Under-five mortality rate
By 2030, an estimated 60% of city dwellers will be under the age of 18. Although children living in urban areas are often regarded as better off than their rural peers, this is not always the case, considering that many children live in slums of other adverse environments. Large inequities exist within and between regions, in under-five mortality rates. Within each region, children from the poorest urban families are twice as likely to die as children from the richest urban family. Between regions, mortality rates in urban areas of Africa are roughly double those of the Americas and Asia. Pneumonia and diarrhoeal diseases are the leading cases of child death globally, and can be particular problem in urban areas due to crowding, indoor air pollution, and poor access to healthcare in urban slums. Deaths of children in cities are often the direct result of contamination of water, inadequate sanitation, and lack of solid waste disposal, which exacerbate the occurrence and severity of diarrhoeal and related diseases. Gastrointestinal illness can lead to malnutrition and death, especially among younger and undernourished children, who still have poorly developed immune defences. For similar reason, children in urban areas are susceptible to death from malaria and vaccine-preventable illnesses such as measles. Road traffic injuries among children are also of significant concern in urban areas. Lack of consideration to children in urban and transport planning contributes to the problem.
Globally, the number of children who die before their fifth birthday has been reduced by 35%, from 12.4 million estimated in 1990 to 8.1 million in 2009. Under-five mortality rates (number of deaths per 1000 live births) have declined in all regions of the world in both poor and rich urban populations. Between the periods of 1990 to 1999 and 2000 to 2007, 86% of the countries studied improved their overall under-five mortality rates in urban areas. The few countries with worsened urban under-five mortality rates were all located in sub-Saharan Africa.