Mortality transition in Mexico, 15002000
» 1500-1650: life expectancy worsened with
Christian colonization:
e0 < 20, fell as low as 5 years during worst times!
» 1650-1810: slow recovery punctuated by
epidemics and famine, e0 ~15-25 years
» 1810-1920: significant improvements undermined
by decades of war—1810-20, 1846-68, 1910-20
» 1920: sustained rise in life expectancy
Mexico: life expectancy at
birth over five centuries
Revolution in life expectancy began in 1920s
Life expectancy desperately low til the late 1800s
80
75
72
67
62
58
70
60
50
years
50
41
36
40
30
30
20
20
16
10
20
18
27
20
15
5
0
1500
1600
1700
1800
1900
year
Mexico: Life Expectancy at birth across the centuries
2000
Five centuries of population change in
Mexico (millions log scale)
6 Factors to explain the health
transition
and rising life expectancy
»
»
»
»
»
»
1. Public health
2. Medicine
3. Wealth and income
4. Nutrition
5. Behavior
6. Education
The epidemiological transition,
3 stages (Omran)
» 1. Pandemics
» 2. Receding pandemics
» 3. Degenerative diseases
Mexico: the last devasting epidemic
occurred in 1918 (~250,000 deaths)
• *Huey zahuatl (smallpox)
• *tepitonzahuatl (measles)
• cocoliztli (Mexican typhus?)
• matlazahuatl (typhus?)
• famine and typhus
• typhus
• the great hunger
• typhus
• *cholera
• *influenza
* = virgin soil epidemic
1520
1531
1546-47
1576-77
1692
1737-39
1786-88
1813
1833
1918
The Age of Pestilence and Famine:
Colonial Mexico, 1640-1813
Total annual burials from parish registers
crises were more deadly in the 18th century than in the 17th
20000
typhus
Burials (logarithmic scale)
10000
typhus
4000
typhus
famine
smallpox
smallpox
2000
typhus
1000
smallpox
smallpox
typhus
smallpox
smallpox
measles
typhus
famine
smallpoxsmallpox
measles
typhus
smallpox
400
200
100
40
20
10
1650
1692
1737
1761
1779
Mortality crises in Cholula (near Mexico City)
The Age of Pestilence and Famine
1797 1813
Example from Northern Mexico,
1630-1930
Smallpox: 1724, 1748, 1764, 1780, 1803, 1830
less than 10% of deaths of known causes due to smallpox
1918
2000
1000
1693
logrithmic scale
1899
1849
1810
1671
17051718
1639
1738
1764
1780
1803
1787
1930
1882
1814
1837
1748
100
10
1650
1700
1750
1800
1850
Interpolated years: 1653, 1658-65, 1818-28
1900
3 Centuries of Epidemics: Parral, Chihuahua, 1631-1930
Intensity of mortality crises declined after
mid-19th century
The revolution in life expectancy in
th
20 century Mexico
Biggest advance in 1940-50s; slowed 1990s
1920s: recovery from civil war, rebellion
80
72
70
75
67
62
60
58
50
years
50
41
40
30
36
30
27
20
27
15
Civil war,
1910-17
10
0
1900
1910
1920
1930
1940
1950
year
1960
1970
1980
1990
Mexico: Life expectancy revolution in 20th century
2000
The Mortality transition in Mexico:
catching up with the USA
Omran’s epidemiological transition
Mexico, cause of death: decline of parasitic,
contagious; rise of circulatory, cancer, accidents
% of deaths by cause (other = ~25%)
parasitic
accidents/
year infectious circulatory respiratory digest cancer homicides
1930
47.0
1.9
16.0
4.0
0.7
4.1
1940
43.1
3.7
20.0
4.7
1.2
5.1
1950
34.6
6.2
20.7
5.1
2.0
5.9
1960
25.6
8.5
19.3
5.3
3.4
6.5
1970
23.1
10.5
21.8
5.6
4.0
7.2
1980
13.7
16.4
13.5
7.1
6.5
15.5
1990
9.7
19.8
10.5
7.9
10.1
13.9
Timing of principal gains by age varied greatly
from one decade to another.
