2. Demographic and Epidemiological Characteristics of Major Regions, 1990—2001

Abstract

Health status is both a determinant of population changes, largely through population aging, and a consequence of population growth, with smaller family size associated with lower mortality.

Priority setting in health increasingly depends on the availability of reliable information on diseases, injuries, and risk factors for populations in transition. While most countries undertake routine data collection, these efforts are highly variable in terms of both quality and what is being measured.

Data suggest that more attention should be paid to the key demographic trends of the 1990s, including rapidly falling fertility worldwide, rapid aging of populations, and unprecedented mortality increases in Europe and Central Asia and Sub–Saharan Africa. Key quantitative findings about global demography relevant for disease control and public health development lead to the following conclusions: (1) because of a lack of investment in the health intelligence base needed to monitor and evaluate population health, very little is reliably known about the levels and causes of adult mortality for much of the developing world; (2) demographic change is often poorly understood in relation to health and social development policies; and (3) despite two decades of intense global effort to reduce child mortality, not enough is known about the major causes of death among children to resolve uncertainties about the progress of specific disease control strategies. Action to reduce the enormous burden of premature mortality will be better served if policy makers are more appropriately informed about the causes of death.