The current rapid population growth in many developing
countries is the result of an historical process in the course of which
mortality rates have fallen significantly but birthrates have remained
constant or fallen only slightly. Whereas, in industrial countries, the
drop in mortality rates, triggered by improvements in nutrition and
progress in medicine and hygiene, was a reaction to economic
development, which ensured that despite the concomitant growth in
population no economic difficulties arose (the gross national product
(GNP) grew faster than the population so that per capita income (PCI)
continued to rise), the drop in mortality rates to be observed in
developing countries over the last 60 years has been the result of
exogenous influences: to a large degree the developing countries have
imported the advances made in industrial countries in the fields of
medicine and hygiene. Thus, the drop in mortality rates has not been the
product of economic development; rather, it has occurred in isolation
from it, thereby leading to a rise in population unaccompanied by
economic growth. Growth in GNP has not kept pace with population growth:
as a result, per capita income in many developing countries has
stagnated or fallen. Mortality rates in developing countries are still
higher than those in industrial countries, but the gap is closing
appreciably. Ultimately, this gap is not due to differences in medical
or hygienic know-how but to economic bottlenecks (e.g. malnutrition,
access to health services)
Spatial Approach to Diseases of Affluence Epidemiology and Regional Economic Development