Changes in Mortality by Disease

Abstract

In this chapter we give an overview of mortality by disease, with the intention of marking out those groups of diseases that have diminished or increased in importance as a cause of mortality. It is customary to think of the declines of mortality rates as a national, continental, or even worldwide phenomenon, the result of medical, social, and economic forces. For some eras, it is easy to look back and pick out the salient features as the supposed reasons for the declines; for example, the declines of the last 80 years may be thought of as being part of some general long-term demographic process, temporarily disturbed by the influenza epidemic of 1918–1919; but, over a longer period, there have been many greater pestilences, perhaps only in a region, for example, plague, typhus, smallpox, or even measles, and these ideas of a continuing process may be quite irrelevant. Some of these pestilences have been so intense that it is illusory to speak of a decline or improvement in mortality in any era and region in which they have been fully active; they act as “shocks” to the system. Nevertheless, the mortality rates in the developed world have declined rather consistently, and in many instances generalizations can be made that are relevant to all or to most of the developed countries.