Kirk (1996) said that in Europe, the mortality decline, the chief cause of population growth occurred in four phases. In the first phase, up to the latter part of the eighteenth century some improvement in mortality may have occurred due to an improvement in income but nothing is known about this period. In the beginning of the latter part of the eighteenth century, mortality started falling mainly due to public order created by the modern state. Other factors such as improvement in agriculture, improved nutrition, improved hygiene, improvement in infrastructure and means of transportation and communication, and reduction in famines and epidemics, also helped in reducing mortality levels. Yet, the improvement in mortality occurred independently of medical intervention. In the third phase, from the last third of the nineteenth century to World War I, improvement in mortality occurred due to medical discoveries, particularly due to control of diseases like diarrhoea and tuberculosis. Finally, in the fourth phase, during World War II and afterwards, discovery of penicillin and other chemicals reduced mortality due to epidemic and contagious diseases. Thus it is perhaps not correct to say that advancement in medical sciences is the major factor in improvement in mortality in the nineteenth century.
The case of less developed countries is different. Here, much of the mortality decline occurred after World War II when a large number of them became independent and the national governments in the new countries took special interest in promoting health and nutrition with financial support from outside. This was the time when DDT, antibiotics and other drugs were already available in the developed countries and the less developed countries had to apply them to control infectious diseases as part of public health programme. In this period, mortality improved in all less developed countries suddenly and this happened irrespective of culture, religion, level of economic development, ideology and social structure, though the positive correlation between development and life expectancy continued. This sudden decline in post-War mortality in the less developed countries caused population explosion and in several of them population was found growing at rate three percent and above. This suddenness created disequilibrium in society. We do not yet understand the full implications of this. |
