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Plummeting Maternal Mortality Rates Are a Sign of Progress

Blog Post | Overall Mortality

Plummeting Maternal Mortality Rates Are a Sign of Progress

The global maternal death rate fell from 385 per 100,000 live births in 1990 to 216 in 2015

Plummeting Maternal Mortality Rates Are a Sign of Progress

The World Health Organization defines maternal mortality as “the death of a woman while pregnant or within 42 days of termination of pregnancy.” Such deaths can occur for a variety of reasons, including bleeding and infection after childbirth, high blood pressure during pregnancy, complications during delivery and unsafe abortion. Early statistics are difficult to come by, but British parish records indicate a maternal mortality rate of 1,000 per 100,000 live births in the first half of the 18th century. Since women were pregnant more often than is the case today, the actual risk of dying due to complications from pregnancy would have been much higher.

Consider preeclampsia, the most common prenatal complication, affecting 6 percent of pregnancies. That’s more than 1 in 20 pregnancies. Chances are high that you know someone, or several people, who have had preeclampsia.

Preeclampsia raises a pregnant woman’s blood pressure to dangerously high levels, and if left untreated, often results in violent seizures (eclampsia). It can lead to the death of the mother, the child, or both. Historically, no amount of wealth or privilege could save a woman from the horrific condition. It was tragically realistic when Lady Sybil, a wealthy British aristocrat in the popular television shown Downton Abbey, died of eclampsia during an episode set in 1920, despite being able to afford the best medical care of the day.

The condition’s exact cause is unknown, although it seems to begin with improperly functioning blood vessels in the placenta. There is no surefire way to prevent the condition. Some of the risk factors—such as advanced maternal age, obesity, or having children less than two years apart—can be avoided, but preeclampsia can still strike women without any known risk factors. Researchers have found some evidence that low-dose aspirin or calcium supplementation can reduce the risk of developing the condition.

Today, blood pressure monitoring is a routine part of all prenatal medical visits, to identify preeclampsia before blood pressure rises too high. The most effective treatment for preeclampsia is delivery. Advancements in the ability of doctors to induce labor and care for preterm infants have thus dramatically improved preeclamptic women’s—and their children’s—odds of survival. In cases where preeclampsia occurs too early in pregnancy for the child to survive delivery, several drugs that lower blood pressure can be prescribed to keep the woman’s condition stable until delivery is a realistic option. In wealthy countries, the vast majority of women diagnosed with preeclampsia now survive.

It wasn’t always the case that medical care improved pregnancy outcomes. In the mid-19th century, a Hungarian physician named Ignaz Semmelweis noticed that women who gave birth at home died at a lower rate than women who were assisted by doctors. He hypothesized that doctors, who did not used to wash their hands, passed diseases from other patients to pregnant women. Unfortunately, Semmelweis’ insight was ignored until the French biologist Luis Pasteur established a definitive link between germs and disease in the 1860s. After doctors started to disinfect their hands, maternal mortality began to fall – a trend that was much enhanced when German scientists Fritz Mietzsch, Joseph Klarer and Gerhard Domagk discovered antibiotics in the early 1930s.

As the knowledge of best medical practices spread and pharmaceutical drugs became more affordable, maternal mortality rates plummeted throughout the world. The global maternal death rate fell from 385 per 100,000 live births in 1990 to 216 in 2015. That’s a reduction of 44 percent. In sub-Saharan Africa, the world’s poorest region, the number of maternal deaths fell from 987 to 547 over the same time period. That’s a reduction of 45 percent.

Similar declines took place in all other geographical regions, except for North America, where the U.S. maternal death rate rose from a miniscule 12 per 100,000 live births to 14. The increase in the U.S. maternal mortality rate seems to be driven by the rise in opioid addiction, which complicates pregnancy, as well as women becoming pregnant much later in life and resorting to more risky C-section child deliveries.

Globally, maternal mortality rates remain higher among women in far-flung rural areas that are difficult to reach by professional medical staff, women in cultures where adolescent pregnancy remains relatively popular and women in very poor countries without proper medical facilities. That said, the United Nations expects the maternal mortality rate to keep declining and fall to 70 per 100,000 live births by 2030.

This first appeared in CapX.

