Infant Mortality

Like infectious and parasitic diseases, and as Table 4.1 shows, infant mortality is many times higher in the less developed nations than in the more developed na- tions. The most common causes of infant mortality in poorer nations are malnutrition and infections (particularly respira- tory infections and diarrheal diseases). Because we examined these factors earlier in this chapter, we focus here on two other important sources of infant mortality: women’s status and infant formula manufacturers.

The Role of Women’s Status The low status of women plays a critical role in infant mortality in less developed nations. In these countries, infant mortality occurs most often among babies born to underfed, overworked mothers, many of whom suffer from untreated illnesses.

These conditions reflect women’s low status. Throughout the less developed nations, girls and women often spend long hours in heavy labor. Yet they typically receive less food and less health care (including immunizations) than do boys and men. As a result, girls often enter their childbearing years already ill and malnourished—a situation that worsens as pregnancies further stress their bodies and drain their energy.

Similarly, infant mortality is highest among infants born to the youngest or oldest mothers and to infants born less than 18 months after a sibling. This situ- ation occurs most commonly in cultures that expect women to marry at young ages, that judge women’s worth by how many children they have (especially male children), and that restrict women’s access to contraception. In part, these cultural values reflect the economic realities of agricultural life: In agricultural societies, children produce more economic resources than they consume, so a family with many children is more likely to survive than a family with few children. In addi- tion, in the absence of pension systems, individuals can guarantee their security in old age only by having sons given that daughters generally are expected to take care of their husbands’ parents rather than their own. For this reason, it is common for families in some parts of Asia to let girl babies die by giving them less food or medical care, to use medical technologies to identify and then abort female fetuses, or to kill girl babies outright. This situation is discussed in “Ethical Debate: The Ethics of Prenatal Sex Selection.”

In sum, research suggests that if women’s social status were higher, they would enter their childbearing years with healthier bodies, would wait longer before having babies, would wait longer between babies, and would have fewer babies in total, with each of these factors lowering the infant mortality rate. For all of these reasons, many researchers and public health workers have suggested that the most effective way to reduce infant mortality is to improve the status of women, thereby increasing their power to make decisions for themselves. This at least partly ex- plains why infant mortality is so much lower in Costa Rica and China than in some other countries at similar levels of development.