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The Epidemiological Transition: Policy and Planning Implications for Developing Countries (1993)

Chapter: SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS

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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

Shifts in the Structure of Population and Deaths in Less Developed Regions

Larry Heligman, Nancy Chen, and Ozer Babakol

INTRODUCTION

During the process of the demographic transition, the age structure of a population changes toward one that is older. The age structure of deaths also changes toward one in which greater proportions of deaths take place at the oldest ages; this shift in the structure of deaths is a consequence of the greater share of population that has reached the older ages, and interrelatedly, the low probabilities of dying in all but the oldest age groups.

In general, countries exhibit relatively similar demographic structures at the beginnings and the ends of their demographic transitions, although the movement from here to there is neither smooth nor uniform. Many of the same factors underlie the mortality and fertility changes that comprise the demographic transition; nevertheless the two components move at different paces both within and among countries. In particular the transition process has differed in Africa, Asia, and Latin America. As the United Nations (1991:12) described:

During the period 1950–1955, the earliest data for which the United Nations provides demographic estimates on a regular basis, population growth rates ranged from 2.7 percent per year in Latin America to 2.2 percent in Africa and 1.9 percent in Asia. The high Latin American population growth rate is primarily explained by the region’s earlier start of mortality reduction. Life expectancy at birth in the major area was 10 years greater than

L.Heligman and N.Chen are with Population Division, United Nations, New York; O. Babakol is with Statistics Division, United Nations, New York. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the United Nations.

 

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

in Africa and Asia and the crude death rate about 10 deaths per 1,000 lower. Africa and Asia exhibited similar life expectancies at birth and similar crude death rates but African women, on average, exhibited about 0.7 more births per woman than their Asian counterparts; the African population growth rate was hence higher.

A temporary convergence in growth rates occurred during the period 1965–1970. Africa, Asia and Latin America had similar growth rates, varying only from 2.4 to 2.6 percent per year. The population growth rate had risen sharply from the earlier period in Africa and Asia owing to falling mortality rates and little or moderate fertility change. The Latin American population growth rate held steady, as crude birth and death rates fell by similar amounts. Currently, population growth rates have diverged again. The African population growth rate has risen to 3 percent per year owing to falling mortality and little fertility change; whereas, Asian and Latin American population growth rates fell to 1.9 percent and 2.1 percent respectively.

This paper focuses on describing the changes in certain population characteristics projected to take place during the next quarter-century in Africa, developing regions of Asia and Oceania, and Latin America. To put these projected changes into a context, changes during the past 25 years are also described. In particular, we describe past and projected changes in (1) the number of people, growth, and age structures of population residing in the total, urban, and rural sectors of these major areas; and (2) life-table mortality patterns, numbers dying, and the age structure of deaths for these regions, including the potential implications of the AIDS pandemic in Africa. Because Africa exhibits very high mortality and there is greater uncertainty with respect to future trends, a special section is included on African mortality.

The analysis in this paper is carried out at the level of major area: that is, Africa, developing regions of Asia and Oceania (i.e., excluding Japan, Australia, and New Zealand), and Latin America. From here on, “Asia” is used to refer to the developing regions of Asia and Oceania. The tables present data for India and China separately because of their particularly large population sizes. Eight age groups are considered.

The major sources of data considered for this paper are the 1990 revisions of the official United Nations total, urban, and rural population projections for countries of the world (United Nations, 1991a-c). We have also made new and consistent estimates and projections of the age distribution of urban and rural populations, of age patterns of mortality, and of the potential number of deaths due to the AIDS epidemic in some African countries.

POPULATION GROWTH AND AGE STRUCTURES

In 1990, approximately 4.1 billion persons resided in the less developed regions (LDRs) of the world (Table 1). Of these, 73 percent reside in Asia,

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 1 Total Population and Percentage of Population in Less Developed Regions, 1965, 1990, and 2015

 

1965

1990

2015

Region

Both

Male

Female

Both

Male

Female

Both

Male

Female

Population (thousands)

Total

2333400

1186835

1146565

4085638

2078534

2007104

6332461

3205134

3127327

Africa

317056

157039

160017

642111

319381

322731

1301371

649645

651726

Latin America

250843

125665

125178

448076

223523

224553

673172

334458

338714

Developing regions of Asia and Oceania

1765501

904131

861370

2995451

1535630

1459820

4357918

2221031

2136887

China

729191

375124

354067

1139060

586189

552871

1435683

732233

703450

India

495196

255886

239270

853094

440888

412206

1304001

668729

635272

Distribution (%)

Total

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Africa

13.6

13.2

14.0

15.7

15.4

16.1

20.6

20.3

20.8

Latin America

10.8

10.6

10.9

11.0

10.8

11.2

10.6

10.4

10.8

Developing Regions of Asia and Oceania

75.7

76.2

75.1

73.3

73.9

72.7

68.8

69.3

68.3

China

41.3

41.5

41.1

38.0

38.2

37.9

32.9

33.0

32.9

India

28.0

28.3

27.8

28.5

28.7

28.2

29.9

30.1

29.7

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

16 percent in Africa, and 11 percent in Latin America. During the next 25 years, the population of the LDRs is projected to increase more than half, to 6.3 billion. The fastest growth is projected for Africa, which will increase more than twice, from 642 million persons to 1.3 billion, and will contain 20 percent of the total LDR population in 2015. Asia and Latin America are projected to increase 45 and 50 percent, respectively, from 3.0 billion to 4.4 billion in the case of Asia, and from 448 million to 673 million for Latin America.

As fertility and mortality have declined, the age structures of the populations of the LDRs have aged. For example, in 1965, 42 percent of the LDR population was under age 15, whereas 36 percent is now—an increase from 977 million in 1965 to 1.45 billion. Simultaneously, the population aged 15–64 has risen from 54 to 60 percent, and that aged 65 and over from 3.7 to 4.5 percent (Tables 2 and 3).

With projected fertility and mortality declines, these trends will continue during the next 25 years. By 2015, the population under age 15 will have declined to 29 percent, and the share in the age group 15–64 and age 65 and over will have risen to 65 and 6 percent, respectively. Nonetheless, even among those ages, which will exhibit declines in their relative shares, large absolute and percentage increases in numbers of people will occur between 1990 and 2015. The numbers of persons aged 0–4 and 5–14 are projected to rise by 15 and 33 percent, respectively (Table 4). The population in the reproductive ages (15–49) will rise by 60 percent, and those aged 50 and over will more than double in size. In fact, the population aged 80 and over in the LDRs is projected to rise by 170 percent, from 21.4 million to 58.1 million.

Child Population Aged 0–14

In 1990 there were about 544 million children under the age of 5 and 909 million aged 5–14. Representing respectively 13 and 22 percent of the LDR population, these preschool and early school-age children make up well over one-third of the LDR population. The 1990–2015 average annual growth rates for these age groups are projected to be only 1.38 and 0.54 percent annually, respectively. Nonetheless, significant absolute increments will occur because of the large population bases. Nearly 80 million children (15 percent increase) aged 0–4 and nearly 300 million children (33 percent increase) aged 5–14 will be added to the populations during the next 25 years.

