The Epidemiological Transition Policy and Planning Implications for Developing Countries (1993) / Chapter Skim
Currently Skimming:
MORTALITY BY CAUSE, 1970 TO 2015
MORTALITY BY CAUSE, 1970 TO 2015
Pages 42-68
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 42... ...
Halstead, Dean T Jamison, Bernhard Liese, Jose Martinez, Alberto Torres, and Patrick Vaughan, as well as participants in meetings for the World Bank health sector priorities review, for their comments and suggestions.
|
From page 43... ...
and six regions or country groups (industrial market economies, industrial nonmarket economies, Latin America and the Caribbean, sub-Saharan Africa, the Middle East and North Africa, and Asia and the Pacific)
|
From page 44... ...
causes Polio Yellow fever, dengue, and encephalitis Malaria Schistosomiasis and filariasis Intestinal parasites Other infectious and parasitic diseases Data on Causes of Death Although data on causes of death can be problematic, these data are used largely as reported by WHO, without attempting such corrections as regrouping codes or reallocating undefined causes. (WHO has procedures for scrutinizing the data before including them in its reports.)
|
From page 45... ...
For most other countries reporting to WHO, data were available on each cause of death. The major exceptions were the Latin American and Caribbean countries, for which 1970 but not 1985 data were available on other causes and four specific causes (chronic obstructive pulmonary disease, polio, mental disorders, and micronutrient disorders)
|
From page 46... ...
These data were adjusted proportionally where necessary to produce the mortality levels separately estimated. The regression equations for major causes of death, obtained from Hakulinen et al.
|
From page 47... ...
(The industrial market economies as a group have a standardized crude death rate of 5.8 for 1985, as contrasted, for example, with 9.0 for Latin America and the Caribbean.) Estimating Cause-Specific Mortality Rates New regression equations were estimated for mortality rates from 21 specific causes by using the rate for the major cause under which each falls as the predictor.
|
From page 48... ...
mean R2 between .35 and .60: tuberculosis, measles, chronic obstructive pulmonary disease, other infectious and parasitic diseases, cerebrovascular disease, nephritis/cirrhosis/ulcers, micronutrient disorders, and malnutrition; (3) mean R2 between .20 and .25: intestinal parasites, ischemic heart disease, and diabetes; and (4)
|
From page 49... ...
Even with projected improvements across the board, regional differentiation will remain sharp: by 2015, life expectancy in subSaharan Africa will have barely caught up with 1985 life expectancy in the Middle East and North Africa, and will not have caught up with 1985 life expectancy in any other region. On the other hand, crude death rates will converge.
|
From page 50... ...
so THE EPIDEMIOLOGICAL TRANSITION TABLE 2 Estimated and Projected Mortality Rates (per 100,000) , by Major Cause, Sex, and Region, 1970-2015 1970198520002015 Region and CauseMaleFemale MaleFemale MaleFemale MaleFemale World All causes 1293128110641004863802880 776 Infections 449449318294176179140 133 Neoplasms 95961089610898128 114 Circulatory 297324262286292283339 314 Pregnancy 01309090 7 Perinatal 86707959483637 27 Injury 93409756783179 32 Other 273289201204161167157 150 Developed Countries All causes 10541069104710139979631161 1059 Infections 14611210974785990 63 Neoplasms 167163203172182170213 188 Circulatory 463552473563486536575 597 Pregnancy 0201010 1 Perinatal 2610151013913 7 Injury 99518740773780 39 Other 153180161154160152191 163 Developing Countries All causes 1383137310701001830759823 714 Infections 564595382368200211150 148 Neoplasms 686878709079111 98 Circulatory 234225198192244216291 252 Pregnancy 0180120110 9 Perinatal 109969875564342 31 Injury 913510062782979 30 Other 318336213221162171150 147 Industrial Market All causes 1036102198695010079431173 1045 Infections 106858266644768 38 Neoplasms 186169240192196171236 200 Circulatory 500567461518513551615 639 Pregnancy 0000000 0 Perinatal 2178510610 5 Injury 98587440703674 40 Other 125135120128154131171 123 Nonmarket All causes 108911551162112698010001139 1082 Infections 2241591588810379128 106 Neoplasms 129152136135158169173 168
|
From page 51... ...
MORTALITY BY CAUSE, 1970 TO 2015 TABLE 2 Continued 1970 1985 2000 51 2015 Region and CauseMale Female Male Female Male Female MaleFemale Nonmarket coned Circulatory 392 524495644437509505 526 Pregnancy 0 403020 2 Perinatal 37 152817201319 11 Injury 100 4010939903890 37 Other 209 260237200172189225 231 Latin America and Caribbean All causes 1097 903883706677557722 594 Infections 366 3012111771008667 55 Neoplasms 79 7676709486122 109 Circulatory 238 214228196242215306 275 Pregnancy 0 1206040 Perinatal 61 426544402830 20 Injury 98 319029762878 29 Other 255 227213184124111119 102 Sub-Saharan Africa All causes 2163 18821727144811961024947 785 Infections 1070 937817683498430346 286 - Neoplasms 52 575255545560 60 Circulatory 243 226209191182169180 162 Pregnancy 0 270210170 14 Perinatal 200 1571671291199082 61 Injury 108 399634863082 28 Other 491 438386334258233196 174 Middle East and North Africa All causes 1563 152011841121775733691 624 Infections 624 653459473209237142 164 Neoplasms 60 566560696281 70 Circulatory 250 224200183191171209 176 Pregnancy 0 210130120 10 Perinatal 140 12612097735752 39 Injury 90 378032752876 28 Other 400 404260263157166131 137 Asia All causes 1280 1342963946784736833 734 Infections 506 577319323149176110 119 Neoplasms 70 70857410187130 113 Circulatory 230 227191194268235338 292 Pregnancy 0 170110100 8 Perinatal 98 918867423230 22 Injury 87 3410578772979 31
|
From page 53... ...
