Societies in transition: mortality patterns in Pacific Island populations.

The 22 Pacific Island countries and territories are in a state of demographic and epidemiological transition. Mortality data for the period around 1980 were collected from various sources and are presented in this comparative study. Because death registration in many Pacific countries is deficient some data have been adjusted for underenumeration; and some mortality estimates have been calculated by indirect means, using data from censuses or surveys. Cause of death information is affected by diagnostic inaccuracy and often tabulated in broad categories only; in some Pacific countries cause of death data are only available on hospital deaths. The less developed Melanesian malarious countries and the less developed dispersed atoll nations manifest higher mortality, and higher proportional mortality from infectious disease compared with other states. The more developed US-associated states, two New Zealand-associated states, and New Caledonian Europeans all have reasonably low mortality, and relatively high proportional mortality from cardiovascular disease (CVD). Females have longer life expectancy at birth than males in all countries except Vanuatu and the Solomon Islands. The phosphate-rich island of Nauru presents an atypical picture with considerable adult male mortality from diseases associated with modernization.