Exam #2 Flashcards
Numbers alive in 2000 US population (000) who would have suffered various fates if 1900 mortality conditions prevailed (White and Preston 1996)?
Hypothetical Total Deaths 137,277 50% of actual pop. Been born and died (direct deaths) 68,441 25% of actual pop. Had mothers who died before their birth 38,096 14% of actual pop. Had grandmothers who died before mother’s birth 22,573 8% of actual pop. Had earlier ancestor die 8,167 3% of actual pop.
Selected life expectancy figures:
Pre-history (before 1300) 20-25 years Greeks, Romans 20-30 British aristocrats 1330 – 1650 30 England 1600-1750 35 1800-1850 39 1900 47 1990 75 2010 80.1 U.S. 1900 48 2010 78.7
Life expectancy at birth, 2011:
Range: Sierra Leone 47 to Japan 83
Global average: 70 years
Points of Reference:
U.S. (78.7), Canada (82), Mexico (75)
Classification of Causes of Death (WHO):
- Infectious and parasitic diseases
- Degenerative or chronic diseases
- Products of the social and economic environment
- Reductions in death rates from infectious and parasitic diseases led to dramatic mortality decline.
- Historically, mortality improvements occurred among young. Today, improvements are concentrated among old.
Hunter-gatherer societies:
Life expectancy = low 20s
Golden Age of Bacteria (1300-1650):
Exchange of diseases among populations newly in contact
- Smallpox
- Syphilis
The Plague
1650 - 1850:
Population growth begins as mortality rates start to decline slowly
Factors responsible for mortality decline (Europe):
- Disappearance of plague
- Agricultural revolution
Medical technology
- Smallpox vaccination developed purely by observation
- No theory of disease was developed at this time
What accounts for mortality decline after 1850?
Economic growth leading to improved nutrition and increased standards of living
Medicine
Public and private preventive measures
These explanations are not mutually exclusive and their relative importance has been of much contention.
Mortality decline due to economic growthThomas McKeown: Modern Rise in Population (1976):
For multiple diseases, bulk of mortality decline occurred BEFORE effective drugs became available .
Concluded that economic growth (which led to improved nutrition) must be responsible but provided no direct proof.
Mortality decline due to economic growth (Robert Fogel):
Found a close connection between improved nutritional status (e.g. height) and lower mortality
Miasma Theory:
A representation of the cholera epidemic of the 19th century depicts the spread of the disease in the form of poisonous air.
Public and Private Preventive Measures:
Germ theory of disease replaces miasma theory (1870s) and led to a series of public and private health initiatives
Public Health Initiatives
- Water sewer systems and sewage disposal improvements
- Pasteurization of milk
Private Health Initiatives:
Better Mothering Campaigns
- “We’ve discovered that the source of most diseases is not outside the home in public spaces, but inside the home. You’re making one another sick. Mothers, it’s your responsibility to maintain hygienic conditions and save your babies. Here’s what you can do.”
Formation of Children’s Bureau (1912)
Main Points:
Dramatic improvements in life expectancy over time since 1850s
Through transition, major causes of death change from infectious to noninfectious, chronic diseases
MDRs have completed the mortality transition
Much of MDR decrease in mortality occurred BEFORE modern medical advances, so medicine is NOT seen as a primary explanation for the decline.
Although debate continues, most demographic and medical historians conclude that mortality declined largely because of public and private health interventions. Rising standards of living as part of economic growth also played a role.
Epidemiological TransitionOmran, 1971:
Basic Components
High and fluctuating mortality and low life expectancy caused by infectious disease replaced by low, stable mortality and high life expectancy
Degenerative and manmade diseases become major causes of death
A shift in mortality from young to old ages.
Increase in life expectancy is implicit in these changes.
