Decline of tuberculosis mortality in an urban Mexican-origin population, 1935-1984

Through a series of life table analyses, this paper describes the natural history of tuberculosis mortality in a Mexican-origin community over five decades (1935-84) during which the disease underwent a transition from a major underlying cause of death to a disease conditioned mentioned more often on death certificates as contributing to death than causing death. The decline in death rates from 1940 to 1950 was especially remarkable. Successive birth cohorts of Mexican Americans, separated by as little as five years of age, experienced distinctly lower risk 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 that by 1960 tuberculosis was primarily a cause of death in old age rather than young adulthood. The impact of changing environment, both through improvements of conditions within neighborhoods and through residential mobility, on birth cohorts at risk of tuberculosis needs to be examined in further research.