Inequality in health will be explored by focussing on child mortality in two countries; Nigeria and UK. This paper will examine the influence of social class, race, culture, gender and age. It will also examine and try to explain the difference in mortality and mortality rates in UK and in Nigeria with the focus on analysing why health is socially determined. For example in Nigeria the life expectancy at birth is 51years whereas in UK is 80 (UNICEF 2010).

Infant mortality (death) rate refer to number of children who died before they reaches the age of 1 years per 1000 birth live. Globally, infant mortality has decreased by 35 per cent from 88 per cent death per 1000 live birth to 57 per cent in 2010, The number of children under five of age who died yearly, has declined from more than 12 million death in 1990 to 7.6 million death in 2010, which shown that fewer children who are dying each day are closely to 12,000 than in 1990 according to the figure released by UNICEF and World Health Organisation in September 2011.

The major causes of infant mortality rate in the world are respiration distress syndrome this leads to low oxygen absorption, collapsed lungs. Congenital disorder associated to immaturity (premature births), low birth weight ( child weighting less than the average gram) and lack of importance of life I.e. malnutrition, shelter, clear water, poor hospital infrastructure, sanitation, and HIV/AIDS contribute to child mortality (death) in typical population. W.H.O and UNICEF 2010. Malnutrition contribute to under five mortality rate with an estimate of more than one third, every 5 second a child die related to hunger, every hour 700 lost their life, 16.000 die per day, 6 million death every year, an estimate of 60 percent of child death (W.H.O, 2002-2008). An estimate of 117million and 24 million illness and over 700,00 died per yearly due to the causes of malaria, 90 percent which occurred within children under five years of age (USAID, 2012). The most vulnerable group that it affected in society, most are those who are poor. Malaria is a disease causes by parasites which are transmitter to people from the bite of the female anopheles mosquitoes.

Nigeria is one of the most significant and populous country in Sub-savannah Africa with a population of 155,215,573 estimate according to Nigeria demographics, 2011.
In Nigeria 66 percent of its population live in poverty of one US dollars per day and been
13 the poorest country in the world and contributed 11 percent of infant mortality and under five mortality rate in the world ( world bank, 2001).
The infant mortality (death) rate in Nigeria has declined from the figure that was shown in 1990 which was 126 death per 1000 birth live to 88 death per 1000 birth in 2010
(UNICEF 2010). There are difference in gender of infant mortality rate, in male 97.42 death per 1000 birth live while in female is 85.31 deaths per 1000 birth live
(CIA WORLD FACKBOOK,2011). infant mortality rate of an estimated of 91.54 death per 1000 live birth 2011, In 2012 estimate figure shown the total infant mortality
Ratio was 74.36 death per 1000 live births and male child was 79.44 death per 1000 live birth and female child shown 68.97 death per 1000 live births which shown reduction
Infancy death in 2012 (CIA WORLD FACTBOOK, 2012). Although in some part of Nigeria infant mortality isaccelerating and increasing in rural area. Infant mortality is survival is threatened by deficiencies nutrition and illness, mostly diarrhoea disease, malaria, Measles, respiratory disease, infection such as HIV
(which as be transmitted from mother to child) this are preventable or treatable disease which account for more than 70 percent and malnutrition account for more than 50 percent for most of the cases of mortality and mortality in childhood (USAID, 2002).
Separated from this disease, low birth weight underlie significant percentage of infancy in early death, is mostly due to poor weight gain during the period of pregnancy which come up from maternal .

The social factor that mainly associated to widely infant mortality rate are due to the
Extended spread of severe poverty. This is a reality that portray a lack of food and education that contributed to infant mortality. According to Chimobi Ucha 2010 poverty is the primary issue that lead to poor health, parents not having sufficient money to take care of their children due to inadequate health care facility that leads to infant mortality.
To obtaining health care commodities in the country are a problematic to many individual because they have no access to a pharmacy. According to Nigeria policy project, 2002 inherent factor of infant mortality rate, maternal education, poor living condition( housing , water, sanitation and poor home practice during illness of childcare. Poor sanitation include insufficient waste disposal, an open toilet facility littered with domestic waste and no water draining that to breeding grounds for mosquitoes and no breastfeeding of infancy contributed to increased in morbidity that leads to infant mortality rate. maternal education matters when it come to health and it make people to be aware of our to attend to heath and where to go when health is falling apart. According to Fotso 2011 for the research that was carryout in 2008 it find that infant mortality rate was 84.6 death per 1000 live births with mothers’ with no knowledge of education, infant mortality rate of 71.2 death per 1000 live births with those mothers’ with primary education and infant mortality rate was 59.5 death per 1000 live births those mothers’ who have secondary education and above.

According to Mukosolu 2007 she find that there several epidemiological, programmatic and cultural reason for null in critical statistic in infant mortality in Nigeria which involved with the 250 ethnic groups with the most domination which are the Hausa and
Fulani 29 percent, Yoruba 21percent and lgbo 18 percent with their own practice culture and language. In Nigeria infant mortality rate can be examine by different social classes of people living in different areas, has where we living has a great impact on our health. Infant mortality rate, there are difference within region, the infant mortality in the rural region was 121 death per 1000 live birth and in urban region infant mortality rate was 81 death per 1000 live births this was due to more poverty and lack of maternal education in rural region the low class and the urban region most of this lost occur in the middle class with their religion believe (NDHS,2003). According to the
Criticism of the people by the voice of America 2008 of high infant mortality due to the terrible and unbelief harmful practice traditional and local midwives who have no knowledge and understanding of medical training. The encompassment of unobservable and observable norm, belief and rituals that govern respective life event.

inequalities is the differences in the health result of various geographical groups of people. The health inequalities makes us know that children living in different socio- economic environment face very different risks of ill health and death.

