This book examines issues concerning how developing countries will have to prepare for demographic and epidemiologic change. Much of the current literature focuses on the prevalence of specific diseases and their economic consequences, but a need exists to consider the consequences of the epidemiological transition: the change in mortality patterns from infectious and parasitic diseases to chronic and degenerative ones. Among the topics covered are the association between the health of children and adults, the strong orientation of many international health organizations toward infant and child health, and how the public and private sectors will need to address and confront the large-scale shifts in disease and demographic characteristics of populations in developing countries.

Contents

• WORKSHOP ON THE POLICY AND PLANNING IMPLICATIONS OF THE EPIDEMIOLOGICAL TRANSITION IN DEVELOPING COUNTRIES
• COMMITTEE ON POPULATION
• INSTITUTE OF MEDICINE BOARD ON INTERNATIONAL HEALTH
• Preface
• Introduction
• Shifts in the Structure of Population and Deaths in Less Developed Regions
  • Introduction
  • Population Growth and Age Structures
  • Distribution of Deaths by Sex and Age
  • Summary
  • References
• Mortality By Cause, 1970 to 2015
  • Background
  • Method
  • Results
  • Discussion
  • References
• Childhood Precursors of Adult Morbidity and Mortality in Developing Countries: Implications for Health Programs
  • Introduction
  • Background
  • Classification of Diseases or Conditions of Infancy and Childhood with Consequences for Adults
  • Synergism of Childhood Risk Factors Producing Adult Disease
  • Influence of Childhood-Acquired Diseases on Adult Mortality—Country Studies
  • Conclusion
  • References
• Projecting Morbidity and Mortality in Developing Countries During Adulthood
  • Introduction
  • Combining Multiple Data Sources
  • Forecasting Model Based on Individual Health Changes
  • Examples
  • Summary
  • References
• Health Indices as a Guide to Health Sector Planning: A Demographic Critique
  • Introduction
  • Background
  • Evaluating the Effectiveness of Health Interventions
  • Discussion
  • Summary
  • References
• Health Policy Issues in Three Latin American Countries: Implications of The Epidemiological Transition
  • Introduction
  • Conceptual Framework for Examination of Policy Implications
  • Health Policy in Brazil, Colombia, and Mexico
  • Health Policy Issues and Options
  • Conclusion
  • References
  • Appendix Economic, Social, and Health Status Characteristics of Brazil, Colombia, and Mexico
• Goals of the World Summit for Children and Their Implications for Health Policy in the 1990s
  • Introduction
  • Magnitude of the Summit Goals
  • Methods for Implementing Summit Goals
  • Summary and Conclusions
  • References
  • Appendix Goals For Children and Development in the 1990s (From Unicef, 1990a:31-35)
• Distributional Implications of Alternative Strategic Responses to the Demographic-Epidemiological Transition—An Initial Inquiry
  • Introduction
  • The Overall Situation
  • Range of Intracountry Mortality Differences
  • Framework
  • Age-specific Mortality
  • Cause-specific Mortality
  • Other Considerations
  • Conclusion
  • References
  • Appendix Intergroup Differences in Mortality Within Developing Countries
  • Notes
• Health, Government, and the Poor: The Case for the Private Sector
  • Introduction
  • Why is Government Health Spending Both Inefficient and Inequitable?
  • Future Effectiveness of Government Spending on Health
  • Examples and the Privatization Solution
  • Conclusion and Political Strategies
  • References
• Roles of Women, Families, and Communities in Preventing Illness and Providing Health Services in Developing Countries
  • Introduction
  • Traditional Society and Health Beliefs
  • Traditional Family and Community Structure—Implications for Care and Health Decisions
  • Transitional Society
  • Identifying Policy Paths
  • Other Stages of the Epidemiologic Transition and Questions of Adult Mortality
  • References

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce Alberts and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council.