Biggest gains for 50+ since 1980s
Mexico 1930 - 1997
9
Age: timing of gain
8
50+:
1943-60; 1983+
7
years gained
15-49: 1930-60, 1983+
6
5
5-14: 1930-60
4
1-4:
3
2
1
Civil war,
1910-17
0:
0
1930-43
1930-80
since 1940
1943-60
1960-83
Life expectancy gained per decade by age group
1983-97
6 factors for explaining the health
transition and rising life expectancy:
the case of Mexico
» 1. Public health—substantial efforts from 1919
» 2. Education—from the 1940s
» 3. Nutrition—improved significantly only from
1950s
» 4. Medicine—important since the 1950s
» 5. Behavior—deaths from violence (homicides)
dropped substantially in the 1960s, but accidents
rose sharply
» 6. Wealth and income—only since the 1970s
Public health insurance has risen steady since
1950 & now covers 60%+ of the population
•
•
•
•
•
•
Year
1940
1950
1960
1970
1980
1990
Population (millions)
20
26
35
48
67
81
% insured
<1%
4
11
25
46
59
Literacy (aged 10+) doubled
1900-30 and 1930-80
percent literate of population aged 10+
literate
100
90
80
% literate
70
60
50
40
30
20
10
0
1900
1920
1910
1940
1930
1960
1950
Literacy in Mexico, 1900-1990
1980
1970
1990
Mexico won the race between
population and grain supply,
1925-1985
240
220
200
100=1945
180
160
140
120
100
80
60
40
1925
1935
1945
1955
1965
Indexed values: 1945=100
1975
Mexico: Grain production per capita 1925-1985
1985
millions--log scale
Mexican agriculture won the race against
population--1940-65
corn
mexpop
wheat
80
40
population
20
10
8
corn
4
2
1
.8
wheat
.4
.2
1925
1935
1945
1955
1965
grains in millions of tons
1975
Race between Population and Grain Production
1985
Food availability increase per capita
by type: Mexico 1940-1960, 1960-1975
Grains, pulses, fruits and veggies all increased
Only meat and diary did not increase significantly
200
% increase
150
100
50
0
Beans
Eggs
Corn
Milk
Meat
Potatoes
Oranges
Tomatoes
Sugar
Food availability increased substantiality, 1940-1975
Wheat
Social modernization in Mexico, 1970-2000
Social conditions improved from 1970 to 1990 and 2000
Source: National census microdata
100
2000
80
percent
1990
60
40
20
1970
0
electricity
midschool/+
occup:ter
sewage
literacy
occup:sec
pipedwater
Social modernization in Mexico
urban
Mexican middle class emerged
slowly—since 1950
Computed from census data on occupation & income
100
upper
middle
percent
80
working
60
40
20
0
1900
1920
1940
year
1960
Long trends in Mexican class structure
1980
Infant mortality declined from 13%
in 1950 to 2.5% in 2005 (still more
than 3 times the US rate of 0.7%).
6 significant infant mortality risks in
Mexico, 1987-1991: base = 10/1000
• 1. Mother less than 7 years of schooling
2.3x
• 2. Birth interval <18, >59 months
2.3x
• 3. Mother’s age <19, >32 years
1.4x
• 4. Home has dirt floor; no water, sewage
1.4x
• 5. Fourth or higher birth
1.2x
• 6. Male birth
1.2x
• 7. Rural residence
1.05x
Note:
1. no data available on mother’s health, nutrition, access to prenatal care, etc.
2. 1980-1995: infant mortality rates by educational levels scarcely
changed; even though the overall rate declined by 1/3. Increasing
educational levels of mothers cut IMR from 46 to 33/1000.
6 factors for explaining the health
transition and rising life expectancy:
the case of Mexico
» 1. Public health—substantial efforts from 1919
» 2. Education—from the 1940s, greatest 1970s
» 3. Nutrition—improved significantly only from
1950s
» 4. Medicine—important since the 1950s
» 5. Behavior—deaths from violence (homicides)
dropped substantially in the 1960s, but accidents
rose sharply
» 6. Wealth and income—only since the 1970s
Mortality transitions:
Examples from Latin America
» Earlier and faster in Argentina,
Uruguay, Cuba, and Costa Rica
» Later and slower in Chile, Mexico,
Brazil and Peru
» Slowest in Guatemala, much of
Central America, and Haiti
Life Expectancy, 1900-1980, 4 LA
countries (unequal in 1900; now converging)
Life expectancy, 150 countries:
1960, 1995
Leading mortality crises in the
twentieth century
Conclusions:
» France:
19th century: major advances for children
20th century: improvement for adults
since 1970: improvements for elderly
» Mexico
Age of pestilence continued to 1918
Major improvements since 1930
By 1980, differences between countries had
narrowed greatly
Conclusions:
» Minimal levels of economic and social
development are sufficient to initiate
the fertility transition.
» Modest investments in preventive
public health could improve quality of
life and longevity in many regions of
the globe.
» The demographic explosion is nearly
over everywhere, except in Africa.