In England and Wales in 2008, the infant mortality that occurred were 3,284 and this give infant mortality rate at 4.6 death per 1000 live births this can be compare to infant mortality rate of 4.7 death per 1000 live births in 2007, according to office of national
Statistics 2008, the lowest infant mortality rate ever recorded.
Neonatal mortality rate (infant death under 28 days) and post neonatal mortality rates
(infant deaths between 28 days and one year) there are been a steady declined since
1980, the neonatal mortality rate drop from 58 per cent from 7.7 death per 1000 live birth in 1980 to 3.2 death per 1000 live birth in 2008 and the post neonatal mortality rate also drop from 68 percent over same season from 4.4 death per 1000 live birth in 1980 to 1.4 death per 1000 live births in 2008 (office of national statistics, 2008). In 2010 infant mortality were 3,140 this give the rate of 4.3 death per 1000 live births and compared to 2009 which was 4.7 death per 1000 live birth (office of national statistics
2011). According to the figure in 2010 which was released in 2011 by national statistics shown that infant mortality rate were high among infancy of mother under age 20 years and 40 years and above at 5.6 and 5.8 deaths per 1000 live births respectively.

The main cause that lead to infancy death were low birth weight (under 1,500 grams),
In 2008 low birth weight infant( under 1,500 grams) and low birth weight infant( 2,500 grams) the level of low weigh were 181.9 and 39.8 death per 1000 live birth according to national statistics 2008. In 2010 very low weight infancy (under 1,500 grams) shown that had the highest infant and prenatal mortality rates of 164.7 and 250.9 deaths per 1000 live births ( office of national statistic,2011). Complication in pregnancy, congenital anomalies were 871with rate of 28.8 death per 1000 live births, and immature-relate conditions example , cardiovascular and respiration disorder 1,290 with the rate of 42.7 death per 1000 live births, antepartum infection 871 and asphyxia 210 and these gives the death rate of 1.7 and 6.9 death per 1000 live births. infections and other specific conditions causes were 139 and 43 which give infancy rate of 4.6 and 1.4 death per
1000 live births according to office of nation statistic 2010. Congenital anomalies, ante partum infection and immaturity related conditions all causes 73 per cent of infant death and85percent of all neonatal deaths. Congenital anomalies causes 28.9percent, infection 11.9 percent, 13.7 sudden infant deaths 15.0 percent of immaturity related conditionrelated to post neonatal in 2010 (office of nation statistic 2010).

According to office of nation statistic in 2010, infant mortality varies with social factor such as the mother’s country of birth (ethnicity) and the socio-economic position of the family and biological factor such as mother age, birth weight are key determinations of infant Mortality. Infant mortality show a pattern in relation to ethnic minority groups are higher than the rate of overall population. Babies that their mother’s were born out of
England and Wales were seemed to have a higher infant mortality. Babies that were born to a mother born in central Africa were 8.9 death per 1000 live birth, followed by babies born by Pakistan mother 8.5 deaths per 1000 live births and babies born by the western Africa mother’s were 7.3 death per 1000 live birth and they had high infant mortality compared with 4.2 deaths per 1000 live birth. Social class account for most of the infant mortality rate. Lower income have a huge impact with higher infant mortality rate, babies of father that were in semi-routine occupations has an infant mortality of
5.2 death per 1000 live births and infant mortality rate for those whose father’s were in large employers and higher managerial Occupations were 2.5 deaths per 1000 live birth with a huge difference in both side in those outside marriage. Those babies with father who were inside marriage in a semi-routine occupation also had the highest infant mortality rate of 5.8 per 1000 live births and those who never work had the highest infant mortality (office of nation statistic,2010). High infant mortality in the semi- routine occupation may because of the lack of proper childcare with living in poverty and lack of education. Low income lead to a poorer housing in unsafe and polluted environment with a little opportunity to create social support network and this source of condition lead to poor health. Where there is no income source can make it more # difficult for a households to apply what they may know to be a healthy choice.
According to office of national statistic 2010, infant mortality vary by mother age at the time of birth of the babies.

Reference www.chidinfo.org/mortality.html Accessed (2-3-2012) www.ceeindia.org/mdges/goal4.htm Accessed (2-3-2012) www.southasia.oneworld.net/resourse/treands-in-global-child-mortality Accessed (3-3-2012) www.WHO.int/mediacentre/…/2011/child_mortality…20110915/enl Accessed (3-3-2012)
Goal4 in 2010 www.mdgs.un.org/…/progress2011/11 Accessed (3-3-2012) www.unicef.org/infobycountry/nigeria_statistics.html Accessed (3-3-2012)
UNICEF-state of the world’s children 2008 www.who.int/features/qa/13/en/index.html Accessed (3-3-2012)
World health statistics 2010 www.who.int/whostat/2010/en/index Accessed (3-3-2010)
USAID Health: infection diseases malaria www.usaid.gov/ourwork/health/10 (Accessed 3-3-2012)