|The Nutrition and Health Transition of Democratic Costa Rica (INFDC, 1995, 228 p.)|
|4. Evolution of an epidemiological profile|
In order to facilitate the analysis of the events that have taken place in the area of health during this century, the author considers that it is convenient to divide them into several stages based on specific characteristics involving the behavior of health indicators as well as the socioeconomic situation and the response of the country institutions to what at the time were considered the most important health problems:
· In an initial stage, which covers the first four decades of this century, mortality rates were high and fluctuating, with a clear predominance of infectious and parasitic diseases among children under five years of age. The predominant health activities involved the creation and institutionalization of entities whose mission was to solve specific problems.
· A clear mortality decline can be observed between 1940 and 1970 at the same time that infectious and parasitic diseases continued to be prevalent. During this stage, health actions were based on the treatment approach.
· During the 1970s, a dramatic decline in mortality and morbidity due to infections and parasites can be observed in all age groups. During this stage, a cohesive see of policies and health strategies guided the activities following a broad preventive approach.
· During the 1980s, the country experienced the worst socioeconomic crisis, and the government reduced the resources allocated to the health sector. Whereas during the first half of the 1980s the rate of decline in mortality decreased, during the second half of the past decade a greater improvement in health indicators was observed coinciding with a resolution of the crisis, a modest increase in resource allocation and continuing decentralization of the health sector.
· The last decade of this century will be the final stage. The trends observed during the last decade allow for the prediction of the probable evolution of the health status and principal causes of death in all age groups and geographic regions, assuming that new factors do not cause a deviation from past trends.