RESUMO
PIP: 2 closely related aspects of health assessment are the definition of health and the purpose of the measurement. Health indicators are variables that may be used to evaluate hospital or community health care, detect unsatisfied needs, quantify the impact of an illness in daily life, examine costs and benefits of a particular program, determination priorities, or for other purposes. Life expectancy and the infant mortality rate are considered more useful from an operational perspective and for comparisons than is the crude death rate because they are not influenced by age structure. Morbidity rates are less available and are subject to wide variations of quality. Significant changes have occurred in Spain's fertility and mortality rates in the past few decades. Between 1970-80, the crude birth rate declined from 19.55 to 15.21/1000, the crude death rate from 8.41 to 7.71/1000, the infant mortality rate from 26.30 to 12.34/1000 live births, and the perinatal mortality rate from 25.48 to 14.35/1000 live births. Life expectancy at birth increased from 34.8 years for both sexes in 1900 to 73.3 in 1975. The changes in mortality and fertility rates have led to changes in Spain's age structure, primarily a gradual aging of the population. Chronic diseases have assumed new importance as causes of death. In 1980, circulatory diseases caused 43.8% of deaths, followed by tumors with 20.2% and respiratory diseases with 9.3%. The most important single cause of death in 1979 for children under 14 was accidents, for adults aged 15-64 it was tumors, and for persons over 65 it was cardiovascular diseases. The evolution of Spain's age structure is similar to that of other developed countries, although the proportion of children under 15 continues to be higher and that of persons over 65 to be lower.^ieng
