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- ItemAcesso aberto (Open Access)O envelhecimento da população mundial: um desafio novo(Faculdade de Saúde Pública da Universidade de São Paulo, 1987-06-01) Kalache, Alexandre; Veras, Renato Peixoto; Ramos, Luiz Roberto [UNIFESP]; London School of Hygiene and Tropical Medicine Unit for the Epidemiology of Ageing; Universidade do Estado do Rio de Janeiro Instituto de Medicina Social; Universidade Federal de São Paulo (UNIFESP)Ageing has now become a universal phenomenon, of increasing importance to developed and developing countries alike. In this, the first of a series of articles on ageing in developing countries, the actual demographic revolution is discussed, with special reference to Brazil. Estimates are provided up to the year 2025. The article analyses the factors which are responsible for this ageing process - such as the rapid decline in fertility and mortality rates that many Third Word countries have been experiencing over the last few years - and the various gradual stages of this process, which is usually referred to as the 'epidemiological transition', are discussed. The consequences for any society with a population that is gradually becoming older are considerable, and are of particular importance for the Health Sector. The article discusses the changing morbidity and mortality patterns and the concept of autonomy as a possible way to quantify quality of life is introduced. On this particular point a suggestion is made to redefine the concept of 'Ageing', in order to take into consideration the context in which senior adults in the Third World live. Finally, the article addresses itself to points relating to the interaction of ageing and social change. That there is such an interaction is apparent in developing countries and this raises questions to which answers could be found through the use of the epidemiological method.
- ItemAcesso aberto (Open Access)Envelhecimento populacional: uma realidade brasileira(Faculdade de Saúde Pública da Universidade de São Paulo, 1987-06-01) Ramos, Luiz Roberto [UNIFESP]; Veras, Renato Peixoto; Kalache, Alexandre; Universidade Federal de São Paulo (UNIFESP); Universidade do Estado do Rio de Janeiro Instituto de Medicina Social; London School of Hygiene and Tropical Medicine Unit for Epidemiology of AgeingIt was focuse on the ageing process in Brazil, giving evidence of the boom of elderly people in the country, bearing in mind that by the year 2025 they will represent the 6th largest elderly population in the world. Data are presented showing that both Infant Mortality Rates and Fertility Rates have been decreasing significantly for the whole population since 1940 and 1960 respectively. Age-sex pyramids are analysed in the light of the demographic changes. It is stressed that the elderly have been the fastest growing age-group in Brazil since 1940. In fact, from 1980 up to the year 2000, the over-60s will increase 107% whereas the under 15s will increase only 14%. Comparing the rates of growth for the elderly populations in England and Brazil, the tendency is to have a decreasing rate of growth in England (230% between 1900-1960 and 80% between 1960-2025) and an increasing rate of growth in Brazil (497% and 917% respectively). Life tables are presented from 1950 to 1982 for the population of S. Paulo (a highly industrialised urban area). Life Expectancy, Survival, and Mortality Rate curves are generated from these life tables. The data show that the expectation of life at birth in S. Paulo State (Brazil) has risen from 57 years in the 50's, to 70 years in 1982. Interestingly enough, in that year, a woman in the county of S. Paulo, after the age of 45, could already expect to live more than women of the same age in England. In terms of survival chances, 77% of the cohort of women born in the county of S. Paulo in 1982 are expected to be alive at the age of 65, compared to 85% in England. Figures for men are 62% and 75% respectively. It was concluded that although far from solving the problems related to the very young, the Brazilian authorities are already facing an ageing process comparable to that experienced by the developed countries, with all its implications for the health and social care systems.