Convergences and divergences in mortality

Abstract

Abdel Omran's 1971 theory of Epidemiologic Transition was the first attempt to account for the extraordinary advances in health care made in industrialized countries since the 18th century. In the framework of the Demographic Transition, it implied a general convergence of life expectancies toward a limit imposed by the new epidemiological features of modern societies. However, important failures, occurred in the past decades (mainly the health crisis in Eastern Europe and AIDS in Africa), seem to have stopped that process of convergence. In fact such failures do not really contradict the theory. The latter is much more ruined by the unexpected dramatic improvement in the field of cardiovascular disease experienced since the seventies, which results in a new step of a more general process. On the basis of the broader concept of “Health Transition” initiated by Julio Frenk et al., the present paper tries to rethink the full process in term of divergence/convergence sequences inferred by successive major changes in health technologies and strategies. 1 Institut national d'etudes demographiques, 133, bd Davout 75980 Paris Cedex 20, France. Email: vallin@ined.fr 2 Institut national d'etudes demographiques, 133, bd Davout 75980 Paris Cedex 20, France. Email: mesle@ined.fr Demographic Research – Special Collection 2: Article 2 -Determinants of Diverging Trends in Mortality -12 http://www.demographic-research.org