In Venezuela, mortality related to nutritional deficiencies was low with a total of 178 cases in 1973 and 391 cases in 1981, affecting mainly children under the age of 12 months. In 1988 the System of Nutritional Surveillance (SISVAN) reported that the majority of hospital admissions with serious nutritional deficit were those with inadequate weight-height ratio: 37.0% of children under 1 year of age in 1988 and 46.4% in 1989. In 1988 SISVAN reported a decrease in the weight-height deficit in children under 10 years of age: 28,609 children in 1988 and 28,548 in 1989; whereas the age group from 2 to 6 years was the most affected by such deficit. Overall, however, there had been a slowdown in the improvement in child nutrition with the increase of grave malnutrition according to 1988 and 1989 data. 1990 and 1991 data showed an improved situation as a result of better use of state medical services by families and the milk program, indicating a decrease of the weight-height ratio deficit in children under 10 years of age: 18.0% in the first trimester of 1990 and 14.0% in 1991, along with the reduction of grave deficit from 0.9% in 1990 to 0.6% in 1991. Feeding as a determinant aspect of nutrition deals with the precarious nature of existing supplies, the diminution of acquisitive capacity, and the habits of consumption. The initiatives of the state for overcoming the situation include the basic basket of foodstuffs, direct subsidies to the low income population, and programs that fight nutritional deficiencies of children, such as the Expanded Maternal-Child Nutrition Program (PAMI). Households of daily care constitute the regional initiatives and the ability of the state to maintain these programs. The responses of urban centers before this initiative included a successful experiment, the center of education and nutritional recovery, and the child survival program.

In the 1980s, urbanization in Central America was increasing compared to the three previous decades. By 1990, the urban population reached 42% in Guatemala, 44% in El Salvador, 43% in Honduras, 59% in Nicaragua, 53% in Costa Rica, and 54% in Panama. The urban population increased mostly in the largest cities, in contrast to Latin America, where secondary cities grew fastest. This trend was particularly true in Managua and San Salvador because of the military conflicts. The only exception was Honduras, where the second city underwent stronger growth. The urban population comprised 51.7% women and 48.3% men in Central America. The segregation and polarization of social classes was also increasing because of increased poverty and unemployment during the 1980s. This was partly caused by the increasing privatization of public services, decentralization, and the reinforcement of local governments, which all ensued from the structural readjustment programs of the International Monetary Fund. This neoliberal model of economic development in the short run resulted in increased poverty and unemployment for the urban populations. In 1982, the informal sector represented 29% of the total employment in Central America, and its share reached 40% in Managua and San Salvador. Urban unemployment increased from 2.2% in 1980 to 12% in 1988 in Guatemala; from 8.8% to 13.1% in Honduras; and from 10.4% to 20.8% in Panama. In the political arena, the process of democratization was underway, with civil presidents taking power and promoting privatization and deregulation of the economy. There was a close relationship between the urban social structure, the economy, and politics in the region. In Costa Rica, during the Arias administration between 1986 and 1990, a program was implemented creating 80,000 new homes, and in El Salvador there was an increasing demand to find a negotiated solution to the military conflict. These new political and economic perspectives could lead to genuine popular participation in solving urban problems.

The decade of the 1980s was catastrophic for the countries of Latin America because of profound transformations in the world economy, which started in the 1970s, the wilting of the state development programs that were imposed after World War II, and the collapse of socialism with the incipient transition to market economies. The crisis started because of the erosion of the world economic system as constituted under the Bretton Woods agreement; the drastic drop in the economic growth of market economies; the increased costs of living and the deterioration of the environment; the decrease in industrial capacity; and the emergence of transnationalization of production. In Latin America, the economic models that had been in place without solving underdevelopment became even more obsolete (import substitution, internal trade, and the role of the state). The crisis of socialism and the rapprochement of eastern European countries to western Europe also affected Latin America (e.g., Germany cancelled 30 mine exploration projects in Bolivia due to investments in East Germany). The structural readjustment policies of the International Monetary Fund and the World Bank resulted in currency devaluations, redistribution of government funds, elimination of various subsidies, reduction of public debt and social expenditures, reduction of public employment, and payment of external debt. The result was more inflation (in Bolivia, Brazil, Peru, and Argentina, inflation rates were 683.7%, 157.1%, 100.1%, and 326.2%, respectively, between 1980 and 1986), unemployment, and poverty in the lost decade of the 1980s. After 1982, state expenditures on roads, education, hospitals, and nutrition declined by 40% in Mexico. Even though most countries returned to democracy in the region, this was at the cost of the increased role of the military and the transnationals. The grand parties collapsed and in Venezuela, Mexico, and Colombia authoritarian tendencies survived into the 1970s degrading democracy. The states' socioeconomic regulatory role has to be redefined.

This work argues that the economic crisis in Latin America resulting from structural adjustment programs and recession has had deleterious effects on the relationship between demographic factors and health. 2 works presented at the 1989 International Union for the Scientific Study of Population meeting in New Delhi considered the difficulty of demonstrating unambiguously the demographic effects of the economic crisis. This work, instead of looking at overall rates which may not have been greatly affected, focuses on 3 specific areas that reflect the relationship between population and health in the context of the crisis. Although the infant mortality rate has continued to decline in almost all countries and regions of Latin America during the crisis, the decline has been unequal in different sectors. A comparison of data from the 1987 National Survey of Fertility and Health in Mexico with that of the 1982 National Demographic Survey shows that rural infant mortality declined by only 1% between the 2 surveys, while urban infant mortality declined by 21%. An indicator of available services in the household showed the same increase inequality. Disaggregation of infant mortality data for Mexico suggests that even a presumably biological determinant, maternal age, loses much of its weight when socioeconomic factors are considered. Other studies, on the impact of maternal education, similarly indicate that the relationship is different for different social sectors. The infant mortality data taken together suggest that infant mortality continues to ba a valid indicator of social inequality, and that the crisis has had the effect of increasing inequality and worsening the relative conditions of the least advantaged. In the area of fertility, data from the 1989 National Survey of Fertility and Health in Mexico are used to argue that family planning programs are integral components of an authoritarian governmental political style. The survey indicated that sterilization is now the most commonly used contraceptive method in Mexico and that fully 12.4% of sterilized women did not make the decision to be sterilized themselves. 34% of illiterate women who were sterilized did not make the decision themselves. 14% of all the women but 33% of illiterate women reported they would not be sterilized if they could make the decision again. These data and others on the high proportion of women who undergo sterilization at young ages and low parities and without being informed of other methods suggest that the attitude of the official family planning program is becoming more authoritarian and less respectful of human rights as it seeks to curb population growth. The area of health effects has usually been ignored in migration studies. The phenomenon of Mexican migrant workers in the US who return to Mexico after contracting AIDS is an obvious example of the link between population variables and health.