How We've Been Viewing The Plight Of The World's Poor All Wrong

This feature is brought to you in partnership with Johnson & Johnson.

When asked to picture a poverty stricken child, you probably envision a small boy or girl blinking in the harsh sunlight of an unspecified rural setting, far away from the stability of city life. What we often don’t realize, however, is that child could very well be living right next door — begging at a traffic light, sleeping under a bridge, and struggling to survive in a city slum.

Save the Children’s recently published “State of the World’s Mothers: The Urban Disadvantage” report revealed that nearly one billion people live in desperate poverty in city slums. Thanks to increasing urbanization in developing nations, more than half the world’s population is living in an urban setting, having flocked to cities in search of employment, empowerment and emancipation. But the surge of immigration, both foreign and domestic, places great strain on city infrastructure, causing instability and plunging the most vulnerable citizens, mothers and their children, into shocking poverty.

In Haiti, Jordan and Tanzania, the under-five mortality rate in cities is estimated to be higher than in rural areas.

The misconception that a child living in an urban setting will have better access to basic needs, like health care, sanitation, clean water, education and food, than a child living in a rural area is often far from true. In Haiti, Jordan and Tanzania, for instance, the under-five mortality rate in cities is estimated to be higher than in rural areas. Out-of-pocket health care costs, coupled with city slums rife with unemployment, sends families even further into poverty. Children growing up in city slums also face dangers of overcrowding, which can cause stunted growth as a result of malnutrition and the spread of many diseases.

The report also points out another misconception: the idea that inequality between the urban rich and poor is limited to the developing world. In some U.S. cities, the gap in survival rate between wealthy and poor children is greater than in the developing world. Access to quality, essential health care is a serious contributing factor in that. Washington, D.C., the nation’s capital, has the highest infant mortality rate out of all the wealthy cities surveyed in the State of the World’s Mothers report. In 2013, D.C. reported 6.8 child deaths per 1,000 live births, an all-time low for the city. Still, there is no cause for celebration, as this rate is three times higher than that of other large cities, such as Stockholm and Tokyo. Inside the Beltway the disparity is even starker: The child mortality rate in Ward 8, a lower income area, is nine times higher than its wealthier counterpart, Ward 3.

The huge financial inequality in cities often masks the plight of the poor. Urban averages smooth over the shocking statistics found in city slums, allowing outsiders to remain ignorant of the grave injustices taking place only blocks away from their homes.

Over 860 million people live in urban slums around the world, according to the State of the World's Mothers report.

Poor data collection also skews our perception. In some countries, such as South Africa and China, recent surveys on city life aren’t available, and even when they are, citizens often unwittingly provide inaccurate information. A 2011 article in the journal Psychological Science titled, “Economic Inequality is Linked to Biased Self-perception,” found that "people’s self-perception biases often lead them to see themselves as better than the average person (a phenomenon known as self-enhancement)…and greater self-enhancement is found in societies with more income inequality.”

Furthermore, Francesca Tamma, an economics advisor at a behavioral science policy consultancy based in London, concludes that “we base our estimates on our reference group and we have a limited understanding of what the income distribution actually is.”

Geographical location is another factor that leads to both urban disparity and lack of awareness. “The social engineering of apartheid came down to a very successful model of spatial engineering,” explained Edgar Pieterse, Director of the African Centre for Cities at the University of Cape Town, in a 2014 Guardian article investigating the disparity between the impoverished Khayelitsha township and its neighbor affluent Cape Town, South Africa. Pieterse went on to explain how, under the apartheid government, both the natural landscape and man made infrastructure were utilized to maximize the isolation of different racial groups. Investment, after all, tends to be centralized to city centers; areas on the outskirts, separated by natural or artificial barriers, might lack vital access to infrastructure, like public transportation and health care.

But things don’t have to be this way. According to the UN, 2015 needs to be the year for global action. “This year is a unique opportunity for our generation to set clear goals and clear pathways to a safer, better, more prosperous world,” Jeffrey Sachs, the United Nation's Special Advisor on Millennium Development Goals (MDGs), said in an interview with the UN News. The UN's eight MDGs, including the pledge to reduce child mortality and improve maternal health, have reached their target date, and some positive progress has been made: Globally, the child mortality rate has almost been cut in half in the past two decades.

The UN’s Sustainable Development Goals, replacing the MDGs, expect to make even more progress, boldly pledging to end poverty for all. The new goals address the multidimensional aspects of poverty, ensuring that the urban disadvantaged can never slip through the cracks again, thanks to misconceptions and misleading data collection. The UN calls for global action, and hopes to focus on sustainable growth.

Similarly, Save the Children’s “State of the World’s Mothers” report urges donors to focus their financial support in committed, long-term efforts to improve the quality of care around the time of birth, strengthen healthcare systems and invest in comprehensive data collection. Save the Children encourages us to pledge our financial support in ongoing help for all — including those living in our cities, and right next door.

Save the Children's annual State of the World's Mothers report, which was released this month with support from Johnson & Johnson, has become a reliable international tool to show where mothers and children fare best, and where they face the greatest hardships. It is based on the latest data on health, education, economics and female political participation. The full report is available at