Girls under five years old are more likely to die in countries that have greater gender inequality, researchers find, with the most striking differences in low- and middle-income countries.
The new study, led by Valentina Gallo from Queen Mary University of London, UK, looks at the UN’s Gender Inequality Index in 195 countries and compares it to child mortality rates. The researchers conclude that unequal circumstances are counteracting girls’ innate biological advantage for survival.
“The more unequal a society, the more girls are penalised in terms of their survival chances, particularly in lower-middle income countries,” Gallo says.
Girls in highly sexist countries may be less likely to be given access to healthcare, such as vaccines, or may be targeted by female infanticide and circumcision, the researchers say. Moreover, mothers to girls may not be valued as highly and may encounter greater instances of malnutrition, violence, or lack of education, which, in turn, have been shown to affect childhood mortality rates.
Biologically, girl babies are more likely to survive than their male counterparts. The association found by the researchers is between adjusted rates, not absolute rates.
Previous research has found that gender inequality is linked to higher rates of mortality for infant girls, but this is the first study to make that connection for older children.
Worldwide, 5.9 million children under the age of five died in 2015, and researchers say more than half of those deaths were preventable. Risk factors for both genders include being born in rural areas, to poor households, or to a mother who has not received basic education, but these factors are exacerbated by gender, the researchers say.
“Because of a sexist ideology which values boys over girls, young girls are often at greater risk of mortality through diminished access to health resources, as well as through heightened exposure to health risks,” Gallo says.
“These girls are also further exposed to this risk via their mothers, who may themselves be penalised and valued less than mothers of sons, and less able to provide for their daughters.”
The study appears in the journal BMJ Global Health.
Samantha Page is a science journalist based in Spain.
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