Demographic and Epidemiological Characteristics of Major Regions, 1990–2001

Excerpt

This chapter begins by providing an overview of global population trends in each major region of the world and the current size and composition of the population. Given this volume's focus on the descriptive epidemiology of diseases, injuries, and risk factors, we then examine trends in mortality over the past decade in more detail as background against which the current assessment of the disease burden might be more usefully interpreted. This includes both an assessment of trends in age-specific mortality and summary measures of the age schedule of mortality, such as life expectancy and the probability of dying within certain age ranges, as well as a specific discussion of trends in the main causes of child mortality. The focus on child mortality is entirely appropriate because (a) the fact that at the end of the 20th century, we remained woefully ignorant of its levels, let alone its causes, is highlighted; (b) the reduction of child mortality should remain a priority for global health development efforts, and the moral imperative to do so remains as relevant today as it was 30 years ago, when efforts to improve child survival became increasingly organized and focused; and (c) the resulting emphasis by the global public health community on reducing child mortality has yielded vastly more epidemiological information that can be used to assess trends in levels and causes. Nevertheless, we argue later in the chapter that large and unacceptable uncertainties about trends in cause-specific child mortality rates persist, with important implications for program planning and evaluation.