Thursday, March 30, 2006

Adult Health and Mortality in Developing Countries

by Edward Hugh

It is now reasonably well known that there is a steady global trend to increased longevtity. Nonetheless there are a disturbing number of case where life expectancy is falling not rising. This situation was highlighted in the 2005 Un human development report, and lead me to deploy Lant Pritchett's old expression 'Divergence Bigtime'.

Basically the question breaks down into two distinct groups of countries: some ex-member states of the old USSR, and a number of countries in Sub-Saharan Africa.

Some discussion of the situation in the former member states of the USSR can be found here (and here, and here).

In the case of Sub-Saharan Africa the critical importance of the impact of HIV/AIDS is also relatively well-known. Less well-known is the fact that even when this issue is discounted, mortality in some states is still rising.

A number of papers in this PAA session draw attention to this phenomenon, and try to offer some interpretation:

Adult Mortality in a Rural Area of Senegal: Trends and Causes of Death, Géraldine Duthé, Institut national d'études démographiques (INED); Gilles Pison, Institut National d'Études Démographiques (INED) (extended abstract).

Levels and Trends in Adult Background Mortality in Sub-Saharan Africa, Patrick Gerland, United Nations; François Pelletier, United Nations; Thomas Buettner, United Nations (extended abstract)

Adult Health and Mortality in the Gambia: Relationships between Anthropometric Status and Adult Mortality Risk, Rebecca Sear, London School of Economics and Political Science (LSE) (full paper)

The Duthé and Pison paper looks particularly interesting, as it studies mortality trends in rural Sudan. This is expecially worthwhile since, as they point out, in this area there are relatively few deaths due to AIDS, because there is a comparatively low HIV prevalence among adults:

Adult mortality in developing countries, particularly in sub-Saharan Africa is difficult to estimate because of the lack of reliable data. This is true for the overall level of mortality and also for mortality due to specific causes of death. In this presentation, we provide original estimates of adult mortality in Mlomp, a rural population of Senegal which has been monitored for twenty years. Though remaining at a relatively low level, global mortality increased slightly during the early '90s. In this study, we focused on the description of the causes of death among adults to determine which causes are responsible for raising the mortality level: accidents and external causes bring about many deaths among adults who work and travel, and cancer mortality appears to have increased in the last twenty years. All these causes and diseases more specifically concern men, who have higher levels of mortality than women.

1 comment:

S.M. Stirling said...

I don't think there's any particular mystery about why longevity might decline in some African countries even without HIV. If you have a deterioration in infrastructure and public services -- the things which caused mortality declines in the first place -- you can logically expect mortality to go back up.

And tropical Africa has the worst disease environment in the world anyway.

It's important to remember that even the increasing longevity of the developed countries doesn't mean that our potential lifespans are getting any longer.

It just means that more and more people are living to the same ages as the lucky have always managed to reach.

To date, modern medicine just makes it more likely you'll reach the point at which we're genetically programmed to fall apart.