The epidemiologic transition is that process by which the pattern of mortality and disease is transformed from one of high mortality among infants and children and episodic famine and epidemic affecting all age groups to one of degenerative and man-made diseases (such as….
Among currently developing nations, the transition from infectious to degenerative disease predominance has started but has not yet been completed, as shown by the graphs for Chile and Ceylon in Figure 4. The recession of infectious diseases that began in Chile in the 1920's has been gradual but discernible.
More specifically, epidemiology is concerned with the distribution of disease and death, and with their determinants and consequences in population groups.
Proposition Three During the epidemiologic transition the most profound changes in health and disease patterns obtain among children and young women.
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The epidemiologic transition. A theory of the Epidemiology of population change. 1971 Bull World Health Organ. 2001;79(2):161-70.
Abstract The epidemiological transition was thought to be a unidirectional process, beginning when infectious diseases were predominant and ending when noncommunicable diseases dominated the causes of death.
In 1971 Abdel R. Omran published his classic paper on the theory of epidemiologic transition. By the mid-1990s, it had become something of a citation classic and was understood as a theoretical statement about the shift from infectious to chronic diseases that supposedly accompanies modernization. H …
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The Epidemiologic Transition: A Theory of the Epidemiology of Population Change
One of the major practical implications stemming from historical studies of the epidemiologic transition in western countries is that disease control programs may be not only a prerequisite of fertility transition but an effective instrument of socioeconomic development as well. Mortality and Population Dynamics.
During the transition, a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are gradually displaced by degenerative and man-made diseases as the chief form of morbidity and primary cause of death. Typically, mortality patterns distinguish three major successive stages of the epidemiologic transition:
In this stage the major determinants of death are the Malthusian “positive checks,” namely, epidemics, famines and wars. Graunt's study of London's Bills of Mortality (Graunt 1939) in the mid-seventeenth century shows, for example, that nearly three-fourths of all deaths were attributed to infectious diseases, malnutrition and maternity complications; cardiovascular disease and cancer were responsible for less than six per cent.2(See graph for seventeenth century London in Figure 4.)
In this stage the average life expectancy at birth is low and variable, vacillating between 20 and 40 years.
In the modern period after 1650 the growth curve of world population departed from the cyclic pattern and assumed an exponential form. However, mortality continued to be of overwhelming importance in determining population movements before the Industrial Revolution in the west, as is indicated by a number of studies (Chambers; Eversley 1957; Utterstrom 1965; Vielrose 1965). Vital statistics gleaned from several parish register studies show that both fertility and mortality were extremely variable and moderately high and that the range of variation in mortality was significantly greater than in fertility in the early part of the modern era, as shown in Table 1. No secular downward trend in mortality is apparent in any country before the middle of the eighteenth century, about the same time that population growth began to demonstrate an exponential curve. The initial period of sustained population growth in nearly every country for which reliable data are available corresponds with at least two decisive changes in the death rate. First the fluctuations in mortality became less frequent and less drastic. Second, the initial, slow—sometimes imperceptible—decline in mortality gradually gained momentum and eventually stabilized at relatively low levels in the twentieth century. Thus steady rises in life expectancy, progressively diminishing death rates and more stable and predictable mortality patterns have accompanied the persistent increments in world population.
More specifically, epidemiology is concerned with the distribution of disease and death, and with their determinants and consequences in population groups. Inasmuch as patterns of health and disease are integral components of population change, epidemiology's reservoir of knowledge about these patterns and their determinants in population groups ...
As noted earlier, one important use of epidemiology is to identify the factors that place some members at greater risk than others.
Over time, the concept of agent has been broadened to include chemical and physical causes of disease or injury. These include chemical contaminants (such as the L-tryptophan contaminant responsible for eosinophilia-myalgia syndrome), as well as physical forces (such as repetitive mechanical forces associated with carpal tunnel syndrome). While the epidemiologic triad serves as a useful model for many diseases, it has proven inadequate for cardiovascular disease, cancer, and other diseases that appear to have multiple contributing causes without a single necessary one.
