Jones
H3 Mortality
Crude Death Rate: (CDR) D/P x1000 Pas=
no. in standard pop of age&sex as
Age / Sex specific death rate:
Das/Pas x 1000 Das=
annual death rate of age&sex as
Standardized death
rate S (Pas Das) /P x1000 à =expected chance of death for as
Life Expectation @ Birth (LEB) S dx (x+1/2)=Eo à sum (aantal doden x leeftijd)
Infant Mortality Rate (IMR) D0/B
x 1000 D0=death
at age 0
Any statistical analysis is only as sound as
the quality of the data is uses.
Development didn’t always mean decline of
mortality, In pre-Industrial Europe diseases mostly happened in cities, which
are stimulated by trade. Only in this century development can be related to
mortality.
Nowadays, in well developped countries
increase of GNP has little or no effect on mortality.
Education has a linear relationship with
mortality.
Death: 1)Infectious,
parasitic and respiration diseases (less-dev
countries, insects, trop. climate;malaria 2)Cancer (dev countries, icm life
expectations)
3)Diseases
of the circulatory system (heart diseases, dev. countries,
4)Violence (stable,)
5)Other
causes (undev. Countries more,
drinkwater)
LEB is highest for females. Due to fysical
factors and lifestyle.
17th-19th population growth in Europe:
visions:
-agri/cultural/industrial/transport Rev. stimulated growth pop.
-agri/cultural/industrial/transport Rev. declined death
-undependend growth causing economic changes
Did economical changes stimulated poplutaion
growth or did the population growth stimulate th economical changes? (the
search for ways to produce enough food for instance)
It’s difficult to see trends in population
before 19th because of the lack of sufficient/accurate data.
In pre-transition fase: temperature/diseasesàagriculture àresistanceà deaths/diseases. But this can be doubted, little proof, and elite
(well fed) Eo matches the mass Eo.
Modern opinion: short period varying death
rates because of influencial epidemics and wars.
Downward trend of mortality because of 5
processes:
-Improved nutrition: Agricultural
Revolution: oa potato (high calorific/acre, climatological more reliable)(à less starvation, infections)
-Increased manufacturing output Industrial Revolution;
soap/cotton etc)
-Medical advances -Vaccination
against smallpox and cowpox (1798)1850; 82% vaccinated
-Inoculating (giving a small dose of disease to make the person
resistant)
-Sterilization
of instruments (1880’s)
-Chemotherapeutic/antibiotics
-Pasteurization
of milk (infant mortality)
(-health
education (hygienics/ food prep./ waste disposal))
-Public health developments -Drinking water (cholera)
-House-improvement
(tuberculosis)
-Changing internal character of -the ever-evolving relationship
between micro-organism and man
infectious diseases
North
America
The same as in Europe/England tough
nutritional improvements are unlikely to have played such a significant role
because of the high food percentage per person. Lack of data.
Soutern
and Eastern Europe, the Sovjet Union, Japan
Because of economic development; mortality declined in the late 19th century. Rapid decline in the 20st century to a same death rates the US had by 1950. Important were technology, sciences, public health and medicin. Just as imporatant as socio-economic changes. In Japan ani-biotics, vaccinations, health centers had much influence.
In USSR and Eastern Europe, from 1960-80 death rates stagnated. Western explanations were: bureaucratic inefficiencies, alcohol, industrial pollution. But Dinkel argues: healthy males were killed in WOII, and the infant mortality is due to the spatial distribution of births, which focus moved towards the asian/poorer part. Now death rates decline again due to less violence and alcohol prevention.
1900: Eo=28, 1985: Eo=63, still 12 below European rates. (LA-66, Asi-61, Afr-52) seems due to development and modernisation levels. But after a closer look medical and public health programmes contibuted more.
-Programmed disease control. Many measures, vaccination, anti-biotics, where initiated by WOII allied troops. Than smallpox was eliminated (1978), by WHO. Stolnitz: ‘levels of living and lifestyle can be greatly offset or even dominated by what might be called programmed disease control.’
-Deceleration of mortality decline
Against expectation the death rate decline slowed down in the 70’s and in several countries stagnated . Disease campaigns can reduce mortality levels so far, but no further. A lot is contributed to infant mortality.
Factors : -Malnutricion and poverty malnutricion is not a factor itself, but influences resistance.
-Defective water supply and waste disposal 36% of rural less develp people has safe water.
-Urban bias; spatial allocation of scarce recources/doctors
-Complacency and resistance; when enviromental conditions remain poorà diseases expensive
-West not always best; western drug compagnies promotion, tobacco,
Political responses:
-Rural development and primary health care
Povertyàpoor health, key stategy is local, community-based programmes.
They are accessible, affordable and social acceptable
-Social development:
-education , àmedical kneledge, read prescriptions etc.
-female autonomy
-egalitarian policies
-Refined medical intervention programmes
1-promotion of breastfeeding
2-mass production of treatments for diarroeal dehydration
3-monitor the weight of infants
4-mass immunization programmes
to provide everyone is more a socio-political than a medical or economic matter
Social status of polygyny. Level of AIDS is most likely to be decided by lifestyle trends. In Afrika; 10% of the worlds population contains 30% of all people infected.