Mortality Experience of Tsimane Amerindians of Bolivia: Regional Variation, Temporal Trends and Epidemiological Transition

Hillard S. Kaplan, University of New Mexico
Michael D. Gurven, University of California, Santa Barbara

This paper examines mortality patterns among the Tsimane, small-scale forager-horticulturalists from lowland Bolivia. We compare age-specific mortality in remote versus acculturated regions and examine changes among all age groups and by sex over the past fifty years. Villages in remote regions show 2-4 times higher mortality from infancy until middle adulthood than in the acculturated region. Overall life expectancy at birth improved by 8 years from 45 to 53 after 1990. Over half of all deaths are due to respiratory and gastrointestinal infections. Accidents and violence account for a quarter of all deaths. Unlike typical patterns described by epidemiologic transition theory, we find a much larger period reduction of death rates during middle and late adulthood than during infancy or childhood. We hypothesize that that this pattern is due to differential access to medical interventions, a continued lack of public health infrastructure and cultural beliefs concerning sickness and dying.