Treatment should be initiated early because the disease is more likely to be fatal if treatment is delayed or not given at all.
A number of models of disease causation have been proposed. Among the simplest of these is the epidemiologic triad or triangle, the traditional model for infectious disease. The triad consists of an external agent, a susceptible host, and an environment that brings the host and agent together. In this model, disease results from the interaction between the agent and the susceptible host in an environment that supports transmission of the agent from a source to that host. Two ways of depicting this model are shown in Figure 1.16.
Disease prevention can be accomplished by blocking any single component of a sufficient cause, at least through that pathway. For example, elimination of smoking (component B) would prevent lung cancer from sufficient causes I and II, although some lung cancer would still occur through sufficient cause III.
In demography and medical geography, epidemiological transition is a theory which "describes changing population patterns in terms of fertility, life expectancy, mortality, and leading causes of death.". For example, a phase of development marked by a sudden increase in population growth rates brought by improved food security ...
Omran divided the epidemiological transition of mortality into three phases, in the last of which chronic diseases replace infection as the primary cause of death. These phases are:
The developments of modern healthcare and medicine, such as antibiotics, drastically reduce infant mortality rates and extend average life expectancy which, coupled with subsequent declines in fertility rates, reflects a transition to chronic and degenerative diseases as more important causes of death. The theory of epidemiological transition uses ...
Worldwide, mortality rates have decreased as both technological and medical advancements have led to a tremendous decrease in infectious diseases. With fewer people dying from infectious diseases, there is a rising prevalence of chronic and/or degenerative diseases in the older surviving population.
While better health and greater longevity enjoyed by females of reproductive age tend to enhance fertility, the reduced risks to infants and young children that occurs in the later stages of the transition tends to have the opposite effect: prolonged breastfeeding associated with reduced mortality among infants and toddlers, together with parental recognition of improved childhood survival, tend to lengthen birth intervals and depress overall reproductive rates .
Before the first transition, the hominid ancestors were hunter-gatherers and foragers, a lifestyle partly enabled by a small and dispersed population. However, unreliable and seasonal food sources put communities at risk for periods of malnutrition.
Omran developed three models to explain the epidemiological transition. Classical/Western model: (England, Wales, and Sweden) Countries in Western Europe typically experienced a transition that began in the late eighteenth century and lasted over 150 years to the post-World War II era.
The epidemiologic transition is that process by which the pattern of mortality and disease is transformed from one of high mortality among infants and children and episodic famine and epidemic affecting all age groups to one of degenerative and man-made diseases (such as…. mortality.
human disease, an impairment of the normal state of a human being that interrupts or modifies its vital functions.…
Epidemiologic (al) transition, a somewhat more recent concept, considers patterns of mortality change and causes of death (and sometimes ill health) from patterns dominated by infectious diseases to those in which chronic, degenerative physical ailments predominate, and increasingly mental ill-health conditions, including dementias.
Demographic transition refers to the shift in vital rates within population groups at various geographical scales from a pattern of high birth (fertility) and death (mortality) rates to one of low rates.
The Epidemiologic Transition: A Theory of the Epidemiology of Population Change
One of the major practical implications stemming from historical studies of the epidemiologic transition in western countries is that disease control programs may be not only a prerequisite of fertility transition but an effective instrument of socioeconomic development as well. Mortality and Population Dynamics.
During the transition, a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are gradually displaced by degenerative and man-made diseases as the chief form of morbidity and primary cause of death. Typically, mortality patterns distinguish three major successive stages of the epidemiologic transition:
In this stage the major determinants of death are the Malthusian “positive checks,” namely, epidemics, famines and wars. Graunt's study of London's Bills of Mortality (Graunt 1939) in the mid-seventeenth century shows, for example, that nearly three-fourths of all deaths were attributed to infectious diseases, malnutrition and maternity complications; cardiovascular disease and cancer were responsible for less than six per cent.2(See graph for seventeenth century London in Figure 4.)
