Who lives ... who dies

The Feast of All Souls celebrated at church last night and the Mission District celebration of the Day of the Dead that I'll attend tonight both remind me to reflect on those who have died. I keep coming back to an awareness that we -- contemporary people in the rich parts of the world -- live with an expectation about who lives that would seem extremely foreign (and happy) to most of humans during in history. That is, when a child is born, we assume the baby will live.

Not so until very recent human history. An interesting survey of the history of infant (under 1 year) and child (under 5 years) mortality reports:

In 1661, John Graunt examined English bills of mortality and concluded that "one third of all that were ever quick, die under five years old."

... Before 1850, infant deaths were commonly accepted as a part of everyday life, a reflection of the natural order in which the strong outlived the weak. In the latter half of the century, however, families began to value children as more than an economic resource, and infant deaths no longer seemed acceptable. Reformers believed that all children deserved to be protected from the ravages of poverty and unsanitary living conditions.
... Far from being a natural state of affairs, the high urban death rate reflected a society's moral standing.

According to the same article, as late as 1911, the United States had an infant mortality rate of 135 infant deaths per 1000 live births. Only three countries today, Angola, Afghanistan, and Mozambique, exceed that rate of infant deaths.

Kul C. Gautam of UNICEF puts contemporary child mortality rates [pdf] in perspective:

The association between poverty and child mortality has long been recognized. Indeed U5MR [under age 5 mortality rate] is often an excellent proxy indicator for the measurement of poverty. Over 90 percent of the world’s child deaths occur in 60 countries – all of which are low income or least developed countries, or the poorest areas of middle-income countries. ... These same countries also account for the vast majority of maternal deaths, malnutrition and lack of safe drinking water and sanitation.

Gautam points out that the UN Millennium Development Goals, not only by directly working for children's health, but also by empowering women and improving sanitation, amount to a map for reducing deaths among children. ***Last summer I visited a cemetery where many of my ancestors are buried. What struck me, that I had not properly noticed before, was how many of the headstones marked the graves of children who never grew to adulthood. The grieving parents erected quite elaborate monuments. Here are some of them:






The parents of the Bemis infant twins above not only listed them on the large family monument, but also set up their own little stones, below.






Arthur and Charlotte were my mother's siblings, born and died before she was born.


My Aunt Steva's child never even received a name.


Even in the middle of the last century. ...And today...

America may be the world’s superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia.

Among 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies, according to a new report. Latvia’s rate is 6 per 1,000. ...

The U.S. ranking is driven partly by racial and income health care disparities.

Associated Press
May 9, 2006