ABSTRACT
Mortality decline in the developed countries has been associated with a specific course of evolution in the structure of mortality by cause of death. The preindustrial mortality pattern was characterized by high mortality from infectious disease. The historical decline in mortality has been brought about largely by increased control over infectious disease, due as much to improvements in public sanitation and rising living standards as to vaccines (Goldscheider, 1971; United Nations, 1973). Throughout the industrial world degenerative diseases are now the leading causes of death. These differ from infectious disease in that they involve processes which are typically irreversible and which are difficult to detect until they have progressed into rather advanced stages. It is generally agreed that prevention of these diseases requires subtle adjustments in life-style that fall outside the scope of traditional medical approaches to health care.
