sowm_2015__int__africa_full_report_low_res

Urban Inequity
in Wealthy Countries
In more developed countries, as in less
developed countries, it is the poorest, most marginalized
children who suffer the most in cities
and continue to die in the greatest numbers.
While child deaths are much less common in
wealthy countries than in developing countries,
there remain striking differences in death rates
between the richest and the poorest children in
cities throughout the industrialized world. In
some United States cities, urban child survival
gaps between rich and poor are greater than
those found in developing countries.
In measuring child mortality in the industrialized
world, most countries focus on infant
mortality – deaths of children in the first year
of life. This is because relatively few children in
wealthy countries die after their first birthday
from diseases such as pneumonia, malaria and
diarrhea, which continue to kill young children
in large numbers in developing countries.
Complications from prematurity account for
a large percentage of infant deaths in wealthy
countries – these are babies being born too soon
or too small.
While infant deaths in most major industrialized
cities surveyed outside the United States
were below 5 deaths per 1,000 live births, our
research also found significant gaps between
babies born to wealthy, well-educated urban
mothers and those born to poor, less-educated
mothers. Save the Children found examples
of significant urban inequities in cities in
the United States, Canada, Japan, Australia
and Europe. Here are some of the most
compelling findings:
United States: Cites in the United States have
some of the highest urban infant mortality rates
in high-income countries. Save the Children
examined infant mortality in capital cities of
wealthy (OECD) countries and found that
Washington, DC had by far the highest infant
mortality rate among the 25 capital cities
(see chart on page 45). In 2012, the District of
Columbia had an infant mortality rate of 7.9
deaths per 1,000 live births as compared to
Stockholm (Sweden) or Oslo (Norway) with
infant mortality rates at or below 2.0. Late last
year, DC officials released preliminary figures
for 2013 indicating a sharp decline in the city’s
infant mortality rate to 6.6 deaths per 1,000
live births. 129 This rate, which represents an
all-time low for Washington, DC is still higher
than any of the capital cities outside the U.S.
surveyed and remains above the U.S. national
average of 6.1.
Many major U.S. cities have even higher
infant mortality rates than Washington, DC
in recent years. In 2011, Cleveland and Detroit
reported infant mortality rates of 14.1 and 12.4,
respectively. Eight other cities had death rates
at or above 8.9 in 2011 (see table on page 42).
A Detroit News investigation last year found that
a majority of deaths among Detroit children
under 5 occurred during the first year of life.
Infant deaths accounted for 130 of the 208
Detroit children who died before the age of 5 in
2011. Prematurity was cited as the leading killer
of Detroit babies. Other factors contributing to
infant deaths included pervasive poverty, young
and uninformed mothers and poor prenatal
care. 130 Race is also a factor. In many U.S. cities,
poor, unmarried and young African-American
mothers are losing their babies at much higher
rates than the U.S. average of 6.1 deaths per
1,000 live births. In San Francisco, an African-
American mother is 6 times as likely as a white
Oslo, Norway
STATE OF THE WORLD’S MOTHERS 2015 41