In 1940 infectious, parasitic, and respiratory illnesses accounted for nearly 70 percent of all deaths in Mexico. Three decades later, these illnesses still produced more than half of all deaths. By 1990, however, their share of the overall mortality level had dropped to around 20 percent. Cardiovascular illnesses, cancer, accidents, diabetes mellitus, and perinatal complications emerged as the top causes of death in 1990, a sharp change from the previous pattern. Yet despite the progress, health officials recognize the continuing serious threat posed by infectious, parasitic, and respiratory illnesses. Two such illnesses--pneumonia and influenza--and intestinal infections remained within the top ten causes of death in 1990. Among the twenty leading causes of death were such maladies as nutritional deficiencies, chronic bronchitis, measles, tuberculosis, anemia, and severe respiratory infections.
Government census data record a continuous and significant decline in infant mortality from 1930 to 1980 (see table 6, Appendix). The infant mortality rate stood at 145.6 deaths per 1,000 registered live births in 1930. It dropped to 96.2 by 1950, to 68.5 in 1970, and to 40.0 in 1990.
Wide regional variations in infant mortality levels persisted into the 1990s. The 1990 census indicated, for example, that infant mortality rates clustered around the mid-twenties in Baja California Norte, Baja California Sur, the Federal District, and Tamaulipas, and the mid-fifties in Oaxaca, Guerrero, Puebla, and Chiapas (see fig. 8). Even more dramatic variations could be found across municipalities. In general, the lowest levels appeared in highly urban municipalities, especially state capitals and metropolitan areas. In contrast, the highest rates typically were associated with remote, rural, and largely Indian communities.
Nationally, 52 percent of all recorded infant deaths in 1990 occurred during the postneonatal stage, when infants are most susceptible to infections and poor diet. Although perinatal complications accounted for 35 percent of all infant deaths in 1990, intestinal infections and influenza and pneumonia also remained important causes, representing 15 and 13 percent of infant deaths, respectively.
The government reported significant reductions between 1980 and 1990 in early childhood mortality. Early childhood mortality declined from 3.4 per 1,000 preschoolers in 1980 to 2.4 in 1990. Intestinal infections headed the list of causes of death, followed by measles, pneumonia and influenza, and nutritional deficiencies. Preliminary figures for 1991 suggested a sharp decline in early childhood mortality to 1.6 per 1,000 preschoolers. The 1991 figures pointed to notable statewide variations, with rates below one in Coahuila, Durango, Sinaloa, Sonora, Tamaulipas, and the Federal District, and above three in Chiapas, Oaxaca, and Puebla.
Maternal mortality also declined over the same period, with rates falling from 9.4 deaths per 10,000 registered live births in 1980 to 5.4 in 1990, and to 5.1 in preliminary 1991 data. Baja California Sur reported no maternal deaths in 1991, with several, mostly northern states--Chihuahua, Coahuila, Durango, Jalisco, Nayarit, Nuevo León, Sinaloa, Tabasco, and Tamaulipas--indicating rates below three deaths per 10,000 registered live births. In sharp contrast stood Oaxaca, with a rate exceeding fourteen deaths per 10,000 registered live births.
Although infectious diarrhea and severe respiratory infections have declined significantly as causes of mortality, they remain major illnesses in the early 1990s. Reported cases of infectious diarrhea escalated dramatically from 1,661 per 100,000 residents in 1980 to 2,906 in 1990, and to 4,685 in 1991. During the same period, severe respiratory infections climbed from 3,334 cases per 100,000 residents in 1980 to 10,800 in 1990, and to 13,732 in 1991.
Mexican health officials reported substantial progress in relation to several illnesses controllable by vaccination. Pertussis declined from 122.6 cases per 100,000 residents in 1930 to 4.4 cases in 1980, to 1.3 cases in 1990, and to only 0.2 cases in 1991. Chiapas's rate in 1991 stood at ten times the national average, however. The total number of cases of poliomyelitis declined from 682 in 1980 to seven in 1990 and to zero in 1991. The government recorded only a single case of diphtheria in 1991. Measles epidemics continued to occur, with rates surging from 24.2 cases per 100,000 residents to 80.2 in 1990 before falling sharply to 5.9 in 1991. Even here, however, improvement over past decades could be noted because epidemics occurred only every four or five years as compared with the previous pattern of occurring every other year. Somewhat less progress was apparent in the campaign against tuberculosis, with rates declining from 16.1 cases per 100,000 residents in 1980 to 14.3 in 1990.
Vector-transmitted illnesses remain major public health challenges, especially in southern Mexico. Malaria increased dramatically from 36.9 cases per 100,000 residents in 1980 to 171.5 cases in 1985, before dropping to 31.1 in 1991. Chiapas, Oaxaca, Guerrero, Michoacán, and Sinaloa are priority areas for government antimalarial campaigns. After not a single case of onchocerciasis was reported in 1980 and 1985, the disease reemerged in the late 1980s. Health officials identified 2,905 cases in 1987 and 1,238 cases in 1991, most of them in Oaxaca and Chiapas. In contrast, significant progress occurred in the reduction of dengue, with cases per 100,000 residents declining from 73.8 in 1980 to 6.9 in 1991. The disease is found along the Gulf of Mexico and Pacific coastal regions, the mouth of the Río Balsas, and central Chiapas.
Although most sexually transmitted diseases declined throughout the 1980s, acquired immune deficiency syndrome (AIDS) proved a glaring and deadly exception. Mexico reported its first cases of AIDS in 1983. Both the total number of cases and the ratio increased annually through 1993. In 1993 the government reported 5,095 new cases, or 5.4 cases per 100,000 residents.
Data as of June 1996