Reproductive Age Population Aged 15–49

The less developed regions were home to 2.1 billion persons in 1990 in the reproductive ages of 15–49, representing slightly more than one-half of

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 2 Total, Urban, and Rural Population and Percentage Urban in Less Developed Regions, 1965, 1990, and 2015

 

Total Population (thousands)

Urban Population (thousands)

Rural Population (thousands)

Percentage Urban

Age

1965

1990

2015

1965

1990

2015

1965

1990

2015

1965

1990

2015

Less Developed Regions

0–4

384656

543767

622983

82716

183713

318002

301941

360054

304981

21.5

33.8

51.0

5–14

592277

909253

206081

123438

302865

606637

468840

606389

599443

20.8

33.3

50.3

15–49

1067037

2081612

3328506

275082

834421

1926834

791956

1247191

1401672

26.0

40.1

57.9

15–24

407221

832733

1159758

105828

333756

671542

301393

498977

488216

25.8

40.1

57.9

50–64

202385

368987

787823

45988

131147

429546

156397

237840

358276

22.7

35.5

54.5

65+

87044

182018

387068

19054

62554

203437

67990

119464

183632

21.9

34.4

52.6

65–79

78963

160572

328989

 

80+

8081

21446

58079

Total

2333400

4085638

6332461

546278

1514701

3484458

1787122

2570938

2848002

23.4

37.1

55.0

Africa

0–4

57787

115751

189646

10505

35062

88626

47282

80690

101020

18.2

30.3

46.7

5–14

83439

173478

335541

15983

54384

158759

67455

119094

176782

19.2

31.3

47.3

15–49

143020

289335

633647

32444

108673

345836

110575

180660

287809

22.8

38.0

55.1

15–24

58183

122136

262387

13257

46389

144500

44925

75746

117887

22.7

37.6

54.6

50–64

23240

44200

98891

4609

13858

47448

18631

30342

51444

19.8

31.4

48.0

65+

9571

19346

43646

1789

5462

18708

7782

13884

24939

18.7

28.2

42.9

65–79

8713

17387

38512

 

80+

858

1959

5134

Total

317056

642111

1301371

65331

217440

659378

251725

424671

641993

20.6

33.9

50.7

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

Total Population (thousands)

Urban Population (thousands)

Rural Population (thousands)

Percentage Urban

Age

1965

1990

2015

1965

1990

2015

1965

1990

2015

1965

1990

2015

Latin America

0–4

42461

57413

64482

20480

38243

49816

21981

19170

14667

48.2

66.6

77.3

5–14

65596

103261

123914

32292

69917

96841

33305

33344

27073

49.2

67.7

78.2

15–49

112806

227589

353154

64219

168588

293052

48585

59000

60102

56.0

73.4

82.6

15–24

45086

89468

117125

25235

65639

96794

19851

23828

20330

56.9

74.1

83.0

50–64

20620

38380

86226

11633

28113

71235

8988

10268

14990

56.4

73.2

82.6

65+

9362

21434

45396

5191

15631

37383

4169

5802

8013

55.5

72.9

82.3

65–79

8313

18163

37559

 

80+

1049

3271

7837

Total

250843

448076

673172

133816

320493

548327

117028

127583

124845

53.3

71.5

81.5

Developing Regions of Asia and Oceania

0–4

284408

370603

368855

51731

110408

179560

232678

260194

189294

18.2

29.8

48.7

5–14

443242

632514

746626

75163

178564

351037

368080

453951

395588

17.0

28.2

47.0

15–49

811211

1564688

2341705

178419

557160

1287946

632796

1007531

1053761

22.0

35.6

55.0

15–24

303952

621129

780246

67336

221728

430248

236617

399403

349999

22.2

35.7

55.1

50–64

158525

286407

602706

29746

89176

310863

128778

197230

291842

18.8

31.1

51.6

65+

68111

141238

298026

12074

41461

147346

56039

99778

150680

17.7

29.4

49.4

65–79

61937

125022

252918

 

80+

6174

16216

45108

Total

1765501

2995451

4357918

347131

976768

2276753

1418369

2018684

2081164

19.7

32.6

52.2

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

China

0–4

112275

112328

89803

16711

30642

46712

95564

81686

43090

14.9

27.3

52.0

5–14

180719

189144

182401

26149

50359

93403

154569

138784

88997

14.5

26.6

51.2

15–49

333339

647436

773358

70803

237785

487116

262537

409651

286241

21.2

36.7

63.0

15–24

121005

252808

231621

24708

90891

142959

96298

161918

88661

20.4

36.0

61.7

50–64

70800

123868

258307

13566

41688

153491

57233

82180

104816

19.2

33.7

59.4

65+

32058

66284

131814

5480

20329

74008

26577

45955

57806

17.1

30.7

56.1

65–79

28944

58255

110305

 

80+

3114

8029

21509

Total

729191

1139060

1435683

132711

380803

854731

596480

758257

580952

18.2

33.4

59.5

India

0–4

78964

114364

117060

13504

28253

47335

65460

86110

69724

17.1

24.7

40.4

5–14

121137

196961

245969

20986

49247

100581

100150

147714

145388

17.3

25.0

40.9

15–49

233924

422266

698267

48625

124629

322369

185300

297638

375896

20.8

29.5

46.2

15–24

87825

165174

244012

19095

50674

116685

68730

114501

127327

21.7

30.7

47.8

50–64

43613

81099

159533

7262

19490

63145

36350

61609

96389

16.7

24.0

39.6

65+

17518

36403

83173

2707

8649

31250

14811

29753

51922

15.5

22.5

37.6

65–79

16267

34743

71861

 

80+

1251

3660

11312

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 3 Distribution of Total, Urban, and Rural Population in Less Developed Regions, 1965, 1990, and 2015

 

Total Population (%)

Urban Population (%)

Rural Population (%)

Age

1965

1990

2015

1965

1990

2015

1965

1990

2015

Less Developed Regions

0–4

16.48

13.31

9.84

15.14

12.13

9.13

16.90

14.00

10.71

5–14

25.38

22.25

19.05

22.60

20.00

17.41

26.23

23.59

21.05

15–49

45.73

50.95

52.56

50.36

55.09

55.30

44.31

48.51

49.22

15–24

17.45

20.38

18.31

19.37

22.03

19.27

16.86

19.41

17.14

50–64

8.67

9.03

12.44

8.42

8.66

12.33

8.75

9.25

12.58

65+

3.73

4.46

6.11

3.49

4.13

5.84

3.80

4.65

6.45

65–79

3.38

3.93

5.20

 

80+

0.35

0.52

0.92

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

Africa

0–4

18.23

18.03

14.57

16.08

16.12

13.44

18.78

19.00

15.74

5–14

26.32

27.02

25.78

24.47

25.01

24.08

26.80

28.04

27.54

15–49

45.11

45.06

48.69

49.66

49.98

52.45

43.93

42.54

44.83

15–24

18.35

19.02

20.16

20.29

21.33

21.91

17.85

17.84

18.36

50–64

7.33

6.88

7.60

7.05

6.37

7.20

7.40

7.14

8.01

65+

3.02

3.01

3.35

2.74

2.51

2.84

3.09

3.27

3.88

65–79

2.75

2.71

2.96

 

80+

0.27

0.31

0.39

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

Latin America

0–4

16.93

12.81

9.58

15.30

11.93

9.09

18.78

15.03

11.75

5–14

26.15

23.05

18.41

24.13

21.82

17.66

28.46

26.13

21.69

15–49

44.97

50.79

52.46

47.99

52.60

53.44

41.52

46.24

48.14

15–24

17.97

19.97

17.40

18.86

20.48

17.65

16.96

18.68

16.28

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

50–64

8.22

8.57

12.81

8.69

8.77

12.99

7.68

8.05

12.01

65+

3.73

4.78

6.74

3.88

4.88

6.82

3.56

4.55

6.42

65–79

3.31

4.05

5.58

 

80+

0.42

0.73

1.16

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

Developing Regions of Asia and Oceania

0–4

16.11

12.37

8.46

14.90

11.30

7.89

16.40

12.89

9.10

5–14

25.11

21.12

17.13

21.65

18.28

15.42

25.95

22.49

19.01

15–49

45.95

52.24

53.73

51.40

57.04

56.57

44.61

49.91

50.63

15–24

17.22

20.74

17.90

19.40

22.70

18.90

16.68

19.79

16.82

50–64

8.98

9.56

13.83

8.57

9.13

13.65

9.08

9.77

14.02

65+

3.86

4.72

6.84

3.48

4.24

6.47

3.95

4.94

7.24

65–79

3.51

4.17

5.80

 

