Survival of the littlest
“The better protection of infant life is one of the most intricate and difficult of modern problems.”
So began Dr Hugh Jones, Lecturer in Bacteriology at the Royal Southern Hospital in Liverpool, in his 1893 essay to the Royal Statistical Society on ‘The Perils and Protection of Infant Life'.
In his essay, Dr Jones records an infant mortality rate in England for the period 1881-90 of 142 deaths per thousand births among children under the age of one.
In 2010, the infant mortality rate in England and Wales was four deaths per thousand births in this age group.
The decline in infant mortality since Dr Jones published his essay has therefore been considerable, but the exact reasons for the decline, and their relative importance, are still debated.
Even in 1893, Dr Jones was aware that infant mortality was a problem with many causes. His essay considered the role of income, the urban environment, clean water, hygiene, sanitation, diet, and a range of infectious diseases including small pox, measles, scarlet fever, whooping cough, diphtheria, and typhoid. He also saw that infant mortality was caused by different problems at different stages of infancy: the causes of deaths in the first week of infancy were often different from those later on.
There are many developments that are likely to have contributed to the reduction in infant deaths. They include the decline of infectious diseases, mass vaccination, the development of antibiotics and other drugs, improved sanitation, better infant nutrition, and improvements in prenatal health and in postnatal care.
Because there are so many factors that have a role in infant mortality, the statistic is viewed as an important indicator of the overall health and wellbeing of a population, and it is one of the indicators used for measuring developing countries' progress towards meeting the Millennium Development Goals. In the period from 2005-2010, the country with the highest infant mortality
was Afghanistan, with 136 infant deaths per thousand births. The country with the lowest infant mortality was Singapore, with less than 2 deaths per thousand births.
Growing older with time
The chart shows the number of deaths per thousand live births within a period of one year from birth in England and Wales