Mind the Gap! Widening Child Mortality Disparities

In parallel to the substantial expansion in global economic transactions and growth during the 1990s, there is evidence that the number of poor has increased and that income disparity among and within countries grew as well. There is, however, considerably less evidence about the situation of children related to these matters. Within this context, this paper explores the evolution of social disparities by analysing the trends in the Under-5 Mortality Rate (U5MR) by wealth level. It is common knowledge that child mortality is higher among the poorest than the richest. However, the size of this mortality gap or the way it varies in relation to the absolute level of child mortality is not as well known. This paper shows, based on a sample of 24 developing countries with comparable surveys, that the U5MR of the bottom quintile of the distribution of wealth is, on average, 2.2 times bigger than that of the wealthiest quintile. This means that, taking into account the greater fertility of poorer households, a child from a family belonging to the bottom quintile of the wealth distribution is three times more likely to die before age 5 than a child belonging to the top quintile. The trends over time show that U5MR differentials remained constant over time in a few countries, but worsened in the majority of them. Only two countries with relatively small populations were able to achieve both a reduction in average U5MR and a decline of U5MR disparities. The implications of this finding for achieving the U5MR Millennium Development Goal is discussed. Under the top-down approach, extrapolating past trends, only six of the 24 countries would reach the goal. However, under the egalitarian approach, 16 of them would attain the two-thirds required reduction. The relation between changes in U5MR differentials and changes in income inequality does not seem to be pronounced, thus suggesting that social policy may play an important role in reducing U5MR disparity.