(June 2000) When it comes to aging in Latin America, Uruguayans are definitely ahead of the pack.

With the largest proportion of people 60 years and older, Uruguay represents the "oldest" nation in Latin America — indeed, in the entire Western Hemisphere.

Trends toward lower fertility and greater longevity in most of the world have made population aging an issue of unprecedented importance. And while the issue has commonly been associated with countries in Europe as well as others like Canada, the United States, Japan, Australia, and New Zealand, some less developed nations are catching up, according to the Pan American Health Organisation (PAHO).

Uruguay offers one example. Some 17.3 percent of Uruguay's population is in the 60-and-older category, compared with 16.5 percent in the United States and 16.3 percent in Canada, according to the report Aging in the Americas into the XXI Century, a joint publication of PAHO, the U.S. Census Bureau, and the National Institute on Aging.

As with other Latin American and Caribbean countries, declines in infant mortality have helped spur increases in life expectancy in Uruguay.

"If you looked at all of the countries in the region and tried to identify one area of significant change that has actually enabled people to live longer, it all has to do with the risks of dying in early childhood," says Dr. Martha Pelaez of PAHO. "Decreasing those risks have been substantial in all of the countries."

Improvements in sanitation, the quality of drinking water, vaccinations, and other public health concerns have helped lower the incidence of communicable diseases that kill children in the early years, says Pelaez, PAHO's Regional Advisor on Aging and Health.

Throughout the region, deaths of infants less than a year old declined from 81 for every 1,000 births in the early 1970s to 36 in the late 1990s, according to UN estimates. In Uruguay, those deaths fell from 46 to 18 during the same period.

But not all countries are equal. And wealthier nations and communities have clearly had the edge, by most measures.

Uruguay, where 92 percent of the people live in urban areas, is one of South America's wealthiest nations. Not surprisingly, the country is ahead of others like Haiti and Guatemala in caring for its population.

In Uruguay, a girl can now expect to live to 78 years — some 27 years longer that her Haitian counterpart, according to the Population Reference Bureau (PRB). In Haiti, still a largely rural society, 103 infants die for every 1,000 births — seven times the rate of Uruguay.

Decreasing birth rates have also influenced the growth in the proportion of older people in the population. The average number of children per woman in Uruguay fell from three in the early 1970s to 2.3 today. Uruguay now accounts for the lowest birth rate in South America. Brazil, Chile, and Suriname have the second lowest rates at 2.3.

Uruguay's drop in birth rates reflects — among other things — relatively high achievements in education. Adult literacy is high, with the Uruguayan female population ahead of males, according to the United Nations Children's Fund. UNICEF's report, State of the World's Children 2000, shows that 98 percent of female Uruguayans 15 years and older are literate, compared with 97 percent of males.

Uruguay

Total population (mid-2000): 3.3 million
Estimated population in 2025: 3.9 million
Life expectancy at birth: 74 years
Total fertility rate: 2.3 children per woman
Per capita income (1998 US$): $6,070


Yvette Collymore is a senior editor at the Population Reference Bureau.