In this stage the average life expectancy at birth is low and variable, vacillating between 20 and 40 years.
In the modern period after 1650 the growth curve of world population departed from the cyclic pattern and assumed an exponential form. However, mortality continued to be of overwhelming importance in determining population movements before the Industrial Revolution in the west, as is indicated by a number of studies (Chambers; Eversley 1957; Utterstrom 1965; Vielrose 1965). Vital statistics gleaned from several parish register studies show that both fertility and mortality were extremely variable and moderately high and that the range of variation in mortality was significantly greater than in fertility in the early part of the modern era, as shown in Table 1. No secular downward trend in mortality is apparent in any country before the middle of the eighteenth century, about the same time that population growth began to demonstrate an exponential curve. The initial period of sustained population growth in nearly every country for which reliable data are available corresponds with at least two decisive changes in the death rate. First the fluctuations in mortality became less frequent and less drastic. Second, the initial, slow—sometimes imperceptible—decline in mortality gradually gained momentum and eventually stabilized at relatively low levels in the twentieth century. Thus steady rises in life expectancy, progressively diminishing death rates and more stable and predictable mortality patterns have accompanied the persistent increments in world population.
More specifically, epidemiology is concerned with the distribution of disease and death, and with their determinants and consequences in population groups. Inasmuch as patterns of health and disease are integral components of population change, epidemiology's reservoir of knowledge about these patterns and their determinants in population groups ...
In demography and medical geography, epidemiological transition is a theory which "describes changing population patterns in terms of fertility, life expectancy, mortality, and leading causes of death." For example, a phase of development marked by a sudden increase in population growth rates brought by improved food security and innovations in public health and medicine, can be fol…
Omran divided the epidemiological transition of mortality into three phases, in the last of which chronic diseases replace infection as the primary cause of death. These phases are:
1. The Age of Pestilence and Famine: Mortality is high and fluctuating, precluding sustained population growth, with low and variable life expectancy vacillating between 20 and 40 years. It is characterized by an increase in infectious diseases, malnutrition and famine, common during the Neolithic …
In general human history, Omran's first phase occurs when human population sustains cyclic, low-growth, and mostly linear, up-and-down patterns associated with wars, famine, epidemic outbreaks, as well as small golden ages, and localized periods of "prosperity". In early pre-agricultural history, infant mortality rates were high and average life expectancy low. Today, life expectancy in deve…
Omran developed three models to explain the epidemiological transition.
1. Classical/Western model: (England, Wales, and Sweden) Countries in Western Europe typically experienced a transition that began in the late eighteenth century and lasted over 150 years to the post-World War II era. The lengthy transition allowed fertility to decline at virtually the same rate that mortality als…
1. Ecobiological: changing patterns of immunity, vectors (such as the black rat partially responsible for spreading bubonic plague in Europe), and the movement of pathogenic organisms. These alter the frequency of epidemic infectious diseases as well as chronic infections and other illnesses that affect fertility and infant mortality.
2. Socioeconomic: political and cultural determinants, including standards of living, health habits, hygiene and nutrition. Hygiene and nutrition are includ…
McMichael, Preston, and Murray offer a more nuanced view of the epidemiological transition, highlighting macro trends and emphasizing that there is a change from infectious to non-communicable disease, but arguing that it happens differently in different contexts.
One of the first to refine the idea of the epidemiological transition was Preston…
The majority of the literature on the epidemiological transition that was published since these seminal papers confirms the context-specific nature of the epidemiological transition: while there is an overall all-cause mortality decline, the nature of cause-specific mortality declines differs across contexts. Increasing obesity rates in high-income countries are further confirming the ep…
• Demographic transition
• Medical anthropology
• Medical sociology
• Nutrition transition