It is, therefore, not a global relationship, neither in all places nor at all times, capable of explaining the generalization of the demographic transition worldwide.
In the next section, we will analyze the demographic transition in Latin America and the Caribbean in order to illustrate the diversity and particularity of developments. Having begun around 1900 in the south of the subcontinent, it has barely started in some countries today. The temporal and spatial disparities are very important, depending on social, economic and cultural contexts.
1.5. The demographic transition in Latin America and the Caribbean
The first phase of the Latin American demographic transition began at the end of the 19th century, when mortality declined in countries with high European immigration (Argentina, Cuba, Uruguay) and large cities, with the best urban and hygiene services of the time, inspired by Paris or New York14. At the beginning of the 20th century, the lowest crude death rates were found in Uruguay (14 per thousand), Argentina (20 per thousand), Cuba (24 per thousand) and Panama (21 per thousand), whereas the rest of the countries recorded crude death rates above 30 per thousand (Delaunay and Cosio Zavala 1992, p. 17). For the whole of Latin America15, Arriaga estimated life expectancy at 25 years around 1825, and at 27 years around 1900 (Arriaga 1968), a considerable delay compared to European levels, which reached around 41 years for life expectancy by 1840 in Sweden, England, Wales and France (Vallin 2003, p. 5). Large differences were also observed within the subcontinent, depending on regions, infrastructure and economic and social development levels. In Cuba, for example, life expectancy in 1910 reached 34 years for men and 37 years for women (Albizu-Campos 2000). The decline in Cuban mortality was particularly rapid and Cuba has the lowest infant mortality rate in Latin America, with a rate of four deaths of children under the age of 1 per thousand births between 2015–2020 (United Nations 2019a, Mort/1-1).
Table 1.3 shows the changes in life expectancies and the infant mortality rate between 1950 and 2020.
1.5.1. The modes of accelerated mortality reduction
In the mid-20th century, the rapid decline in mortality spread throughout Latin America and the Caribbean (Table 1.3). In two decades, between 1950–1955 and 1970–1975, life expectancies at birth increased by almost 10 years, and between 1980–1985 and 2000–2005, the increase was 7 years. Over the last period, between 2000–2005 and 2015–2020, the increase was 3 years. Then, during the 1980s, the “lost decade”16, the progress in mortality slowed down (Table 1.3) due to the Latin American economic crisis. The end of the 2000s also saw a stagnation in mortality, as the health transition now tackles chronic, degenerative diseases and violent causes, in a context of increasing social inequalities, demographic aging and great disparities between cities and rural areas, depending on gender and educational level.
However, over the whole 1950–2020 period, life expectancy at birth increased by 23.8 years (3.4 years per year on average). The infant mortality rate decreased from 126 deaths in 1950–1955 to 59 in 1980–1985, then to 15 deaths of children under the age of 1 per 1,000 births in 2015–2020. Therefore, according to these two indicators, the decline in mortality was particularly swift, reaching 75 years of life expectancy at birth in 2020 for both sexes (Table 1.3).
Table 1.3. Life expectancy at birth and infant mortality in Latin America and the Caribbean: 1950–2020 (sexes combined)
(source: United Nations 2019a, File/Mort 1-1 and Mort 7-1)
1950–1955 | 1970–1975 | 1980–1985 | 2000–2005 | 2015–2020 | |
Life expectancy (years) | 51.4 | 61.2 | 65.3 | 72.3 | 75.2 |
Infant mortality rate (per thousand) | 126 | 80 | 59 | 25 | 15 |
Between 1950–1955 and 2015–2020, life expectancies at birth converged among nations. Between 1950–1955, the lowest values were 38 years in Haiti and 40 years in Bolivia; the highest, 63 years in Argentina and 66 years in Uruguay: the difference was 28 years between the two extreme values. Between 2015–2020, Costa Rica reached 80 years of life expectancy at birth; Haiti had the lowest value (64 years), which is a 16 years difference between extreme values (Figure 1.1). Spanning seven decades, mortality declined more rapidly in countries with high initial levels (Honduras, Peru and Nicaragua). Bolivia gained 31.5 years of life expectancy at birth, which is considerable from its initial level of 39.6 years. In Mexico, rapid progress has stalled since 2000, following an increase in homicides (Cosio Zavala 2017, pp. 25–27). In Argentina, the increase is steady, whereas Costa Rica has drawn level with and then overtaken Cuba (Figure 1.1).
For Latin America and the Caribbean as a whole, between 2015–2020, female life expectancy at birth (78.5 years) was 6.5 years higher than that of men (72 years). For women, the two extreme values in 1950–1955 were those of Uruguay and Haiti (69 and 39 years, respectively), a difference of 30 years, whereas in 2015–2020, the difference between Costa Rica (83 years) and Haiti (66 years) was 17 years. Among men, in 1950–1955, the difference between extreme values was 27 years (63 years in Uruguay versus 36 years in Haiti), and 16 years in 2015–2020 (77 years in Chile and Costa Rica, and 61 years in Haiti) (United Nations 2019a, Mort/7-2 and 7-3). There is, therefore, a certain convergence in mortality between countries over time, although that of men continues to be higher than that of women.
Between 2015 and 2020, we can classify the mortality of Latin American countries into three groups, based on life expectancy at birth for women, which have the most favorable values:
– In a first group, it exceeds 80 years in Cuba, Argentina and Uruguay, which had low mortality levels since the beginning of the demographic transition17. This also includes countries that experienced rapid progress in the medical field and in health (Chile, Costa Rica, Panama) and many Caribbean islands in relation to their metropolises (Barbados, Curaçao, Guadeloupe, Martinique, Puerto Rico, Virgin Islands). Infant mortality rates are low within this group: between 4 (Cuba) and 18 (Panama) deaths of children under the age of 1 per thousand births (United Nations 2019a, Mort/7-3).
– The second group is between 75 and 80 years: Brazil, Colombia, Ecuador, Peru, Paraguay, Venezuela in South America; Belize, El Salvador, Guatemala, Honduras, Mexico, Nicaragua in Central America; Antigua, Aruba, Bahamas, Dominican Republic, Jamaica, Saint Vincent and Trinidad and Tobago in the Caribbean. These countries reached 70 years in the late 1980s, except El Salvador, Guatemala, Honduras and Nicaragua, with around 60 years around 1980. But these Central American countries quickly drew level, reaching the values of the second group in the 1990s. Infant mortality rates reached between 15 and 20 deaths of children under the age of 1 per 1,000 births in Venezuela (15), Mexico (17), Peru (18) and Brazil (20); they ranged from 23 to 31