There is a strong association between child survival and fertility. Total fertility rate (TFR; the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current agespecific fertility rates) and mortality before 5 years of age (child mortality rate [CMR], the probability per 1,000 that a newborn baby will die before reaching the age of 5 years, if subject to current age-specific mortality) have a correlation coefficient of 0.876. Table 1 shows the linear trend between these indicators. 10 Explanations Table 1 The association between fertility and mortality before 5 years of age Poverty, Global Health, and Infectious Disease abound as to why the relationship between child survival and fertility are so robust. One view espoused by many demographers and economists is that families in societies where child survival is low tend to compensate for expected and actual child deaths by having more children. Nobel laureate and economist Gary Becker famously modeled this quality/quantity trade-off with respect to family size. Another explanation is that places with high child mortality also lack access to contraception, educational opportunities for women, and gender equality. Although desired family size is a difficult concept to define and measure, the World Bank does attempt to collect data on access to contraception and indices of gender inequality. 10 Although the correlation between the gender inequality index and child mortality in the World Bank's indicators database is negligible (0.01), perhaps at least in part because of the small sample size (75 countries) and imprecise measuring, contraceptive prevalence is negatively correlated with child mortality (À0.32). Although a major focus of academic inquiry is the direction of causality in the fertility-CMR relation, it seems safe to assume that the relationship is bidirectional. These data imply that efforts to improve public health through the provision of either culturally appropriate family planning or pediatric care would also pay dividends in the other health sector. From an economic standpoint, household resources are divided among fewer individuals as family size shrinks. This division allows parents to invest more in their children's education and nutrition, potentially interrupting the intergenerational transmission of poverty.