The following question crossed my mind recently: how many lives are lost from excess infant mortality?
I asked this question because I wondered if anti-abortion activists couldn’t better spend their time saving the lives of children that died in their first year of life, rather than protesting at abortion clinics. Saving the life of a child who has been born seems like an easier political task, and will almost certainly be more effective.
We have a pretty good sense that this is theoretically possible because of the considerable variation in infant mortality that exists worldwide. Most poor countries have high infant mortality rates (IMR), and most rich countries have low infant mortality rates. There are a number of countries in Africa with IMR above 50 per 1000 live births (meaning 50 children die in their first year for every 1000 live births). There are rich countries with IMR below 5. The difference between these numbers–roughly 45 per 1000 births–tells us that preventing infant death could be very impactful.
In the US, there is variation in IMR across ethnic communities. The IMR among African Americans is 11.4, and 4.9 among whites. All of these babies are being born in the US, but white babies are much more likely to survive past 1 year of age. Preventing infant deaths in African American and other marginalised communities would save lives without the controversy.
In Canada, the IMR for the Inuit population is a shocking 17.7, three times the national average. Improvements to maternal care and access to quality health care in remote rural areas would save the lives of many living infants. Given that there is little popular or political appetite for outlawing abortion in Canada, reducing IMR among the Inuit seems infinitely more productive way to spend time for people who are concerned with preserving lives of children.
Globally, the potential numbers of lives saved would be much greater. I used World Bank data to estimate the number of infant lives that could be saved worldwide if we lowered IMR to 5 per 1000 for in every country in the world that currently has an IMR greater than 5. You can download the R code here. According to these calculations, we could save around 3.6 million children every year by lowering IMR to 5.
3.6 million children every year!
Practical solutions for lowering infant deaths in poor countries are fairly well known. Worldwide, many infant deaths occur because of preventable infection. Most of these infections could probably be treated with investments in medical infrastructure and better access to antibiotics. Other deaths are caused by an absence of simple medical interventions and lack of training. It seems that anti-abortion activists could put their time into lobbying pharmaceutical companies to increase affordable access to antibiotics in developing countries, or improving access to maternal care in the developing world.
Closer to home, we could do more to increase access to health care and support mothers living in poverty, particularly in rural and remote areas. There are many lives to save, and best of all, none of them come with legal wrangling or political and social controversy. It seems that anyone who genuinely cares about saving lives for their own sake could do a lot about it without entering the quagmire of anti-abortion activism.