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26 Cards in this Set

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Health and Mortality Transition
• Transition to better health and lower death rates
• (high death rates, young deaths, communicable disease) -> (low death rates, elderly deaths, degenerative disease)
• Pre-modern
o Life expectancy: 20-30 yrs
o 50% of deaths to children < age 5
o 10% of deaths to adults > age 65
o Hunter-gatherer societies:
 death by poor nutrition
o Agricultural societies:
 nutrition improved
 but, death by infectious disease (closer contact in denser settlements)
• Roman Era to Industrial Rev.
o Life expectancy: 22 yrs
o Nutrition improved later
o In 14th century, the plague (Black Death) hit Europe
 Killed 1/3 of Europe’s pop. between 1346 and 1350
o Columbian Exchange
 Chris Columbus and other explorers took disease with them to the Americas
 No native resistance -> massive deaths
• Industrial Rev. to the 20th Century
o The plague retreated in 18th century
o By early 19th century, rising income improved nutrition, housing, sanitation
 Life expectancy rose to about 40 yrs
o Public health measures lowered mortality
 Clean water, toilets, sewage systems, secure buildings, soap
o Life expectancy in England:
 1851: 40 yrs for men, 44 yrs for women
 2000: 76 yrs for men, 81 yrs for women
• WWII as turning point
o Big investment in ways to prevent spread of disease among troops
 Clean water supplies, disposal of human waste, medical advances for disease and wounds
o This knowledge was then transferred to world
o Result: big declines in death rate
o LDCs death rates fell fast
 Didn’t have to wait for econ. Development
 UN spread knowledge and tech
o Life expectancy rose rapidly around world
Life Span vs. Life Expectancy/Longevity
• Life span: how long you could survive (biological)
• Life expectancy/longevity: avg. length of life expected
• Communicable Diseases
o Also called infectious diseases
o Major cause of death for most of history
o Kinds:
 Bacterial (ex: TB, pneumonia, plague)
 Viral (ex: Flu, AIDS/HIV)
 Protozoan (ex: malaria, diarrhea)
o Cause 1/3 of all deaths in world
o More important in LDCs
o Highest rates in sub-Saharan Africa
o HIV/AIDS
 5% of world’s deaths related to both
 Highest rates in sub-Saharan Africa
• Non-communicable diseases
o Also called degenerative or chronic diseases
o More important in more developed countries
o Account for 59% or world’s deaths
o Account for almost 9/10 deaths in U.S.
o Major killers:
 Cardiovascular diseases (ex: heart attacks, strokes)
 Malignant neoplasms (ex: cancer)
o Also important:
 Respiratory diseases (ex: bronchitis, emphysema, asthma)
o Injuries:
 Accidental death, suicide, homicide, war
• Crude death rate:
o Basic measure
o Formula: (# of deaths / total pop.) x 1000
o Shortcomings: doesn’t take into account age distribution
• Age-specific death rate
o Measures mortality at each age group
o Formula: (# of deaths in age group / total pop. of age group) x 1000
• Infant mortality rate
o General health status indicator
o Formula: (# of death of infants <1 / # of births that yr) x 1000
Life Expectancy
• Estimate of the avg. # of additional yrs a person could expect to live if the age specific death rates prevailed
• Hypothetical
• Differs by sex, race, present age
• Good indicator of current health conditions
Life Table
• Shows the distribution and percentages of people living to a certain age among a group of people
• Used to calculate life expectancies
• Apply age-specific death rates to a hypothetical pop. of 100,000 people born at the same time
UN Millennium Project
• Goal: reduce extreme poverty in the world by 2015
Fertility Transition
• Shift from high fertility to low fertility
• “family building by fate” to “family building by design”
• Side-effect: improves health of mothers and children
Fertility vs. Fecundity
• Fertility = number of children born to women (actual)
• Fecundity = the physical ability to have children (potential)
• Max fecundity of a pop. = about 15-16 children per woman
• Worldwide avg fertility has fallen:
o 1950: 5 children/woman
o 2009: 2.6 children/woman
• Sub-Saharan Africa: 5.3/woman
• Decrease in infant and child mortality
o Fell w/ overall declining death rates
 IMR 1950 (world): 156
 IMR 2009 (world): 46
o More confidence that children will survive -> lower b rate
• Access to family planning/contraception
o Worldwide use of contraception:
 1960: <10%
 2009: 62%
o Regional variations in contraceptive use:
 N. America: 73%
 L. America: 71%
 Europe: 68%
 Asia: 67%
 Africa: 28%
o Fertility decline fast in developing countries
• Increase in female education
o Linked to lower b rates
o Honduras:
 Women w/ no education have 4.9 children
 Women w/ education have 2.2
o Ethiopia:
 Women w/ no education have 6.1
 Women w/ education have 2.0
o Leads to later marriage, contraception, employment
• Economic development
o Health improves (IMR drops)
o Fewer agricultural jobs
o Education levels rise
o Cost of raising children rises
• Urbanization
o Global trend
o Children not as helpful
o Social and econ. Changes
 Higher education, higher incomes, better health
• Negative pressures on b rate
o Competition for jobs
o Housing shortages
o Gov. polices
• Crude birth rate (CBR)
o Simplistic
o Formula: (#of births / mid year pop.) x 1000
• General fertility rate (GFR)
o More refined than CBR and focuses on child bearing pop (15-49)
o Formula: (actual births / # of women 15-49) x 1000
• Age-specific fertility rate (ASFR)
o Can compare at diff. ages or over time
o Formula: (# of briths in age pop. / # of women of group) x 1000
• Total fertility rate (TFR)
o Hypothetical
o Measures the total # of children a woman would have if the age specific fertility rates for a given year applied to her throughout her childbearing yrs