Table 4 provides mortality rates standardized by using the 1985 world age structure. Among infectious and parasitic diseases, four specific causes are the most important, accounting for at least nine out of ten deaths in each region: acute respiratory infections (pneumonia, influenza, acute bronchitis, whooping cough, and diphtheria, but not measles, which has been separated)
|
From page 54... ...
The predominance of these four specific causes in the estimates accurately reflects the data reported to WHO. For instance, among reporting Latin American countries, acute respiratory infections account for one-quarter to one-half of all deaths due to infectious diseases in each age-sex group, and acute respiratory infections and diarrhea combined account for three-fourths of deaths under S years of age.
|
From page 55... ...
ss ct .
|
From page 56... ...
en 6 4 2 [ ) 1 1~ =00 tar fICURE 2 Annual dcalhs by cause, more dc~cloped coun1des' 1970-2015.
|
From page 57... ...
Mortality patterns and trends for Asia, the region with the largest population, are closest to those for the world as a whole, as shown in Table 4, with Latin America and the Caribbean, industrial nonmarket economies, and industrial market economies successively more advanced, on the one hand, and the Middle East and North Africa, and sub-Saharan Africa, successively less advanced, on the other. A convenient index for summarizing these regional contrasts, as well as the manner in which they change over time, is the ratio of deaths from circulatory system
|
From page 58... ...
Sub-Saharan African deaths will increase in proportion for the first two of these causes, and industrial market economy deaths will decrease in proportion for the last two of these causes. The projections of mortality by cause are not straightforward extrapolations from past experience, but involve a combination of population projections with predictive equations for mortality rates by cause.
|
From page 59... ...
Table 6 shows, first, the percentage of deaths due TABLE 6 Distribution of Deaths by Major Cause in 1985 and Incremental Changes Expected by 2015 from Three Factors, World and Developed and Developing Countries Percentage Point Change by 2015 Due to 1985 Percentage Age-Sex Region and Cause Distribution Structure World Mortality Distribution Change Change Infections 29.6 -1.4-3.3-8.4 Neoplasms 9.8 1.11.12.6 Circulatory 26.5 3.34.45.3 Pregnancy 0.5 0.1-0.20.0 Perinatal- 6.7 -1.8-1.60.6 Injury 7.4 -1.1-0.71.1 Other 19.6 -0.10.2-1.2 Developed Countries Infections 8.8 -1.1-0.2-0.6 Neoplasms 18.2 0.8-0.2-0.7 Circulatory 50.4 2.81.5-1.8 Pregnancy 0.1 0.00.00.0 Perinatal 1.2 -0.4-0.20.3 Injury 6.1 -0.9-0.81.0 Other 15.3 -1.2-0.11.9 Developing Countries Infections 36.2 -3.0-3.0-10.8 Neoplasms 7.2 1.81.03.6 Circulatory 18.8 5.23.97.4 Pregnancy 0.6 0.1-0.20.0 Perinatal 8.4 -2.6-1.80.7 Injury 7.8 -1.2-0.61.1 Other 21.0 -0.20.6-2.1
|
From page 60... ...
, and changes in the distribution of deaths all contribute to the decline in infectious diseases. On the other hand, population aging and lower mortality reduce the importance of injury and poisoning, but distribution change raises their importance in relation to other causes of death.
|
From page 61... ...
To illustrate the effects of alternative weightings, Figures 4-6 compare the percentage distribution of deaths by cause with the percentage distribution of deaths under age 65 and with the percentage distribution across causes of death of potential years of life lost. Years lost are calculated under the simplifying assumptions that life expectancy is 75 and that deaths ss snV 45 40 35 30 25 20 15 10 5' Percentage of deaths under age 65 ~ Infectious I Others ~ Circulatory O Perinatal a_ ~ Neoplasm {} Pregnancy 1 v 1 970 1 985 .
|
From page 62... ...
Weighting deaths at younger ages more heavily increases the prominence of infectious and parasitic diseases, perinatal conditions, and injury and poisoning, and reduces the prominence of circulatory system diseases and neoplasms. The effects on the remaining categories are weak or inconsistent.
|
From page 63... ...
(The former USSR is not counted as covered, but China and rural India are.) The 1970 and 1985 estimates for industrial market economies are drawn almost entirely from WHO reports, which is true to a lesser extent for the estimates for Latin America and the Caribbean and industrial nonmarket economies.
|
From page 64... ...
This comparison is permissible because the equations for major causes had been estimated separately (by Hakulinen et al.) with other data; the procedure is less informative regarding the equations for specific causes, which were estimated by using the reported data in the comparison.
|
From page 65... ...
65 o so .so :s o v ~o pa in so ad Id 'e ;^ In cd o o · - ~ .4 cn .ad 4~ Ho a, o 'e au is · - ~ in pa ~ Do ~ o m ~ ¢ En .= Cal ¢ is C)
|
From page 66... ...
66 s .~ s oo ¢ EM .
|
From page 67... ...
These two major causes were responsible for about equal numbers of deaths in Latin America and the Caribbean by 1985. They caused equal numbers of deaths in Asia around 1990, and will do so in the Middle East and North Africa by around 2005, and in sub-Saharan Africa sometime after 2015.
|
From page 68... ...
Omran, A.R. 1971 The epidemiological transition: A theory of the epidemiology of population change.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.