Morocco World News | Population Demographics

Morocco’s Remarkable Progress in Reducing Child Mortality

“According to the report, the under-five mortality rate in Morocco has declined by an impressive 4.8 percent, dropping from 81 deaths per 1,000 live births in 1990 to 52 in 2000, and further to 17 in 2022.

The report also reveals that the infant mortality rate in Morocco has decreased from 64 deaths per 1,000 infants in 1990 to 15 deaths in 2022. Additionally, the neonatal mortality rate has declined by 3.9 percent, falling from 37 deaths per 1,000 live births in 1990 to 29 deaths in 2000, and reaching 11 in 2022.”

From Morocco World News.

Science | Vaccination

First Malaria Vaccine Slashes Early Childhood Mortality

“In a major analysis in Africa, the first vaccine approved to fight malaria cut deaths among young children by 13% over nearly 4 years, the World Health Organization (WHO) reported last week. The huge evaluation of a pilot rollout of the vaccine, called RTS,S or Mosquirix and made by GlaxoSmithKline, also showed a 22% reduction in severe malaria in kids young enough to receive a three-shot series.”

From Science.

Blog Post | Health & Medical Care

Surprisingly, the World Is Becoming More Equal

Chelsea Follett and Vincent Geloso measure the global decline in income inequality in their comprehensive new paper.

Summary: Contrary to popular belief, global inequality is shrinking across many dimensions of human well-being, including income, lifespan, nutrition, education, internet access, and political liberty. This article presents a new Inequality of Human Progress Index that measures and confirms this trend, arguing that greater global interconnectedness and market liberalization have contributed to increases in equality across the globe.


Read Chelsea Follett and Vincent Geloso’s full paper, “Global Inequality in Well‐​Being Has Decreased across Many Dimensions,” here.

Reading the news or listening to politicians and pundits speak, one could easily get the impression that global inequality is getting worse. But is the widely held belief that the world is becoming less equal true, or is it mistaken? The overwhelming majority of long‐​term trends regarding living standards—ranging from rising life expectancy to declining rates of poverty and hunger—show considerable improvement, even accounting for recent pandemic‐​related setbacks. You can explore the evidence for yourself on websites such as Human​Progress​.org. Have those improvements been widely shared, or have they accumulated mainly to a small population while much of the world is left behind?

That’s what George Mason University economist Vincent Geloso and I set out to discover. What we found is that while global inequality unquestionably still exists, it is in fact shrinking.

Our Inequality of Human Progress Index offers a new way of measuring global inequality. It is more comprehensive than any prior international inequality index, taking into account a greater number of dimensions. We found that in addition to a global decline in income inequality, there have also been declines in lifespan inequality, nutritional inequality, educational inequality, internet access inequality, and political liberty inequality. Around the world, gaps in these areas are shrinking.

Most importantly, there has been a decline in overall global inequality. That result was consistent, even under a variety of specifications that we tested. The data show that across all but two of the areas we examined, the world has become more equal since 1990. The data does not support the narrative of rising worldwide inequality.

The exceptions were infant survival inequality and clean air inequality. While infant mortality has decreased everywhere, it has fallen faster in rich countries with advanced medical technology and neonatal intensive care units. Clean air inequality has also gone up, probably because economic development often results in more pollution during industrialization before falling as a nation attains postindustrial prosperity—a tendency economists call the “environmental Kuznets curve.” Much of the world is still undergoing this transition.

Our research shows that improvements in international development have been both greater and more dispersed than many people realize. While there are still gaps, they are shrinking, and an accurate assessment of current trends is critical as we try to deepen our understanding of the drivers of human progress. The greater global interconnectedness and market liberalization of the past few decades have, it seems, not only raised absolute living standards but also equality. The world is not only better off than is commonly appreciated but also more equal.

This article was originally published at Cato.org. Read Chelsea Follett and Vincent Geloso’s full paper here.

Blog Post | Health & Medical Care

Why Are We So Gloomy?

Our evolved instincts are making us more anxious and depressed than we should be.

Summary: Many young people today are pessimistic about the future of the planet and humanity, believing that environmental degradation, poverty, violence, and inequality are getting worse. However, this gloomy outlook is not supported by the facts, which show remarkable improvements in living standards, health, education, peace, and prosperity over the last century. This article explores why people are so prone to pessimism and how to overcome it by examining the evidence of human progress.