80+

0.35

0.54

1.04

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

China

0–4

15.4

9.9

6.3

12.6

8.0

5.5

16.0

10.8

7.4

5–14

24.8

16.6

12.7

19.7

13.2

10.9

25.9

18.3

15.3

15–49

45.7

56.8

53.9

53.4

62.4

57.0

44.0

54.0

49.3

15–24

16.6

22.2

16.1

18.6

23.9

16.7

16.1

21.4

15.3

50–64

9.7

10.9

18.0

10.2

10.9

18.0

9.6

10.8

18.0

65+

4.4

5.8

9.2

4.1

5.3

8.7

4.5

6.1

10.0

65–79

4.0

5.1

7.7

 

80+

0.4

0.7

1.5

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

Total Population (%)

Urban Population (%)

Rural Population (%)

Age

1965

1990

2015

1965

1990

2015

1965

1990

2015

India

0–4

16.0

13.4

9.0

14.5

12.3

8.4

16.3

13.8

9.4

5–14

24.5

23.1

18.9

22.5

21.4

17.8

24.9

23.7

19.7

15–49

47.2

49.5

53.6

52.2

54.1

57.1

46.1

47.8

50.8

15–24

17.7

19.4

18.7

20.5

22.0

20.7

17.1

18.4

17.2

50–64

8.8

9.5

12.2

7.8

8.5

11.2

9.0

9.9

13.0

65+

3.5

4.5

6.4

2.9

3.8

5.5

3.7

4.8

7.0

65–79

3.3

4.1

5.5

 

80+

0.2

0.4

0.9

Total

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

100.00

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

the total population (Table 5). Of these, 1.02 billion persons are women. About one of every four persons in the developing world is a woman of reproductive age.

The number of people in this age group doubled from 1.07 billion in 1965 to 2.09 billion in 1990 and is projected to increase another 60 percent during the next quarter century, adding 1.2 billion persons. By 2015, 53 percent of all persons in less developed regions will be between the ages of 15 and 49.

Currently about 40 percent of persons aged 15–49 are adolescents in the 15–24 age group. The number of adolescents will grow by about 40 percent by 2015; they are making up a declining share of the reproductive age populations of the developing world.

Postreproductive Age Population: Those 50 and Older

The most rapid population growth is projected to occur among the older population. The population aged 50 and over is projected to increase at an average annual rate of 3 percent per year, so that this population will double by 2015, from 551 million to 1.2 billion. As a result, this age group will rise from 13 to 19 percent of the total population (Table 3).

About 182 million people were age 65 and over in 1990, and the population of this group is also expected to double during the next 25 years. Particularly rapid growth, however, is projected among the old old (i.e., those aged 80 and over), whose number may increase at 4 percent per year, rising from 21 million to 58 million. Among persons aged 65 and over, those over age 80 rose from 9 percent in 1965 to 12 percent in 1990 and are projected to rise further to 15 percent in 2015.

Up to about age 65, one can safely make the generalization that “half the population are men and half are women.” However, due to greater longevity, women make up greater shares in older age groups. At ages 50–64, women comprised 50 percent of the population in 1990, but the female share rose to 53 percent for ages 65–79 and nearly 60 percent for ages 80 and over.

Urban-Rural Makeup

Thirty-seven percent of the LDR population lived in urban areas in 1990 (Table 2). Age differences in the percent urban population range from about one-third under age 15 and over age 50, to about 40 percent between ages 15 and 49. The result is a noticeably younger population in rural areas, where 38 percent is under age 15 compared to 32 percent in urban areas. The trade-off comes at ages 15–49:55 percent of the urban population is between these ages, compared to 49 percent of the rural population.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 4 Change (percent) and Average Annual Rate of Change of Population, by Age, in Less Developed Regions, 1965–1990 and 1990–2015

 

Total Population

Urban Population

Rural Population

 

Change (%)

Rate of Change

Change (%)

Rate of Change

Change (%)

Rate of Change

Age

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

Less Developed Regions

0–4

41.4

14.6

1.38

0.54

122.1

73.1

3.19

2.19

19.2

−15.3

0.70

−0.66

5–14

53.5

32.6

1.71

1.13

145.4

100.3

3.59

2.78

29.3

−1.1

1.03

−0.05

15–49

95.1

59.9

2.67

1.88

203.3

130.9

4.44

3.35

57.5

12.4

1.82

0.47

15–24

104.5

39.3

2.86

1.33

215.4

101.2

4.59

2.80

65.6

−2.2

2.02

−0.09

50–64

82.3

113.5

2.40

3.03

185.2

227.5

4.19

4.75

52.1

50.6

1.68

1.64

65+

109.1

112.7

2.95

3.02

228.3

225.2

4.76

4.72

75.7

53.7

2.25

1.72

65–79

103.4

104.9

2.84

2.87

 

80+

165.4

170.8

3.90

3.99

Total

75.1

55.0

2.24

1.75

177.3

130.0

4.08

3.33

43.9

10.8

1.45

0.41

Africa

0–4

100.3

63.8

2.78

1.97

233.8

152.8

4.82

3.71

70.7

25.2

2.14

0.9

05–14

107.9

93.4

2.93

2.64

240.3

191.9

4.90

4.29

76.6

48.4

2.27

1.58

15–49

102.3

119.0

2.82

3.14

235.0

218.2

4.84

4.63

63.4

59.3

1.96

1.86

15–24

109.9

114.8

2.97

3.06

249.9

211.5

5.01

4.54

68.6

55.6

2.09

1.77

50–64

90.2

123.7

2.57

3.22

200.7

242.4

4.40

4.92

62.9

69.5

1.95

2.11

65+

102.1

125.6

2.81

3.25

205.3

242.5

4.46

4.92

78.4

79.6

2.32

2.34

65–79

99.6

121.5

2.76

3.18

 

80+

128.3

162.1

3.30

3.85

Total

102.5

102.7

2.82

2.83

232.8

203.2

4.81

4.44

68.7

51.2

2.09

1.65

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

Latin America

0–4

35.2

12.3

1.21

0.46

86.7

30.3

2.5

1.06

−0.1

−23.5

−0.55

−1.07

5–14

57.4

20.0

1.81

0.73

116.5

38.5

3.09

1.30

0.1

−18.8

0.00

−0.83

15–49

101.8

55.2

2.81

1.76

162.5

73.8

3.86

2.21

21.4

1.9

0.78

0.07

15–24

98.4

30.9

2.74

1.08

160.1

47.5

3.82

1.55

20.0

−14.7

0.73

−0.64

50–64

86.1

124.7

2.49

3.24

141.7

153.4

3.53

3.72

14.2

46.0

0.53

1.51

65+

128.9

111.8

3.31

3.00

201.1

139.2

4.41

3.49

39.2

38.1

1.32

1.29

65–79

118.5

106.8

3.13

2.91

 

80+

211.8

139.6

4.55

3.50

Total

78.6

50.2

2.32

1.63

139.5

71.1

3.49

2.15

9.0

−2.1

0.35

−0.09

Developing Regions of Asia and Oceania

0–4

30.3

−0.5

1.06

−0.02

113.4

62.6

3.03

1.95

11.8

−27.2

0.45

−1.27

5–14

42.7

18.0

1.42

0.66

137.6

96.6

3.46

2.70

23.3

−12.9

0.84

−0.55

15–49

92.9

49.7

2.63

1.61

212.3

131.2

4.55

3.35

59.2

4.6

1.86

0.18

15–24

104.4

25.6

2.86

0.91

229.3

94.0

4.77

2.65

68.8

−12.4

2.09

−0.53

50–64

80.7

110.4

2.37

2.98

199.8

248.6

4.39

4.99

53.2

48.0

1.71

1.57

65+

107.4

111.0

2.92

2.99

243.4

255.4

4.93

5.07

78.1

51.0

2.31

1.65

65–79

101.9

102.3

2.81

2.82

 

