With all the economic doom and gloom out there and folks thinking we're on the precipice of the decline of Western civilization, some good news about the bigger picture seems in order. A new study in the British medical journal Lancet finds that mortality rates of children under the age of 5 are falling in just about every country on the planet.
Using a new method of calculating mortality that they say is more complete and accurate than previous methods, the team at the University of Washington says the number of under 5 has plummeted from 11.9 million in 1990 to 7.7 million in 2010.
When we think about long-run human progress, the infant and child mortality rate is as good an indicator as any about how far we have come. When we consider that almost half of children died before age 18 in the richest countries in the world 200 years ago, and that under-5 death rates 100 years ago were multiple times what we see now, the progress of humanity becomes clear.
Even as the economic challenges we face are very real, the world's increased ability to enable children to see their 5th birthday is equally real and I believe a much better indicator of where we are headed in the long run than is the price of gold or the Dow. I'm a short-run cynic but a long-run optimist!
One side point: some reports on this study have tried to make hay out of the fact that the US child mortality rate is 42nd in the world (having fallen from 29th). The hay they want to make is usually about the failures of the US healthcare system. However, that higher child mortality rate can be explained by two factors, one of which has nothing to do with healthcare and the other being an unintended consequence of how good our system is.
1. Kids in the US are more likely to die in car crashes and from violence as those are more common here than elsewhere.
2. Because the US healthcare system is so good at caring for very premature babies, more babies are born alive in the US pre-term than anywhere else in the world. In the rest of the world, those babies would be stillborn or perhaps even aborted. Because they are born alive in the US, they count in the denominator of the infant/child mortality rate. And despite medicine's best efforts, a fair number of those premies don't make it, increasing the numerator. The result is a higher infant/child mortality rate than other places because we are able to save enough premies that more get born alive than elsewhere.
So the next time someone tells you that Cuba's healthcare system is better than that in the US because it has a lower infant mortality rate, the proper response is "yes, that's what happens when your system is so awful that you can't do much of anything for children born prematurely and your only choice is to deliver them stillborn. If you think a system with more dead babies is better, you can have it." A lower infant mortality rate doesn't mean you have fewer dead babies. You just have fewer babies born alive.
Bonus Econ 100 point: it's amusing how the reports note that the rate of decline in the infant mortality rate has leveled off in the advanced countries and the reporters gloss this as an indictment of those countries. Rising marginal costs anyone?