Demographic and epidemiologic changes in Colombia during the 20th century: facts and explanations.

Abstract

Introduction. Research, education, organization and administration activities in health need an updated panoramic view of demographic and epidemiologic changes and tendencies.
Objectives. To describe the main changes in demography and epidemiology during the 20th century in Colombia and to comment on the causative models used by some authors.
Materials And Methods. A descriptive and longitudinal study. Second hand information from various sources was used. The final section of the review includes a discussion on the interpretation of data given by the original authors.
Results. In 1905-2005, population increased from 4,737,588 inhabitants to 48,864,013. The age distribution of the population showed dramatic changes: the true pyramid, as seen in 1951, changed into a distorted figure (no apparent differences between 0 and 14 years of age). Both children and youngsters lost representation on age structure, while adult and older individuals gain representation. During 1905-1938, the birth rate was 43% and by the end of 2005 it will be 22%. Mortality dropped a 75%, falling from 23% in 1905-1912 to 6% in 1885-1993, but it rose a 33% after 1993, and will reach 8.3% in 2010. In 1938, the urban population was 31% and in 2002, 72%. Mortality discriminated by cause changed in a significant manner during the second half of the 20th century. Infectious-parasitic and perinatal diseases, the main cause of death by the end of the 1960-1969 decade, lost importance on behalf of degenerative diseases, accidents and homicides which are now the most frequent. Conclusions. Our present population density is relatively low. The demographic change has been profound but the velocity has been more important. The aging of population has serious implications for the country. These notable modifications in Colombian families raise challenges in all social fields. The demographic and epidemiological changes (structure and level of morbimortality) require a serious analysis, and easy explanations do not have to be accepted without repairs.