80+

162.6

178.2

3.86

4.09

Total

69.7

45.5

2.11

1.5

181.4

133.1

4.14

3.39

42.3

3.1

1.41

0.12

China

0–4

0.0

−20.1

0.00

−0.90

83.4

52.4

2.43

1.69

−14.5

−47.2

−0.63

−2.56

5–14

4.7

−3.6

0.18

−0.15

92.6

85.5

2.62

2.47

−10.2

−35.9

−0.43

−1.78

15–49

94.2

19.4

2.66

0.71

235.8

104.9

4.85

2.87

56.0

−30.1

1.78

−1.43

15–24

108.9

−8.4

2.95

−0.35

267.9

57.3

5.21

1.81

68.1

−45.2

2.08

−2.41

50–64

75.0

108.5

2.24

2.94

207.3

268.2

4.49

5.21

43.6

27.5

1.45

0.97

65+

106.8

98.9

2.91

2.75

271.0

264.1

5.24

5.17

72.9

25.8

2.19

0.92

65–79

101.3

89.3

2.80

2.55

 

80+

157.8

167.9

3.79

3.94

Total

56.2

26.0

1.78

0.93

186.9

124.5

4.22

3.23

27.1

−23.4

0.96

−1.07

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

Total Population

Urban Population

Rural Population

 

Change (%)

Rate of Change

Change (%)

Rate of Change

Change (%)

Rate of Change

Age

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

1965–1990

1990–2015

India

0–4

44.8

2.4

1.48

0.09

109.2

67.5

2.95

2.06

31.5

−19.0

1.10

−0.84

5–14

62.6

24.9

1.94

0.89

134.7

104.2

3.41

2.86

47.5

−1.6

1.55

−0.06

15–49

80.5

65.4

2.36

2.01

156.3

158.7

3.76

3.80

60.6

26.3

1.90

0.93

15–24

88.1

47.7

2.53

1.56

165.4

130.3

3.90

3.34

66.6

11.2

2.04

0.42

50–64

86.0

96.7

2.48

2.71

168.4

224.0

3.95

4.70

69.5

56.5

2.11

1.79

65+

107.8

128.5

2.93

3.31

219.5

261.3

4.65

5.14

100.9

74.5

2.79

2.23

65–79

113.6

106.8

3.04

2.91

 

80+

192.6

209.1

4.29

4.51

Total

72.3

52.9

2.18

1.70

147.4

145.2

3.62

3.59

54.9

18.7

1.75

0.69

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

The share of population of ages 50–64 and 65 and over is about the same in the two areas: about 9 percent aged 50–64 and 6 percent aged 65+.

Both urban and rural areas contain more males than females; males exceed females by 6 percent in urban areas and 2 percent in rural areas. Urban areas exhibit higher sex ratios than do rural areas at every age group except 5–14 and 65 and over. Particularly, urban areas exhibit a large “male excess” at ages 15–49, where males exceed females by 9 percent. The female population significantly exceeds the number of males only at the older ages: for ages 65 and over, by 21 percent in urban areas and 11 percent in rural areas (Table 6).

The percentage of urban residents is projected to rise to 55 by 2015, with differentials among age groups ranging between only from 50 to 58 percent. The urban population is projected to grow by a factor of 2.3 between 1990 and 2015 (whereas the rural population will increase by only 11 percent). Urban growth is projected to be particularly rapid among those aged 50 and over (more than 4.7 percent per year) so that the share of urban population at these older ages will rise to 18 percent (from the current 13 percent). Nonetheless, the urban population will also be doubling at younger ages, from 485 million to 925 million at ages 0–14 and from 834 million to 1.9 billion at ages 15–49.

The rural population is also projected to age during the next 25 years, with a decline in the preschool population from 360 million to 305 million, and a stabilization in the size of the population aged 5–24 at about 1.1 billion persons. However, the number of persons aged 50 and over will probably increase by 50 percent to 542 million. As a result, the percentage of the rural population aged 0–14 is projected to decline from 38 to 32 percent. The percentage aged 50 and over will rise from 14 percent to 19 percent, similar to that in urban areas.

Africa is expected to add 659 million people during the next 25 years. Of these, 442 million (67 percent) will be in urban areas, and 217 million (33 percent) will be rural dwellers. Rural growth rates are projected to average only 1.65 percent per year during the next quarter of a century; urban growth is projected to average 4.44 percent (Table 4).

Africa’s age distribution in urban areas is characterized by smaller population shares under age 15 than their rural counterparts. Among urban populations, 50 percent is between ages 15 and 49, 41 percent under age 15, and 9 percent age 50 and over; among rural populations, the corresponding shares are 43 percent age 15–49, 47 percent under age 15, and 10 percent age 50 and over. Both areas will exhibit rises during the next 25 years in population share aged 15–49 (from 50 to 52 percent in urban areas, and 43 to 45 percent in rural areas). Of similar size, but in the opposite direction, declines of relative share are expected among the preschool and child population: from 41 to 38 percent in urban areas, and 47 to 43 percent in rural areas.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 5 Total Population by Sex and Age in Less Developed Regions, 1965, 1990, and 2015

 

