|The Nutrition and Health Transition of Democratic Costa Rica (INFDC, 1995, 228 p.)|
|4. Evolution of an epidemiological profile|
Mortality decreased substantially between 1940 and 1970 (down from 17.1 to 6.6/1,000, during these 30 years, representing an average annual reduction rate of 2.1 %) than infant mortality (down from 132.4 to 61.5/1,000, representing an average annual reduction rate of 1.8%). The under-five mortality remained high but nevertheless decreased from 51.8% to 40.9%, while mortality among people aged 50 years and older increased from 22.9% to 41.6%. Life expectancy at birch increased from 46.9 years at the beginning of the period to 68.1 between 1965 and 1970.
Mortality caused by infections and parasites began to decline. Infectious and parasitic diseases accounted for 47.6% of coral deaths in 1940 and 20.5% in 1970. The prevalence of these diseases declined from 81.31 10,000 in 1940 to 13.6/10,000 in 1970, representing an annual reduction rate of 2.8%. Malaria declined so much thee by the end of this stage it was considered to be practically eradicated.
By contrast, motor vehicle accidents became an important cause of death. During this period, particularly during the 1950s, the economy grew in a sustained and substantial fashion and a new style of development was adopted. The government expanded its field of action and adopted policies that allowed it to provide a large number of jobs and to allocate a substantial amount of resources for the provision of public services. Illiteracy declined from 26.7% to 11.2%.
The enormous technological advances that took place throughout the world provided useful insecticides for the fight against several pathogen carriers, new vaccines for the prevention of some diseases and effective drugs for treating diseases, as well as new and better equipment for diagnosis and treatment. This period represents the beginning and rapid development of the era of antibiotics.
The government of Costa Rica defined a group of social policies. Among them, chose that led to the creation and expansion of the Social Security Institute deserve special mention. Health coverage was expanded with the construction of new hospitals and the replacement of the old hospitals that were incapable of satisfying the demand. A large variety of government, private, and volunteer health organizations remained, which were not adequately coordinated even though they received some funding from the government (Sz, 1983).
Even though the health policies were still based on the curative approach, as indicated by the face that 80% of the budget was allocated to hospital care, legislation was created to protect public health, new specialized entities were created for preventive health, and new organizations were created at the local level.