Epidemiologic transition theory and aging: Hispanic populations of North America and the Caribbean.

As the forces of social and economic development combine with epidemiological transitions, population aging will continue to impact world health status and the provision of health services. Epidemiology provides an interdisciplinary link to the traditional study of population change by enhancing the demographic parameters of fertility, life expectancy, and migration, with specific measures of mortality and morbidity in order better to predict the pace and concentration of aging within a population. In this article, the authors examine three theoretical models of epidemiological transition and offer historical (1950-1995) and projection (1995-2050) data for the development patterns in Cuba, Dominican Republic, Puerto Rico, and Mexico. They contrast trends in fertility, life expectancy ratios, and gender differences in these countries with the Hispanic population of the United States. Central to this study are the cause of death statistics presented to identify the model occurring in each country. Shifts in the gender mix at older ages are presented due to the decline in fertility and death associated with childbearing years and the timing of the transition from high mortality to infectious disease to high mortality from chronic and age-related disease.