Demographic Transition in the Americas * The population of Latin America increased from 11 distribution of risk factors that contribute to the million in 1700 to 30 million in 1850, with an annual appearance of diseases, the resources available, the growth rate of 0.6%. It had risen to 61 million by 1900 accessibility of health services, and their effectiveness and to 165 million by 1950; by 1995 it is estimated that in responding promptly to these changes. Regardless of the Latin American population will total 482 million, whether or not one accepts the validity of theories that which signifies annual growth rates of 1.4% between attempt to explain demographic and epidemiological 1850 and 1900, 2.0% between 1900 and 1950, and 2.4% changes in light of socioeconomic and political changes, during the second half of the present century. the fact that such changes have taken place cannot be Inasmuch as the size, growth, and age structure of a denied. Moreover, it seems highly likely that most of country's population are the result of the interaction of these changes cannot be reversed. three basic factors--mortality, fertility, and migration-- "Demographic transition" is understood to mean a any attempt to explain population dynamics in the series of stages characterzed by successive reductions medium and long term must first establish an interpretive in mortality and fertility. In order to define these stages, model that relates these variables with one another and the artificial indicators of mortality and fertility will be with other variables of economic and social development. used: life expectancy at birth (LEB) and total fertility The rapid population growth that has occurred worldwide rate (TFR). It will thus be possible to eliminate the in this century provided the basis for the theory of influence of age distribution, a problem that arises when demographic transition, which grew out of the historical crude death and birth rates are used. Owing to lack of experience of the western countries, especially those of generalized information, the variable "migration" will Europe, and viewed population growth as a feature of not be considered, although it is recognized that it is contemporary development. This theory attempts to impossible to study population dynamics in various formulate a generalized explanation of the process of countries of the Amercas without taking into account declining mortality and fertility observed in the developed migratory movements. As a clear illustration of the countries of Europe (excluding from the model, except importance of migration it suffices to point out that of i n isolated cases, the role of the migration). It postulates the 54 million emigrants who left Europe between 1815 a close relationship between the rate of population growth and 1930,50 million settled in the Americas, 32.6 million and the level of socioeconomic development. Although of them in the United States, 6.4 million in Argentina, in individual cases it cannot always be maintained that 4.7 million in Canada, 4.3 million in Brazil, and a large less population growth is synonymous with more number in Uruguay and Cuba, as well. development, in general there appears to an inverse Adapting L. Tabah's presentation of the subject in relationship between these two processes. "World Population at the Turn of the Century" (United As the trend toward lower mortality in the early years Nations, New York, 1989, ST/THAT/SER.A/111), this of life continues, the age distribution of the population article will separate the demographic transition into 5 will also change, as will the most prevalent health stages with the following levels of mortality and fertility: problems in most countries of the Region of the Americas. These changes, together with the clear reduction in Stage one (1,I): fertility observed in recent years, will undoubtedly result High mortality and high fertility. in an intensification of the trend toward aging in the LEB of under 45 years and TFR of more than 6.5. medium and long terms. With a growing proportion of the population entering adulthood and old age, the Stage two (2,2): epidemiological profiles of the countries of LatinAmerica Both mortality and fertility begin to decline, although will tend increasingly to reflect diseases and health the decline in mortality takes place first. problems of adults and the elderly rather than those of LEB of between 45 and 55 years and TFR children. In some countries--Chile, Costa Rica, Cuba, of between 5 and 6.5. Barbados, Bahamas--this process has been hastened in recent decades by rapid declines in infant and child Stage three (3,3): mortality. These demographic and epidemiological The declines in mortality and fertility accelerate. changes are occurring at different rates, depending on LEB of between 55 and 65 years and TFR of between existing fertility and mortality levels, as well as on the 3.5 and 5. 