1965

1990

2015

Age

Males

Females

Sex Ratio

Males

Females

Sex Ratio

Males

Females

Sex Ratio

Less Developed Regions

0–4

196253

188403

1.04

277886

265881

1.05

317586

305397

1.04

5–14

302683

289594

1.05

465445

443808

1.05

614883

591198

1.04

15–49

546706

520331

1.05

1064569

1017043

1.05

1697318

1631188

1.04

15–24

208513

198708

1.05

426861

405872

1.05

591621

568137

1.04

50–64

100687

101698

0.99

185718

183269

1.01

395399

392424

1.01

65+

40505

46539

0.87

84916

97102

0.87

179949

207119

0.87

65–79

37141

41822

0.89

76159

84413

0.90

155806

173183

0.90

80+

3364

4717

0.71

8757

12689

0.69

24143

33936

0.71

Total

1186835

1146565

1.04

2078534

2007104

1.04

3205134

3127327

1.02

Africa

0–4

29067

28720

1.01

58341

57410

1.02

95808

93838

1.02

5–14

41873

41566

1.01

87369

86109

1.01

169123

166418

1.02

15–49

70762

72258

0.98

143995

145340

0.99

317056

316591

1.00

15–24

28948

29235

0.99

61304

60832

1.01

131858

130529

1.01

50–64

11108

12132

0.92

21034

23165

0.91

48043

50848

0.94

65+

4230

5341

0.79

8640

10706

0.81

19614

24032

0.82

65–79

3885

4828

0.80

7854

9533

0.82

17520

20992

0.83

80+

345

513

0.67

786

1173

0.67

2094

3040

0.69

Total

157039

160017

0.98

319381

322731

0.99

649645

651726

1.00

Latin America

0–4

21531

20930

1.03

29158

28255

1.03

32824

31658

1.04

5–14

33150

32446

1.02

52266

50995

1.02

62933

60981

1.03

15–49

56479

56327

1.00

113712

113877

1.00

177020

176134

1.01

15–24

22705

22381

1.01

45082

44386

1.02

59265

57860

1.02

50–64

10124

10496

0.96

18619

19761

0.94

41607

44619

0.93

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

65+

4381

4981

0.88

9768

11666

0.84

20075

25321

0.79

65–79

3926

4387

0.89

8379

9784

0.86

16956

20603

0.82

80+

455

594

0.77

1389

1882

0.74

3119

4718

0.66

Total

125665

125178

1.00

223523

224553

1.00

334458

338714

0.99

Developing Regions of Asia and Oceania

0–4

145655

138753

1.05

190387

180216

1.06

188954

179901

1.05

5–14

227660

215582

1.06

325810

306704

1.06

382827

363799

1.05

15–49

419465

391746

1.07

806862

757826

1.06

1203242

1138463

1.06

15–24

156860

147092

1.07

320475

300654

1.07

400498

379748

1.05

50–64

79455

79070

1.00

146065

140343

1.04

305749

296957

1.03

65+

31894

36217

0.88

66508

74730

0.89

140260

157766

0.89

65–79

29330

32607

0.90

59926

65096

0.92

121330

131588

0.92

80+

2564

3610

0.71

6582

9634

0.68

18930

26178

0.72

Total

904131

861370

1.05

1535630

1459820

1.05

2221031

2136887

1.04

China

0–4

57709

54566

1.06

57946

54382

1.07

46162

43641

1.06

5–14

92791

87928

1.06

97651

91493

1.07

93781

88620

1.06

15–49

175922

157417

1.12

335427

312009

1.08

397921

375437

1.06

15–24

63881

57124

1.12

130227

122581

1.06

119162

112459

1.06

50–64

34340

36460

0.94

64827

59041

1.10

131878

126429

1.04

65+

14361

17697

0.81

30338

35946

0.84

62490

69324

0.90

65–79

13137

15807

0.83

27465

30790

0.89

53794

56511

0.95

80+

1224

1890

0.65

2873

5156

0.56

8696

12813

0.68

Total

375124

354067

1.06

586189

552871

1.06

732233

703450

1.04

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

1965

1990

2015

Age

Males

Females

Sex Ratio

Males

Females

Sex Ratio

Males

Females

Sex Ratio

India

0–4

40744

38220

1.07

58837

55527

1.06

59916

57144

1.05

5–14

63142

57995

1.09

101988

94973

1.07

126199

119700

1.05

15–49

120378

113546

1.06

219947

202319

1.09

360868

337399

1.07

15–24

44902

42923

1.05

86178

78996

1.09

125559

118453

1.06

50–64

22782

20831

1.09

41007

40092

1.02

82133

77400

1.06

65+

8840

8678

1.02

19110

19293

0.99

39613

43560

0.91

65–79

8304

7963

1.04

17323

17420

0.99

34548

37313

0.93

80+

536

715

0.75

1787

1873

0.95

5065

6247

0.81

Total

255886

239270

1.07

440888

412206

1.07

668729

635272

1.05

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 6 Age-Specific Sex Ratios of Urban and Rural Populations of Less Developed Regions, 1965, 1990, and 2015

 

1965

1990

2015

Age

Urban

Rural

Urban

Rural

Urban

Rural

Less Developed Regions

0–4

1.05

1.04

1.05

1.04

1.05

1.03

5–14

1.03

1.05

1.03

1.06

1.03

1.05

15–49

1.09

1.04

1.09

1.02

1.09

0.98

15–24

1.07

1.04

1.08

1.04

1.07

1.00

50–64

1.01

0.98

1.04

1.00

1.04

0.97

65+

0.81

0.89

0.82

0.90

0.84

0.90

Total

1.05

1.03

1.06

1.02

1.05

1.00

Africa

0–4

1.03

1.01

1.03

1.01

1.03

1.02

5–14

0.98

1.01

0.98

1.03

0.98

1.05

15–49

1.10

0.95

1.11

0.92

1.10

0.90

15–24

1.06

0.97

1.08

0.96

1.07

0.95

50–64

1.01

0.89

0.98

0.88

1.01

0.89

65+

0.79

0.79

0.78

0.82

0.78

0.84

Total

1.04

0.97

1.05

0.96

1.04

0.95

Latin America

0–4

1.05

1.01

1.04

1.01

1.04

1.02

5–14

1.00

1.04

1.01

1.06

1.02

1.07

15–49

0.94

1.09

0.96

1.11

0.98

1.13

15–24

0.95

1.10

0.98

1.13

1.00

1.16

50–64

0.87

1.09

0.89

1.12

0.90

1.13

65+

0.75

1.06

0.75

1.11

0.74

1.08

Total

0.96

1.06

0.96

1.08

0.96

1.10

Developing Regions of Asia and Oceania

0–4

1.06

1.05

1.06

1.05

1.06

1.05

5–14

1.06

1.06

1.06

1.06

1.05

1.05

15–49

1.14

1.05

1.13

1.03

1.11

1.00

15–24

1.11

1.05

1.10

1.05

1.09

1.01

50–64

1.07

0.99

1.11

1.01

1.08

0.98

65+

0.83

0.89

0.86

0.90

0.87

0.91

Total

1.09

1.04

1.09

1.03

1.07

1.00

China

0–4

1.06

1.06

1.06

1.07

1.06

1.06

5–14

1.06

1.05

1.07

1.06

1.06

1.05

15–49

1.17

1.10

1.09

1.05

1.08

1.02

15–24

1.16

1.11

1.08

1.05

1.08

1.03

50–64

1.05

0.92

1.10

1.05

1.10

0.97

65+

0.82

0.81

0.77

0.84

0.91

0.90

Total

1.11

1.05

1.07

1.04

1.07

1.00

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

1965

1990

2015

Age

Urban

Rural

Urban

Rural

Urban

Rural

India

0–4

1.07

1.06

1.06

1.06

1.05

1.05

5–14

1.08

1.09

1.07

1.08

1.05

1.06

15–49

1.19

1.03

1.21

1.04

1.16

1.00

15–24

1.13

1.02

1.17

1.06

1.12

1.01

50–64

1.19

1.08

1.10

1.00

1.13

1.02

65+

0.97

1.03

0.95

1.00

0.88

0.93

Total

1.14

1.05

1.14

1.05

1.11

1.01

During the past 25 years, the Latin American urban population increased at an average annual rate of 3.5 percent and the rural population less than 0.4 percent. During the next 25 years, the urban population is projected to increase at 2.2 percent, and the rural population is projected to decline slightly in size.

The population residing in urban areas in Latin American is therefore projected to rise from 71.5 percent in 1990 to 81.5 percent in 2015 (Table 2). The percentage urban is notably higher for ages 15 and over than for younger ages both in 1990 (73 and 68 percent, respectively) and, as projected, in 2015 (83 and 78 percent, respectively). The urban population is hence older than the rural population. In 1990, 34 percent of the urban population was under age 15, compared to 41 percent of the rural population. Correspondingly, 53 percent of the urban population and 46 percent of the rural population are between ages 15 and 49.

Asia is much less urban than Latin America; only 33 percent of Asians resided in urban areas in 1990. However, the urban population is projected to grow by 3.4 percent per year during the next 25 years (compared to 0.1 percent for rural areas) and the urban population will increase to 52 percent of the total.

The share of population aged 15–49 is more pronounced in Asia and Oceania than in Latin America, for both urban and rural areas. In urban areas, 57 percent is currently age 15–49 (compared to 53 percent in Latin America); in rural areas, 50 percent is age 15–49 (compared to 46 percent in Latin America).

DISTRIBUTION OF DEATHS BY SEX AND AGE

Africa, Latin America, and Asia vary not only according to mortality level but also according to the age and sex patterns of mortality. Different

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

mortality patterns, along with variant sex and age patterns of population at risk, lead to very different distributions of deaths across regions.

The effect of mortality level can be indicated with just a few figures. Although 16 percent of the LDR population in 1990 was African, the continent contributed 23 percent of deaths during 1985–1990 (Table 7). Developing Asia and Oceania comprise 73 percent of the LDR population, but 69 percent of deaths. Latin America makes up the remaining 11 percent of population and 8 percent of deaths.

