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For Babies In Big Cities, It's Survival Of The Richest

05/05/2015 12:00 am ET

I will never forget the moment when I looked out the car window at a bustling, steamy intersection in the heart of Manila, and locked eyes with a young woman. She was holding a tiny baby while begging in the street.

I glanced down at my six-month-old son, sleeping contentedly in my arms inside our air-conditioned car. The enormous inequalities between my world and hers struck me as never before. The child in my arms was about the same age and no smarter, cuter, or better than hers. Yet due to mere circumstance of birth, I knew my son would have many more opportunities in life, while this mother and her child would struggle to survive each day to the next.

It’s been 20 years since that fleeting moment, but the vision of the mother and her child has stuck with me. It drove me to change careers and join Save the Children, where we work tirelessly to ensure that every mother and child has a fair chance in life.

These days, more and more mothers in urban areas are seeking better opportunities for their children. That’s why Save the Children’s new report, State of the World’s Mothers 2015: The Urban Disadvantage — released with support from Johnson & Johnson — focuses on the health and survival of moms and babies in cities. The findings reveal a harrowing reality: for babies in the big city, their survival comes down to their family’s wealth.

I have been back to Manila many times. I am happy to report that, along with other urban centers in the Philippines, it is an example of how cities can narrow survival gaps between the rich and the poor by increasing access to basic maternal, newborn and child services, and making care more affordable and accessible to the poorest urban families.

A child’s chance of dying before his fifth birthday has been steadily declining over the years among the poorest 20 percent of urban families in the Philippines. From when I first visited that country in the mid ‘90s until today, child mortality rates among the urban poor have been cut by more than half and the urban child survival gap has narrowed by 50 percent between wealthy and poor kids.

Sadly, the Philippines is one of just a few countries with such dramatic improvements for poor urban children. In too many countries, urban child survival inequality is worsening, even as those nations have been successful in reducing overall child mortality rates.

In my travels throughout the developing world, I’ve never had to look very far to see evidence of these differences. For example, in New Delhi, India – a city with one of the largest health care coverage gaps between rich and poor – it is not unusual to see a gleaming hospital steps away from a sprawling slum, and to have babies literally dying on the doorstep.

But it’s not just in the developing world where our report found stark disparities between the haves and have nots. In our nation’s capital, Washington, D.C., a baby born in the lowest-income district, where half of all children live in poverty, is at least 10 times as likely as a baby born in the richest part of the city to die before his first birthday. And while Washington, D.C. has cut its infant mortality rate by more than half over the past 15 years, the rate at which babies are dying in the District of Columbia is the highest among the 25 wealthiest capital cities surveyed around the world.

We all have a lot more work to do to ensure that every mother has the same opportunities for her baby, whether she lives in Manila, Washington, D.C. or anywhere else in the world.

Find out more about Save the Children’s new report at www.savethechildren.org/mothers.

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