The Timing and Pace of Health Transitions around the World

Abstract

Estimates from some 700 mostly national studies of survival in the past are assembled to create a broad picture of regional and global life expectancy gains across space and time and to examine implications of that picture. At the initiation of their health transitions, most countries had a life expectancy between 25 and 35 years. Countries that began later made gains at a faster pace. Those faster gains are usually associated with the dissemination of Western medicine. But rapid gains occurred in the period 1920-50, largely before the availability of antibiotics or modern vaccines. Especially rapid gains came in the years immediately after World War II in countries where the leading causes of death were communicable diseases that could be managed with antibiotics but also in countries where the leading causes of death were degenerative organ diseases. Both periods of rapid gain await satisfactory explanation. The bibliography of more than 700 sources is published separately on the web at � http://www.lifetable.de.RileyBib.htm �. Copyright 2005 The Population Council, Inc..

The crossover between life expectancies at birth and at age one: The imbalance in the life table

“…Vallin and Meslé (2009) revised Oeppen and Vaupel's findings describing the series of e 0 as multiple segments that correspond to phases of the epidemiological transition (Omran 1971). While the timing, pace, and trajectories of demographic and epidemiologic transitions around the world vary widely (Riley 2005), across all countries initial increases in e 0 were mainly due to considerable reductions in early life mortality. Later and ongoing gains in life expectancy are the result of mortality declines at older ages (Horiuchi 1991;Kannisto et al 1994;Wilmoth 2000).…”

The Health Penalty of China's Rapid Urbanization

“…This apparent urban health advantage contrasts with the historical evidence of urban populations suffering poorer health in Western Europe prior to and during its period of industrialization (Rosen, 1958;Woods, 1985Woods, , 2003. The most likely explanation for this difference in the urban-rural health disparity over time and space is the marked decline in the prevalence of infectious diseases, in low-income as well as high-income countries (Riley, 2005), prompted, in large part, by public health measures built on the germ theory of disease (Preston, 1975(Preston, , 1980Cutler and Miller, 2005) and the introduction of effective medicines, antibiotics and vaccinations (Davis, 1956;Cutler et al, 2006;Soares, 2007). In the past, the opportunities for material gain offered by cities had to be weighed against the dangers of infection.…”

How Was Life?

“…furthermore, since infants are especially vulnerable to epidemics, long-term changes in infant mortality rates provide insight into a population's capacity to deal with outbreaks of disease. (Riley, 2005a(Riley, , 2005b(Riley, , 2005c) and life expectancy rates for England (Wrigley et al, 1997).…”

“…Another selection of the Gapminder data concerns the estimates provided by Riley (2005aRiley ( , 2005bRiley ( , 2005c, who compiled and assessed around 700 sources on historical life expectancy. While Gapminder includes both preferred and "not-preferred" sources as well as a list of estimates from the Riley bibliography, the data used in this chapter are those included in the Riley "preferred files", which have been evaluated through a thorough peerreview process.…”