Different age and sex patterns lead to other interesting variations. For example, during 1985–1990, 48 percent of deaths in Africa occurred to preschool children (Table 8). For developing Asia and Oceania the corresponding percentage is 32, and for Latin America, 26 percent deaths occur under age 5. At the other end of the age spectrum, the share of deaths to those 65 and over varies from 15 percent in Africa, to 33 percent in developing Asia, to 36 percent in Latin America. The male to female sex ratio of total deaths is 1.10 for Africa and 1.09 for Asia and Oceania, but 1.26 for Latin America. Sex ratios are less than unity among the elderly in Africa and Latin America, but slightly more than unity in developing Asia. (Detailed tables on deaths by sex are not included here, in the interest of space, but the most salient gender differences are discussed in the text.)

In general, the age distribution of deaths is youngest in Africa and oldest in Latin America. As a result, although 23 percent of total deaths in the LDRs are among Africans, 31 percent of preschool deaths and 38 percent of early-school-age deaths are. Correspondingly, only 12 percent of LDR deaths at ages 65 and over are African. Latin America contributes 8 percent toward LDR deaths, 6 percent of deaths at ages 0–4, 5 percent of 5-to 14-year-old deaths, and 10 percent of deaths among those 65 and over. Asia and Oceania comprise 69 percent of total deaths in LDRs, 62 percent of preschool deaths, 57 percent of 5- to 14-year-old deaths, and 78 percent of deaths at age 65 and older.

Age Patterns of Mortality

Figure 1 and Table 9 present age- and sex-specific mortality rates (nmx) for each of the three major areas for the period 1985–1990. These age-specific mortality rates are calculated from aggregations of country-specific population and deaths. They are aggregations of heterogeneous experiences and do not necessarily represent a typical country experience.

The country-specific life tables on which the data in Figure 1 and Table 9 are from diverse sources. Some (particularly for Africa) are based on model life tables because of the absence of reliable data. Others are based on the application of indirect techniques to census or survey tabulations such as child survival and parental orphanhood. As many as possible are

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 7 Total Deaths and Percentage of Deaths in Less Developed Regions, 1960–1965, 1985–1990, and 2010–2015

 

1960–1965

1985–1990

2010–2015

Region

Both

Male

Female

Both

Male

Female

Both

Male

Female

Deaths (thousands)

Total

201578

103746

97832

189991

99604

90387

219494

118361

101133

Africa

34160

17758

16402

43970

23005

20965

52194

27648

24546

Latin America

14245

7673

6572

15752

8782

6971

21187

11758

9429

Developing Regions of Asia and Oceania

153173

78315

74858

130269

67818

62452

146113

78954

67159

China

59281

30779

28502

36707

19397

17310

50421

27710

22711

India

45530

22710

22821

45804

23481

22323

44255

23846

20409

Distribution (%)

Total

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Africa

17.0

17.1

16.8

23.1

23.1

23.2

23.8

23.4

24.3

Latin America

7.1

7.4

6.7

8.3

8.8

7.7

9.6

9.9

9.3

Developing Regions of Asia and Oceania

76.0

75.5

76.5

68.6

68.1

69.1

66.6

66.7

66.4

China

38.7

39.3

38.1

28.2

28.6

27.7

34.5

35.1

33.8

India

29.7

30.0

30.5

35.2

34.6

35.7

30.3

30.2

30.4

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 8 Distribution of Deaths by Age in Less Developed Regions, 1960–1965, 1985–1990, and 2010–2015

 

1960–1965

1985–1990

2010–2015

Age

Number

Percentage

Number

Percentage

Number

Percentage

Less Developed Regions

0–4

91611

45.45

65782

34.62

40872

18.62

5–14

19658

9.75

14040

7.39

9366

4.27

15–24

9251

4.59

8139

4.28

6669

3.04

15–49

35341

17.53

30487

16.05

30975

14.11

50–64

21180

10.51

24946

13.13

35390

16.12

65–74

17870

8.86

24847

13.08

38274

17.44

65+

33788

16.76

54737

28.81

102892

46.88

75+

15918

7.90

29890

15.73

64618

29.44

Total

201578

100.00

189991

100.00

219494

100.00

Africa

0–4

17291

50.62

20599

46.85

18076

34.63

5–14

4316

12.63

5306

12.07

5255

10.07

15–24

1770

5.18

2383

5.42

3204

6.14

15–49

5934

17.37

7682

17.47

10513

20.14

50–64

2723

7.97

3787

8.61

5867

11.24

65–74

2086

6.11

3218

7.32

5407

10.36

65+

3897

11.41

6595

15.00

12483

23.92

75+

1811

5.30

3377

7.68

7076

13.56

Total

34160

100.00

43970

100.00

52194

100.00

Latin America

0–4

6367

44.70

4151

26.35

2515

11.87

5–14

1097

7.70

752

4.77

490

2.31

15–24

573

4.02

687

4.36

537

2.53

15–49

2409

16.91

2980

18.91

3403

16.06

50–64

1634

11.47

2266

14.38

3859

18.22

65–74

1314

9.22

2180

13.84

3728

17.60

65+

2738

19.22

5605

35.58

10920

51.54

75+

1425

10.00

3425

21.74

7192

33.95

Total

14245

100.00

15752

100.00

21187

100.00

Developing Regions of Asia and Oceania

0–4

67953

44.36

41032

31.50

20282

13.88

5–14

14246

9.30

7982

6.13

3621

2.48

15–24

6928

4.51

5070

3.89

2928

2.00

15–49

26998

17.63

19825

15.22

17059

11.68

50–64

16824

10.98

18893

14.50

25663

17.56

65–74

14770

9.45

19449

14.93

29139

19.94

65+

27152

17.73

42537

32.65

79488

54.40

75+

12683

8.28

23088

17.72

50349

34.46

Total

153173

100.00

130269

100.00

146113

100.00

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

 

1960–1965

1985–1990

2010–2015

Age

Number

Percentage

Number

Percentage

Number

Percentage

China

0–4

22593

38.1

4750

12.9

1439

2.9

5–14

4909

8.3

1011

2.8

337

0.7

15–24

2600

4.4

1159

3.2

482

1.0

15–49

11057

18.7

5009

13.6

3995

7.9

50–64

7526

12.7

7136

19.4

9788

19.4

65–74

6915

11.7

8322

22.7

12023

23.9

65+

13197

22.3

18801

51.2

34862

69.1

75+

6282

10.6

10479

28.6

22839

45.3

Total

59281

100.00

36707

100.0

50421

100.0

India

0–4

22316

49.0

17607

38.4

8644

19.5

5–14

4584

10.1

3241

7.1

1222

2.8

15–24

2154

4.7

1912

4.2

982

2.2

15–49

7655

16.8

7174

15.7

5399

12.2

50–64

4267

9.4

5601

12.2

6742

15.2

65–74

3709

8.2

5772

12.6

8156

18.4

65+

6707

14.7

12182

26.6

22247

50.3

75+

2998

6.6

6411

14.0

14091

31.8

Total

45530

100.0

45804

100.0

44255

100.0

based on recorded deaths and population by age and sex (from censuses, surveys, or civil registration), adjusted when necessary for incompleteness.

Life expectancy at birth for the less developed regions averaged 61.4 years for this period (60.1 years for males and 62.8 for females). Africa exhibits the lowest life expectancy, 52 years, compared to 66.7 years for Latin America and 62.3 years for Asia. Latin America’s life expectancy exceeds that of Asia by 4.4 years, but male-female differences are large. Among males, Latin American life expectancy exceeds that of Asia by 2.6 years, but among females the difference is 6.3 years. For both males and females, African death rates are the highest among the three areas at all ages.

Female death rates for Latin America are lower than those for Asia at all ages, but differences are small after age 40 and are negligible between ages 40 and 60. Latin American and Asian death rates exhibit a crossover among males at age 55–60. Latin American male death rates are lower prior to age 15 and again after age 55, but are much higher between ages 15 and 55.

