Chinese mortality transitions: The case of Beijing, 1700-1990

This study follows mortality trends and patterns in the city of Beijing from the seventeenth century to the present. It represents one of the first attempts to synthesize demographic data from a variety of sources, both historical and modern, to produce a consistent time series of age-specific mortality estimates for a major mainland Chinese population over an extended period of time. According to these estimates, from the seventeenth to the nineteenth century, death rates in Beijing were high, and above age five, unchanging. Death rates at all ages fell during the first decades of the twentieth century, most likely as the result of local public health efforts, then were stable until the middle of this century, when they began to fall again. These estimates are used in combination with recent cause of death data from Taiwan, Hong Kong, and Singapore to show that long-term mortality trends in Beijing are not consistent with an explanation of China\u27s mortality decline that focuses exclusively on the post-1949 state and its allocation of resources to the health sector, but are consistent with an explanation in which mortality had already begun falling in certain Chinese areas before 1949, and reductions after 1949 resulted from an interaction of an activist state with pre-existing social and cultural factors. Patterns of mortality by age and sex in Beijing, meanwhile, are examined to show that there was not only a reduction in mortality levels in that city after 1949, but a transformation of mortality patterns as well, suggesting that there may have been a fundamental shift in the underlying cause-of-death structure