BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

124* Patternsof Mortality in Childhood
ing countries, as was made clear by Gordon areas, and therefore is discussed for that
et al. (1967). Mortality in the ages 2-4 three-year age group combined, and not by
years is relatively low in many of these single years of life.
MORTALITY IN CHILDREN 1-4 YEARS OF AGE
In all areas in the Latin American projects,
with but two exceptions, more than
half the deaths in this four-year age group
were in the second year of life, that is, at
one year of age. The exceptions were the
interior cit.y of Frunca and rural El Salvador.
The wide variations in mortality in this
age group were illustrated previously in
Figure 35 (Chapter IV).
When mortality was high, the group of
infectious diseases usually was responsible
for more than half the deaths. Table 65
gives the numbers and rates for all causes
and for infectious diseases as underlying
causes, with subdivisions for diarrheal disease,
measles, and other infective and parasitic
diseases. These data for the 25 areas
are )rescnted in two figures: the 13 areas
with higher rates appear in Figure 61 and
the 12 with lower rates in Figure 62 (with a
smaller scale).
The role of the infectious diseases differs
markedly in these two groups of areas; in
the first, more than half the deaths from all
causes were due to these diseases (with one
exception, Franca). In fact in the rural
municipios of El Salvador more than twothirds
of the deaths resulted from infectious
diseases.
In the 12 areas with lower rates (Figure
62) infectious diseases were reponsible for
half the deaths in only one area, the city of
Ribeirito Prfto. In cities such as San Juan
and Santiago only 29 and 23 per cent of the
deaths were due to this group of causes. In
San Francisco only one of the 25 deaths of
children aged 1-4 years had an infectious
disease as underlying cause, and in the suburban
counties of California only four of"89.
Although diarrheal disease was respons ­
ble for high death rates in several areas in
this age group, measles also was an important
contributor to mortality. In Recife anti
Silo Paulo it caused over twice as many
deaths as did diarrhcal disease. In Viacha
and La Paz, the rates for measles were
nearly as high as those for diarrheal disease.
In analyzing the role of infectious diseases
as underlying causes in this age group, it is
necessary to consider also the part played
by nutritional deficiency as underlying or
associated cause. These data are presented
in Table 66. The associated causes have
been divided into those in which nutritional
deficiency was a contributor and those in
which it appeared as a consequence.
Tile close relationship between death rates
for nutritional deficiency and those for all
causes can be seen clearly in Figure 61. The
rates for this deficiency as a contributory
cause were high. It seems evident, therefore,
that to reduce mortality from all causes,
prevention of this condition as well as of
infectious diseases is essential; deaths from
infectious diseases often occur in precisely
those children who are most susceptible, i.e.,
those with nutritional deficiency.