Dechter and Preston (1992) have illustrated that the low Latin Ameri-

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

FIGURE 1 Age-specific mortality rates, males and females, 1985–1990.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 9 Age-Specific Mortality Rates (nmx) in Less Developed Regions, 1985–1990

Age

Less Developed Regions

Africa

Latin America

Asia

Males

 

0–1

.08392

.11822

.06370

.07606

1–4

.00941

.01730

.00435

.00794

5–9

.00440

.00894

.00226

.00352

10–14

.00178

.00410

.00116

.00135

15–19

.00192

.00408

.00168

.00153

20–24

.00246

.00512

.00249

.00198

25–29

.00286

.00578

.00311

.00230

30–34

.00324

.00629

.00365

.00266

35–39

.00395

.00735

.00437

.00333

40–44

.00533

.00908

.00558

.00467

45–49

.00752

.01157

.00751

.00686

50–54

.01087

.01523

.01043

.01028

55–59

.01625

.02088

.01486

.01578

60–64

.02480

.02976

.02152

.02455

65–69

.03824

.04413

.03175

.03831

70–74

.05954

.06734

.04737

.06024

Life expectancy at birth

60.1

50.3

64.0

61.4

Females

 

0–1

.08195

.10548

.04856

.07931

1–4

.00919

.01544

.00331

.00827

5–9

.00455

.00860

.00172

.00388

10–14

.00174

.00390

.00077

.00137

15–19

.00173

.00355

.00095

.00147

20–24

.00213

.00412

.00130

.00187

25–29

.00252

.00477

.00167

.00222

30–34

.00289

.00547

.00212

.00253

35–39

.00343

.00637

.00274

.00300

40–44

.00436

.00744

.00364

.00390

45–49

.00578

.00887

.00499

.00534

50–54

.00805

.01137

.00702

.00763

55–59

.01191

.01582

.01012

.01152

60–64

.01846

.02345

.01503

.01816

65–69

.02941

.03641

.02304

.02927

70–74

.04726

.05749

.03594

.04746

Life expectancy at birth

62.8

53.6

69.5

63.2

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

can death rates at older ages may be partially a function of a common Latin American pattern of age misreporting. In Costa Rica, it is found that correction for age misreporting leads to an age pattern of mortality consistent with the West region of the Coale and Demeny (1983) model life-table system. To see the effects of such age misreporting on the population projections presented here, we prepared a special projection for Latin America, assuming that age-specific death rates followed the West region pattern from ages 45 onward, rather than those exhibited in Table 9. The new life tables exhibit for 1985–1990 a life expectancy at birth 1.8 years below the United Nations estimate.

However, the 2015 age distribution in this new projection (which uses the adjusted life table and assumes that life expectancy improves at the same pace as the United Nations projection, but at the lower level of life expectancy) is altered to only a small degree. With the adjusted life table, the percentages of population in age groups 0–14, 15–49, 50–64, and 65+ are 28.3, 52.9, 12.7, and 6.1, compared with 28.0, 52.5, 12.8, and 6.7 from the United Nations projections (see Table 3 above).

African Distribution of Deaths

Of the 190 million deaths in the less developed regions during 1985–1990, 44 million occurred in Africa; hence, this major area requires a more detailed description of the future evolution of mortality. Slightly more than 52 percent of the deaths are to males, a percentage that has remained nearly unchanged during the past 25 years. However, males make up the majority of deaths only up to age 65: deaths are 53 percent male at ages 0–4, 51 percent male at ages 5–14, and 54 percent male for ages 15–64. From age 65, females make up a majority of deaths: 50.2 percent of all deaths at ages 65–74, and 56 percent of deaths at age 75 and over.

During 1985–1990, 47 percent of African deaths occurred at ages under 5 and another 12 percent between ages 5 and 14. As previously indicated, with 59 percent of deaths under age 15, Africa exhibits a very young death distribution, when compared with 42 percent of deaths occurring under age 15 for the LDRs as a whole. Due to the age pattern of mortality decline during the past 25 years, as well as the fertility decline that has occurred, the number of deaths in Africa has increased more at the older ages. Comparing deaths during the period 1960–1965 with those during 1985–1990, one finds a direct relationship between age and percent increase in number of deaths, as shown in Table 10.

The pattern is very similar if one considers males and females separately, although the percentage increase for male deaths was greater than that for females at all ages. As a result the percentage of deaths occurring under age 14 has fallen during the past 25 years, from 63 to 59 percent; the

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 10 Increase in Africa’s Deaths from 1960–1965 to 1985–1990

Age Group

Deaths 1985–1990 (thousands)

Percentage Increase 1960–1965 to 1985–1990

0–4

20599

19.1

5–14

5306

23.0

15–49

7682

29.5

50–64

3787

39.1

65–74

3218

54.2

75+

3377

86.5

percentage at ages 15–49 has remained at 17 percent; at ages 50–64, the share of deaths has risen from 8 to 9 percent; and at age 65 and over, the share has increased from 11 to 15 percent (Table 8).

Changes in Deaths Over the Next 25 Years Without the AIDS Pandemic

The 1990 revision of population estimates and projections by the United Nations projects a continuation of the above trends for the next 25 years, although at a faster pace due to an assumed more rapid decline in fertility. However, the 1990 revision was undertaken before the extent of the AIDS pandemic was known and before even rough estimates could be made of its potential demographic effects. This section therefore describes how the number and distribution of deaths in Africa would evolve if the AIDS pandemic had not occurred, or if it plays itself out with minimal impact on future mortality. The next section presents some preliminary indications of what the effect of AIDS may be on deaths during the next 25 years.

In the absence of AIDS, 52.2 million deaths in Africa are expected during the 2010–2015 period, 19 percent more than occurred during 1985–1990. All of the increase in numbers of deaths will take place among the adult population. In fact, it is projected that the number of deaths under age 5 will be 12 percent below the 1985–1990 level, and the number at ages 5–14 will be 1 percent below. Increases in the number of deaths at age 15 and over are expected to be much greater than they were during the last 25 years. In comparison to 1985–1990, deaths during 2010–2015 will be 37 percent greater at ages 15–49, 55 percent greater at ages 50–64, 68 percent greater at ages 65–74, and 110 percent greater at age 75 and over.

The total number of deaths that would occur in Africa during 2010–2015 is projected to be 24 percent of the deaths that occur in the LDRs in total—only slightly higher than the 23 percent calculated for 1985–1990. However, below age 25 the proportion of LDR deaths that are located in

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

Africa will continue to rise rapidly. Under age 5, 44 percent of all LDR deaths in 2010–2015 will be African (compared to 19 percent in 1960–1965 and 31 percent in 1985–1990); at ages 5–14, 56 percent of deaths will be African (compared to 22 percent in 1960–1965 and 38 percent in 1985–1990); at ages 15–24, 48 percent of deaths are projected to be African (compared to 19 percent in 1960–1965 and 29 percent in 1985–1990).

Potential Effect of the AIDS Pandemic on the Number and Distribution of African Deaths

However, AIDS exists, and at least in Africa, it will lead to large numbers of additional deaths during the next 25 years. For the 15 countries with the estimated highest current level of human immunodeficiency virus (HIV) prevalence (Malawi, Rwanda, Uganda, Zambia, Zimbabwe, Burundi, Central African Republic, Congo, Tanzania, Zaire, Benin, Burkina Faso, Côte d’Ivoire, Kenya, and Mozambique), potential deaths during the next 25 years due to the AIDS pandemic have been calculated based on the World Health Organization’s (WHO) latest estimates of HIV prevalence and the WHO epidemiological model for projecting future infections and resultant AIDS cases and deaths. The application of the model here is conservative in that it assumes no new adult infections after 2005.

