In fact, between 1900 and 1920, 25% of the decrease in infant mortality can be attributed to decreased use of lead in pipes.

Another contributing factor to this relationship between infant mortality and economic factors is demographics. Economic inequality has a lot to do with infant mortality in some US cities, both historically and today. While education is often linked to income, it can also be linked to infant mortality. Looking at recent data, fathers with no formal education saw an infant mortality rate that was twice the normal rate. Over the period between 1912 and 1915, the Children’s Bureau examined data across eight cities and nearly 23,000 live births. What they found was that income had a lot to do with infant mortality. If the father had no income, the rate of infant mortality was 357% more than that for the highest income earners ($1,250+). As well, differences between races were apparent during this time period. African-American mothers experience an infant mortality at a rate 44% higher than average.

While infant mortality is normally negatively correlated with GDP, there may indeed be some opposing short-term effects to a recession. A recent study by The Economist shows that economic slowdowns reduce the amount of air pollution, which results in a lower infant mortality rate. During the late 1970s and early 1980s, the recession’s impact on air quality is estimated to have saved around 1,300 US babies. It is only during deep recessions that infant mortality increases. According to Norbert Schady and Marc-Francois Smitz, recessions where GDP per capita drops by 15% or more have a negative impact on infant mortality.

While the historical link between infant mortality and wages is significant, infant mortality merely serves as an indicator for other variables such as lead poisoning, demographics and standard of living.

See also

  • Diarrheal diseases
  • Childlessness
  • Rotavirus
    Rotavirus
    Rotavirus is the most common cause of severe diarrhoea among infants and young children, and is one of several viruses that cause infections often called stomach flu, despite having no relation to influenza. It is a genus of double-stranded RNA virus in the family Reoviridae. By the age of five,...

  • Pneumonia
    Pneumonia
    Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

  • Pneumococcal disease

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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