DECLINE OF TUBERCULOSIS MORTALITY IN AN URBAN MEXICAN-ORIGIN POPULATION, 1935-1984

Through a series of life table analyses, this paper describes the natu ral history of tuberculosis mortality in a Mexican-origin community ov er five decades (1935-84) during which the disease underwent a transit ion from a major underlying cause of death to a disease conditioned me ntioned more often on death certificates as contributing to death than causing death. The decline in death rates from 1940 to 1950 was espec ially remarkable. Successive birth cohorts of Mexican Americans, separ ated by as little as five years of age, experienced distinctly lower r isk of death from tuberculosis as they entered young adulthood. There was a rapid convergence in age-specific patterns of tuberculosis death rates in Mexican Americans toward those of non-Hispanic whites, so th at by 1960 tuberculosis was primarily a cause of death in old age rath er than young adulthood. The impact of changing environment, both thro ugh improvements of conditions within neighborhoods and through reside ntial mobility, on birth cohorts at risk of tuberculosis needs to be e xamined in further research.