Preliminary estimates from this model indicate that these 15 countries will provide in aggregate about 18 million AIDS-related deaths during the next 25 years. (Additional deaths due to AIDS will add up to 13 million persons since many would die from other causes anyway). AIDS deaths will occur predominantly to young children and those in the prime working ages. About one-fourth of projected AIDS deaths will occur to children under age 5, and slightly more than one-half will occur to those aged 15–49. About 23 percent of deaths will be to those aged 50 and over, and less than 1 percent to those between ages 5 and 14.

Figure 2 presents the projected aggregate age-specific mortality rates for the 1990–2015 period, with and without AIDS, for these 15 African countries. Table 11 shows the percentage increase in expected mortality rates due to AIDS. The mortality rates in the absence of AIDS are calculated from the United Nations 1990 Revision.

The death rate under age 5 will be 13 percent higher than originally expected, but the largest rises in age-specific death rates can be expected to occur in the middle age groups. The death rate will rise by at least 20 percent between ages 20 and 65, by about 50 percent or more between ages 25 and 60, and by 100 percent between ages 35 and 45.

As a result, the age distribution of deaths in these countries during the next 25 years will be greatly altered. The percentage of expected deaths between ages 15 and 49 is projected to be 25 rather than 19 percent, and the

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

FIGURE 2 Projected aggregate age-specific mortality rates for 15 African countries with and without AIDS, 1990–2015.

TABLE 11 Increase in Mortality Rates Due to AIDS, 1990–2015; 15 Highest-Prevalence African Countriesa

Age Group

Percentage Increase Due to AIDS

0–4

12.8

5–9

0.1

10–14

3.8

15–19

7.9

20–24

22.6

25–29

49.2

30–34

80.0

35–39

103.1

40–44

105.6

45–49

91.7

50–54

70.0

55–59

48.4

60–64

27.7

65–69

15.3

70–74

8.1

75+

2.2

aCountries include: Malawi, Rwanda, Uganda, Zambia, Zimbabwe, Burundi, Central African Republic, Congo, Tanzania, Zaire, Benin, Burkina Faso, Côte d’Ivoire, Kenya, and Mozambique.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

TABLE 12 Distribution of Deaths for 15 African Countries With and Without AIDS, 1990–2015a

 

Percentage

Age Group

Without AIDS

With AIDS

0–4

43.3

39.7

5–14

11.9

9.8

15–49

19.2

25.3

50–64

8.8

10.5

65+

16.8

14.6

Total

100.0

100.0

aCountries include: Malawi, Rwanda, Uganda, Zambia, Zimbabwe, Burundi, Central African Republic, Congo, Tanzania, Zaire, Benin, Burkina Faso, Côte d’Ivoire, Kenya, and Mozambique.

share between ages 50 and 64 will be 11 rather than 9 percent. AIDS mortality will lead to lower shares of deaths at other ages: 40 percent of deaths will be among those 0–4, rather than 43 percent (in spite of an anticipated 13 percent increase in deaths at these ages); 10 percent at ages 5–14 instead of 12 percent; and 15 percent at ages 65 and over instead of 17 percent (Table 12).

It can be expected that these 15 countries will account for the vast majority of all AIDS deaths in Africa, but even if one assumed that no AIDS-related deaths occurred outside these 15 countries, the 1990–2015 total death rate for Africa would be 7 percent higher than otherwise projected. In fact, total expected deaths for Africa will increase by more than 20 percent at ages 30–54, and by at least 10 percent at ages 25–59.

SUMMARY

Currently 4.1 billion persons live in the less developed regions of the world: 642 million in Africa, 448 million in Latin America, and 3.0 billion in the developing regions of Asia and Oceania. During the next 25 years, an average annual population growth rate of 2.8 percent is projected for Africa, compared to 1.6 percent for Latin America and 1.5 percent for Asia. Thus, by 2015, of the 6.3 billion population projected for the less developed regions, 1.3 billion will be African, 673 million Latin American, and 4.4 billion Asian. At mid-1990, 37 percent of the population of the less developed regions lived in urban areas (1.5 billion persons). By 2015, 55 percent of the population of the developing countries is projected to be urban.

The age distribution of population varies significantly across these three major areas. The population share aged 0–4 ranges from 12 and 13 percent

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

in Latin America and Asia, to 18 percent in Africa. The percentage of the population aged 65 and over varies from 3.0 percent in Africa, to 4.7 percent in Asia, to 4.8 percent in Latin America. The population age distribution will be much older by 2015, as the percentage aged 65 and over rises to 3.4 in Africa, 6.7 in Latin America, and 6.8 in Asia.

Africa, Latin America, and Asia vary according to mortality level, and to age and sex patterns of death. Although 16 percent of the LDR population in 1990 is African, the continent contributed 23 percent of the deaths during 1985–1990. Developing Asia and Oceania comprised 73 percent of the LDR population, but 69 percent of deaths, whereas Latin America made up the remaining 11 percent of the population and 8 percent of deaths.

In general, the age distribution of deaths is youngest in Africa. During 1985–1990, 48 percent of deaths in Africa occurred to preschool children, compared to 26 percent in Latin America and 32 percent in Asia. Deaths to those aged 65 and over contribute 15 percent to African deaths, 33 percent to Asian deaths, and 36 percent to Latin American deaths.

Although mortality levels are projected to exhibit substantial declines during the next quarter century, the absolute number of deaths in the less developed regions will be greater in 2010–2015 than during the five years prior to 1990. The age distribution of deaths will, however, be much older, with nearly one-half of all deaths expected to take place at age 65 and over, and less than 20 percent under age 5. For some countries, particularly in Africa, the potential effects of the AIDS pandemic may alter the future course and age patterns of mortality. Preliminary estimates indicate that the 15 African countries with the highest current level of HIV prevalence may experience 18 million additional deaths during the next 25 years due to the AIDS pandemic. These AIDS-related deaths are expected to occur predominantly to young children and to those in the prime working ages. About one-fourth of the projected AIDS deaths during the next 25 years in these countries will occur to children under age 5, and slightly more than one-half will occur to those aged 15–49.

REFERENCES

Coale, A.J., and P.Demeny 1983 Regional Model Life Tables and Stable Populations, 2nd ed. New York: Academic Press.


Dechter, A.R., and S.H.Preston 1992 Age misreporting and its effects on adult mortality estimates in Latin America. Population Bulletin of the United Nations. No. 31/32. New York: United Nations.


United Nations 1991a World Population Prospects 1990. Population Studies No. 120. New York: United Nations.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×

1991b The Sex and Age Distributions of Population, The 1990 Revision. Population Studies No. 122. New York: United Nations.

1991c World Urbanization Prospects 1990, Estimates and Projections of Urban and Rural Populations and Urban Agglomerations. Population Studies No. 120. New York: United Nations.

Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 19
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 21
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 22
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 23
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 24
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 25
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 26
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 27
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 28
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 29
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 30
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 31
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 32
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 35
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 37
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 39
Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
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Suggested Citation:"SHIFTS IN THE STRUCTURE OF POPULATION AND DEATHS IN LESS DEVELOPED REGIONS." National Research Council. 1993. The Epidemiological Transition: Policy and Planning Implications for Developing Countries. Washington, DC: The National Academies Press. doi: 10.17226/2225.
×
Page 41
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This book examines issues concerning how developing countries will have to prepare for demographic and epidemiologic change. Much of the current literature focuses on the prevalence of specific diseases and their economic consequences, but a need exists to consider the consequences of the epidemiological transition: the change in mortality patterns from infectious and parasitic diseases to chronic and degenerative ones. Among the topics covered are the association between the health of children and adults, the strong orientation of many international health organizations toward infant and child health, and how the public and private sectors will need to address and confront the large-scale shifts in disease and demographic characteristics of populations in developing countries.

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