9 Epidemiological BulletinBuIletin 1 PAHO 9 Stagefour (4,4): Stagefive (5,5): Low levels of mortality and fertility. Very low mortality and fertility, below LEB of between 65 and 75 and TFR of Ibetween replacement level. 2 and 3.5. LEB of 75 or more years and TFR of under 2. Table 1 Demographic transition in the Americas: Total fertility rate, life! expectancy of birth, and stages in the transition, by country, 1950-55, 2020-2025 COUNTRY 1950-1955 1970-1975 1990-1995 2020-2025 TFR LEB SDT 1 TFR LEB SDT _ TFR LEB SDT _I TFR LEB SDT ARGENTINA 3.15 62.5 (4,3) 3.15 67.2 (4,4) 2.79 71.3 (4,4) 2.24 74.1 (4,4) ..B.HAM.-.. AS, . ....... =4.2..2, .,- ,. ,..,. 9. ., , .. ,3,,3>.... ,,.. 2 .01?:i:~:::ii~:2ii'-722:i:i:i iiiiii4.4i ii.: :1'.85. 7.'..:i::'.(:::ii77.i..iii..iii. li55 i: BARBADOS 4.67 57.2 (3,3) 2.74 69.4 (4,4) 1.80 75.6 (5,5) 1.85 79.3 (5,5) --6.-50-::' 46.7z "(2,2) :.4:56 61::::.:2 (t':3):>::: -:::::BOLI: ::VIA.';:::'. .-. - '.75:.::::6; .:ii:.:.40.4i :ii:::i<:1:iii iii i' ::i i :.': .'·'·'-- ':':':: ' i....... ::::::::2.55 CC -- :''::': :7:::: .-:72.iiiiiiii:i:iii: :::::::::-.::::.: = = == ::i .:. BRAZIL 6.15 51.0 (2,2) 4.70 59.8 (3,3) 2.75 66.2 (4,4) 2.00 72.1 (5,4) ..",'3.7 0 , . ,. 0 , ......, ",",'"3.,4. ... : 1'.97.. :71'.3 <5,4> 1,7 8 . 7.- .4 .:......i: (5i5......i i i1.80:: . 80.7:':::: r::·...:::: :':::::i:~:<:i5:,i)ii:.ii:;:::: 5i:.:: : ::: ::::::!iiii CHILE 3.63 63.6 (3,3) 2.66 72.0 (4,4) 2.25 74.6 (4,4) : C LOM BIA':;:::::::iii::::-:!.ii:;iii 4..66 61..7. (.3,3) COSTA RICA 6.72 57.3 (1,3) 4.33 68.1 (3,4) 2.34 79.4 (4,5) .... .- ...... .. ..... :1:. ... .. 75... .7..... ..55..... CU. BA. ... .-.... .. .'i'iE3.55,::. 70.9SE' ' *(3,4> 2...00 i.'::· 77::.0 i:i <:::::5,5).-.0. ECUADOR 6.90 48.4 (1,2) 6.05 58.9 (2,3) 3.62 66.6 (4,4) 2.13 72.5 (4,4) ::.-.LSALEVADOR!::E:L ::: 4 :::::::::::2.3 2) .1.-: . .,3.A.%'58:,:. ... .7. :..:.::.::- -- GUADELOUPE 4.49 67.8 (3,4) ............. ... .-...:. ....... 1.85 78.8 (5,5) i::::G::GU:ATEMALA .,i::: .7..096 ' 4.2.1' (1,"''""1"'') 6'ó.45: : ::"(2,'2>::'54.0 2.92.- .: . :i. :: -72.3..'. - :iiiiiiii: .iiiiii:. (4.4)' i ! ' GUYANA 6.68 52.3 (1,2) 4.90 60.0 (3,3) 2.55 65.2 (4,4) 2.10 72.8 (4,4) :i ":HAITi::' - : :::1 :; .: 630:37 6i'ii (2,1) *:.,5.7.6,' 48.5:: ",00'(2,2>: .iii. 7- i:..::i:i 66.1:.:::.i:ii: ;(3,4>:;i HONDURAS 7.05 42.3 7.38 54.0 (1,2) 4.94 67.3 (3,4) 2.69 73.6 (4,4) ' : :JAMAICA : - I.. , 2.....',. .. ,:':J:.. ::.. ::68.6' :' :(3,4) 2 3.1:':'~i3i:::i:: -::3:0.i:'iiii.:: : 6 :iiiiiiI( 4:i>ii:3(.4.)i:iii .. ...... : . v... ." . MARTINIQUE 5.71 56.5 (1,1) 4.08 69.2 (3,4) 1.99 76.2 (5,5> 1.85 79.8 (5,5) ;,'i MEXiCo :: :Ji: 6.37, :62:.9' ,;; : (82,3>- l?:o02.03 753(;4-,5i')'s:53!:.:-:-4 ': :::!;: ; NICARAGUA 7.43 42.3 (1,1) 6.79 55.3 (1,3) 5.04 66.7 (2,4> 2.55 74.1 (4,4) 5.68:- : .. .....5.5 ..3 . (2,3) 4.!94:.i:: ::66:.3::.i:,::i:::: : 3::: 4): ,i:ii~h::i:iii :i:i. : :::.:: :: (.::,:: : PARAGUAY 5.65 65.6 (2,4) 3.10 69.6 (4,4) ' 2::i'":7:::":::::::: .....: ... :iiiiiiii:i:3i::.i::.: ::i:7. : iiiiiiiiiiii::::2.- ;A :ii: i: i::-: ... ?,:::::!. ?. ..m:iilji? :. ......-i?-:i :.. ' i : :::::'~0:0!:i PUERTO RICO 5.02 64.8 ....-(2,3) ... .. ... 2.99 72.5 (4,4) ii : : 3:31:i: :i: :.i:72.:5 :, 4 :::.4:,:.>::¡Aiiiii E... Mi.DO NI.C... AN. " 7.,40-.: ::i461.0. " '59.9'.-' <-2,3>, :::p.· ...... .. 2.19 73.6 (4,4) iREii:PU BLICi:i. ...:- .i::. : : ....:..:.i TRINIDAD & 3.45 65.7 (4,4) 2.10 77.2 (4,5) TOBAGO ...URUGUAY ...2.7,3 66.:.'-....-'óóó.,1<(4,',4,)'. .3,00.3-0 :68.8:. : --,2'.09-0 ' l "7."4.6.......... (4.,4> ...- (4,4) : :.: .. : :.:.:::::.:::i. <'4:'.::::::::::. USA 3.45 69.0 (4,4> 2.02 71.3 1.80 79.7 (5,5) :::,V.ENEZUELA-- ::,,::i .. 46.......... .... ...... .: -.-............ .. .......i2,3) 4':498!:.-i: 66.2:: t3,4) .:: ::::i::::::. :::::'. i : :7:ii ii:ii:i:i: -: ' i:::,4):i 2.12 7:37 3.7 .ii-i <4·i,4>-.::- TFR = Total Fertility Rate LEB = Life Expectancy at Birth SDT = Stage of Demographic Transition (the first number in parenthesis refers to the fertility level and the second one to the mortality level; 1 indicates a high level of mortality or fertility, and 5 indicates very low moitality or fertility levels).