Cardiovascular and tuberculosis mortality: The contrasting effects of changes in two causes of death

Tuberculosis was the largest source of deaths among younger adults, and car diovascular disease among older adults, in the America of 1900. Decreases i n deaths from tuberculosis since 1900 and cardiovascular disease since 1940 explain most of the mortality drops in those age groups over the century. This article, building on previous work by White and Preston, shows the res ults of increased survival from these two causes on the US population struc ture. Standard demographic cause-specific mortality calculations are used t o generate life tables without deaths from cardiovascular disease or tuberc ulosis. Then fixed rates for these diseases from early in the century are a ssumed while all other causes of death are allowed to change as they did hi storically. Improvements in cardiovascular mortality and tuberculosis produ ce some seemingly illogical contrasts. More people are alive today because of the decrease in tuberculosis. Yet more deaths from cardiovascular diseas e have been prevented, and cardiovascular improvements have raised life exp ectancy more. Lower tuberculosis mortality had virtually no effect on the a verage age of the population. Lower cardiovascular mortality alone has rais ed that average more than all twentieth century causes of improved mortalit y combined.