Epidemiologic Transition: Changes of fertility and mortality with modernization

Abdel Omran. The Epidemiologic Transition: A Theory of the epidemiology of population change. Milbank Quarterly. 1971;49:509-538
http://www.who.int/docstore/bulletin/pdf/2001/issue2/vol.79no.2.1 59-170.pdf

Lecture
Epidemiologic Transition s Geographic Studies, what do they tell us?
s

Abdel Omran Evolution of Disease

Charles Darwin Evolution of Species

Epidemiology
    

Psychiatric Epidemiologists Diabetes Epidemiology Cardiovascular Epidemiology Cancer Epidemiology Infectious Disease Epidemiology

we need to look at the patterns of diseases .Instead at looking at individual diseases.

. depopulation would still occur.Mortality is the fundamental factor in the dynamics of population growth and causes of death. Thus if fertility approached its upper maximum. Mortality has no fixed upper limits.

.. a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man-made diseases.During the epidemiologic transition..

Age of Pestilence and Famine Characterized by high mortality rates. little population growth and very low life expectancy . wide swings in the mortality rate.

Age of Receding Pandemics Epidemics become less frequent. infectious diseases in general become less frequent. a slow rise in degenerative diseases begin to appear .

With the 20th Century more related with disease control activities independent of SES: e.g. Mexico. China .The shifts in disease patterns in the 19th century were primarily related to changing SES.

.

.

.

.

Epidemiologic Transition in Developing and Developed Countries 80 70 60 50 40 30 20 10 0 1945 1960 1980 1995 Developing Developed .

14 years 35 years .

.

.

.

Increasing Life Expectancy and Causes of Death 100 Other 80 60 Violence 40 CHD CA 20 Infection 40 44 48 52 56 60 64 68 0 72 76 Population Life Expectancy .

.

.

.

.

Infectious Diseases Mortality Rates NCD Epidemiologic Transition .

Death Rates for TB in England and Wales 4500 4000 3500 3000 2500 2000 1500 1000 500 0 1840 1855 1875 1895 1915 1935 1948 1958 1968 .

Death Rates for TB in England and Wales 4500 4000 3500 3000 2500 2000 1500 1000 500 0 1840 1855 1875 1895 1915 1935 1948 1958 1968 Chemotherapy BCG Vaccination TB Bacillus Identified .

Death Rates for Measles in Children in England and Wales 1400 1200 1000 800 600 400 200 0 1850 1870 1890 1910 1930 1950 1970 .

Death Rates for Measles in Children in England and Wales 1400 1200 1000 800 600 400 200 0 1850 1870 1890 1910 1930 1950 1970 Immunization begun .

NIDDM CHD Mortality Rates Trauma CA Epidemiologic Transition .

.

.

.

.

.

Importance of Geographic Patterns .

Incidence of Stomach CA Males Japan Columbia Iceland Finland UK US NW US White India Nigeria 0 20 40 60 80 100 .

Breast Cancer Incidence Females US Whites US NW UK Poland Jamaica Singapore Brazil Nigeria Japan 0 5 10 15 20 25 30 .

aged 45-54 Finland Scotland UK US Bulgaria Italy Egypt Japan Guatamala Thailand 0 500 1000 1500 .CHD Death Rates Males.

aged 45-54 France Italy Japan US Hong Kong Scotland UK 0 10 20 30 40 50 60 70 80 90 .Cirrhosis Death Rates. Males.

High Incidence of NCDs in Developing Countries V Possible Infectious Etiology Macronodular Cirrhosis Hepatocellular Carcinoma Rheumatic Heart Disease Iron deficiency anemia V Related to Nutrition Deficiency Endemic Goiter Malnutrition Related Diabetes. .

High Incidence of NCDs in Developed Countries Cardiovascular CHD Deep Vein Thrombosis Respiratory Emphysema Lung CA Female Genital Endometriosis Endometrial CA Breast Breast CA Fibrocystic Disease Male Genital Prostrate CA Metabolic NIDDM .

more fiber  Less Stress  . less saturated fats.Back to Nature Improved Physical activity  A Healthier Diet.

Transition    Nomads Farmers Urban 45 yrs 60 yrs 70 yrs .

1960 Urban Rural rural urban Developing Countries USA .

2006 Urban Rural urban rural USA Developing Countries .

Causes of Death Developed s Developing Age 15-44 Accidents CHD CA Age 15-44 Accidents CA CHD s Age 45-54 CHD CA Accidents Age 45-54 CHD CA Accidents .

Sign up to vote on this title
UsefulNot useful