Morbidity and Mortality Trends

Epidemic and Demographic Transition

The most common causes of death and disease in the 19th century were acute and contagious. During the 20th century an epidemic transition occurred whereby the most common causes of morbidity and mortality became chronic and noncontagious (see Table 1.5, p. 12). This epidemic transition paralleled the demographic transition (increased longevity, decreased fertility, aging of the population) of the same time. 

Mortality Trends

Figure 1.3 (p. 12) displays selected mortality trends over the later part of the 20th century. From this it is clear that overall mortality has declined steadily. Trends for specific diseases include:

• Cardiovascular and cerebrovascular disease mortality has declined dramatically, by about 50%.
• Cancer rates overall have been relatively stable, with modest declines over the past 10 or so years.
• Deaths due to external causes (e.g., motor vehicle fatalities, medical accidents, homicide) has increased slightly.
• Chronic obstructive pulmonary disease rates have been on the rise.
• Pneumonia and influenza are still important causes of death.

Life Expectancy

See figure 1.5 on p. 14 displays specific trends. Life expectancy has increased in all groups. Still, women generally outlive men and whites outlive blacks. The rank order of life expectancy by gender and race is: white women, black women, white men, black men.