The health transition and biological living standards: Adult height and mortality in 20th-century Spain

This paper seeks new insights concerning the health transition in 20th century Spain by analyzing both traditional (mortality-based) and alternative (anthropometric-based) health indicators. Data were drawn from national censuses, vital and cause-of-death statistics and seven National Health Surveys dating from 1987 to 2006 (almost 100,000 subjects aged 20-79 were used to compute cohort height averages). A multivariate regression analysis was performed on infant mortality and economic/historical dummy variables. Our results agree with the general timing of the health transition process in Spain as has been described to date insofar as we document that there was a rapid improvement of sanitary and health care related factors during the second half of the 20th century reflected by a steady decline in infant mortality and increase in adult height. However, the association between adult height and infant mortality turned out to be not linear. In addition, remarkable gender differences emerged: mean height increased continuously for male cohorts born after 1940 but meaningful improvements in height among female cohorts was not attained until the late 1950s. © 2011 Elsevier B.V. All rights reserved.