Harald Frederiksen
Determinants and Consequences of Mortality Trends in Ceylon
death rate ceylon declined 198 140 per 1000 29 percent year 1946 1947 abrupt decline death rate given rise postulations advances public health techniques permit significant reductions death rate independently economic development thus application public health measures would increase rate population growth thereby reduce per capita income assuming birth rate remains constant economic development lags frequently cited 15 postulations may accepted descriptive relationship health economic development underdeveloped ereas however hypothetical determinants consequences mortality trends ceylon confirmed sequence events accepted control malaria application insecticides primarily responsible postwar reduction death rate ceylon conclusion confirmed findings precipitous decline mortality preceded largescale application insecticides decline mortality malarious area unprotected nonmalarious area island 6 indeed net demographic effect malaria control made major part island habitable may reduction population pressure death rate ceylon displayed longterm downtrend despite stepbystep improvement reporting deaths downtrend interrupted 1935 disastrous drought reisulted sharp rise mortality semilogarithmic plot death rates quarters years since great drought 1935 1957 indicates fairly constant rate decline quarterly death rates wartime interruption downtrend postwar return prewar downtrend fig 1 seems wartime rise mortality rather postwar decline may notable event wartime rise mortality suggests circumstances arising war may exacerbated one major public health problems malnutrition malaria ranked two foremost health problems ceylon ruled malaria control primary cause postwar decline mortality level nutrition examined fluctuations may influenced death rates rise war return longterm downtrend following war found wartime rise 1943 1946 postwar decline death rate associated development alleviation wartime food deficit table 1 timing extent deficit indicated wartime decline food imports represented principal source food ceylon existence reserves might delayed significant effects decline food imports 1943 following war food imports rose 1947 exceeded dr frederiksen program officer division international health public health service washington dc