Portal de Periódicos da CAPES

[Epidemiological transition in Latin America: a comparison of four countries].

1997; National Institutes of Health; Volume: 125; Issue: 6 Linguagem: Inglês

Cecilia Albala, Fernando Vío, Mabel Yáñez,

Public Health and Social Inequalities

In the last decade, Latin America has experienced important transformations in its health conditions, due to demographic changes and a rapid urbanization process.To analyze socioeconomic, demographic and epidemiological changes in Chile, Guatemala, Mexico and Uruguay and relate them to the different stages in the demographic and epidemiological transition of these countries.Data was obtained from official information of local and international organizations such as Pan-American Health Organization, United Nations, Latin American Center for Demography (CELADE) and World Bank.Guatemala is in a pre-transition stage with a high proportion of communicable diseases as causes of death (61%) as compared with Mexico (22%), Chile (13%) and Uruguay (7%). Mexico is in a prolonged transition situation and Chile is close to Uruguay in a post-transitional stage. Despite decreasing rates of mortality, the proportion of deaths represented by chronic diseases and injuries has increased to over 30% in all countries, except Uruguay. Adjusted mortality rates for cardiovascular diseases are lower in Latin American countries, as compared to Canada. However, excepting Guatemala, there are differences in the pattern of cardiovascular disease, with a higher mortality due to cerebrovascular and a lower mortality due to coronary artery diseases.An increment in non communicable diseases is expected for the next decades in Latin America. Analysis of demographic and epidemiological transition is crucial to define health policies and to adequate health systems to the new situations.This work compares four Latin American countries representing different stages of the epidemiologic transition. In recent decades, demographic changes, rapid urbanization and industrialization, and improved health care and nutrition have combined to produce the long-term changes in patterns of health and disease that are known as the epidemiologic transition. Conditions related to demographic aging and changing risk factors have gradually displaced infectious diseases as the principal cause of death. Chronic and degenerative diseases have emerged as the principal causes of death in most Latin American countries. Socioeconomic, demographic, and epidemiologic data were obtained from the Pan American Health Organization, Latin American Demographic Center, World Bank, government records, and other sources for Chile, Guatemala, Mexico, and Uruguay, as well as the US and Canada. Comparison of demographic indicators for 1970 and 1990-95 shows the countries to be in different phases of their demographic transitions. Guatemala's general mortality rates are declining, but fertility indicators and natural increase rates are still high. Mortality and fertility rates in Chile and Mexico are in decline. Uruguay's demographic indicators are similar to those of Canada and the US. The segment of population under age 15 has declined in all the countries, although it is still 40% in Guatemala. The urban population has increased in all four countries, but 60% of Guatemalans still live in rural areas. Access to potable water and sanitary sewage disposal is still limited in Guatemala and Mexico, and the illiteracy rate in Guatemala is a high 45%. Per capita gross national product has been stable and health spending low in all the countries over the past 2 decades. Guatemala is in a pre-epidemiologic transition stage, with 61% of deaths caused by communicable diseases, compared to 22% in Mexico, 13% in Chile, and 7% in Uruguay. Communicable diseases are declining in Mexico, but they are still the second major cause of death after cardiovascular diseases. Chile and Uruguay have cancer death rates similar to Canada and the US. Mexico and Guatemala have the lowest mortality rates for cancer and cardiovascular diseases.