Do you believe that the world is coming to an end? If so, you are not alone.

In 2021, researchers at the University of Bath polled 10,000 young people between the ages of 16 and 25 in Australia, Brazil, Finland, France, Great Britain, India, Nigeria, the Philippines, Portugal, and the United States. The researchers found that, on average, 83 percent of respondents thought that “people have failed to care for the planet.” Seventy-five percent thought that the “future is frightening.” Fifty-six percent thought that “humanity is doomed.” Fifty-five percent thought that they will have “less opportunity than [their] parents.” Finally, 39 percent stated that they were “hesitant to have children.”

The study remains one of the most comprehensive surveys of young people’s perception of the environmental state of the planet. But is this kind of doom warranted? The following global statistics paint an entirely different picture:

Between 1950 and 2020, the average inflation-adjusted income per person rose from $4,158 to $16,904, or 307 percent. Between 1960 and 2019, the average life expectancy, rose from 50.9 years to 72.9 years, or 43.2 percent. (Unfortunately, the pandemic reduced that number to 72.2 years.)

Between 2000 and 2020, the homicide rate fell from 6.85 per 100,000 to 5.77, or 16 percent.

Deaths from inter-state wars fell from a high of 596,000 in 1950 to a low of 49,000 in 2020, or 92 percent (though the war between Russia and Ukraine is bound to increase that number).

The rates of extreme poverty have plummeted, with the share of people living on less than $1.90 per day declining from 36 percent in 1990 to 8.7 percent in 2019. Though, once again, the pandemic has temporarily worsened that number somewhat.

Between 1969 and 2019, the average infant mortality rate per 1,000 live births fell from 89.7 to 20.9, or 77 percent.

Between 1961 and 2018, the daily supply of calories rose from 2,192 to 2,928, or 34 percent. Today, even in Africa, obesity is a growing concern.

The gross primary school enrollment rate rose from 89 percent in 1970 to 100 percent in 2018. The gross secondary school enrollment rate rose from 40 percent to 76 percent over the same period. Finally, the gross tertiary school enrollment rate rose from 9.7 percent to 38 percent.

The literacy rate among men aged 15 and older rose from 74 percent in 1975 to 90 percent in 2018. The literacy rate among women aged 15 and older rose from 56 percent in 1976 to 83 percent in 2018.

In 2018, 90 percent of women between the ages of 15 and 24 were literate. That number was almost 93 percent among men of the same age. The age-old literacy gap between the sexes has all but disappeared.

There is plenty of good news on the global environmental front as well:

The chance of a person dying in a natural catastrophe — earthquake, flood, drought, storm, wildfire, landslide or epidemic — fell by almost 99 percent over the last century.

Between 1982 and 2016, the global tree canopy cover increased by an area larger than Alaska and Montana combined.

In 2017, the World Database on Protected Areas reported that 15 percent of the planet’s land surface was covered by protected areas. That’s an area almost double the size of the U.S.

That year, marine protected areas covered nearly seven percent of the world’s oceans. That’s an area more than twice the size of South America.

There is more good news for the fish: Since 2012, more than half of all seafood consumed came from aquaculture, as opposed to the fish caught in the wild.

And while it is true that the total amount of CO2 emitted throughout the world is still rising, CO2 emissions in rich countries are falling both in totality and on a per capita basis.

With so much good news around us, why are we so gloomy? We have evolved to look out for danger. That was the best way to survive when the world was much more threatening. But, while the world has changed, our genes have not. That’s why the front pages of the newspapers are always filled with the most horrific stories. If it bleeds, it leads.

To make matters worse, the media compete with one another for a finite number of eyeballs. So, presenting stories in the most dramatic light pays dividends. Or, as one study recently found, for a headline of average length, “each additional negative word increased the click-through rate by 2.3%.” And so, in a race to the bottom, all media coverage got much darker over the last two decades.

We are literally scaring ourselves to death, with rates of anxiety, depression and even suicide rising in some parts of the world. To maintain your mental composure and to keep matters in perspective, follow the trendlines, not the headlines. You will discover that the world is in a much better shape than it appears. You will be more cheerful and, most importantly, accurately informed.

This article was originally published at RealClearPolicy on May 31st, 2023.