Papers pp 1411, 1423

Purely descriptive statistics on the numbers of people dying from different causes at various ages can be of enormous importance. But it is not enough merely to count “who dies of what disease”: the causes of those diseases, particularly in large populations, need also to be reliably measured and their evolution monitored. In rich countries the established vital registration systems, in some cases dating back over 100 years,1 can be used to assess disease patterns and trends, while decades of epidemiological research have identified some of the principal causes of such trends, particularly tobacco use. 2 3 In poorer countries, however, vital registration systems are not yet sufficiently well developed to document disease trends and cannot support large scale studies of the avoidable causes of disease.4

To assess the main patterns of mortality and the main avoidable causes of premature death in large developing …