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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.2.159-170.pdf.

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Epidemiologic transition changes of fertility and mortality with modernization l.jpg

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.2.159-170.pdf


Lecture l.jpg
Lecture

  • Epidemiologic Transition

  • Geographic Studies, what do they tell us?


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Abdel Omran

Evolution of Disease

Charles Darwin

Evolution of Species


Epidemiology l.jpg
Epidemiology

  • Psychiatric Epidemiologists

  • Diabetes Epidemiology

  • Cardiovascular Epidemiology

  • Cancer Epidemiology

  • Infectious Disease Epidemiology



Mortality is the fundamental factor in the dynamics of population growth and causes of death l.jpg

Mortality is the fundamental factor in the dynamics of population growth and causes of death.

Mortality has no fixed upper limits. Thus if fertility approached its upper maximum, depopulation would still occur.


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


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Age of Pestilence and Famine occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man-made diseases...

Characterized by high mortality rates, wide swings in the mortality rate, little population growth and very low life expectancy


Age of receding pandemics l.jpg

Age of Receding Pandemics occurs in mortality and disease patterns whereby pandemics of infection are replaced by degenerative and man-made diseases...

Epidemics become less frequent, infectious diseases in general become less frequent, a slow rise in degenerative diseases begin to appear


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


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Epidemiologic Transition in primarily related to changing SES.Developing and DevelopedCountries


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14 years primarily related to changing SES.

35 years


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Increasing Life Expectancy and primarily related to changing SES.

Causes of Death

100

Other

80

60

Violence

CHD

40

CA

20

Infection

0

40

44

48

52

56

60

64

68

72

76

Population Life Expectancy


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Global Homogenety of primarily related to changing SES.

Mortality Patterns


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Infectious Diseases primarily related to changing SES.

NCD

Mortality Rates

Epidemiologic Transition


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Death Rates for TB in England and Wales primarily related to changing SES.


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Death Rates for TB in England and Wales primarily related to changing SES.

TB Bacillus

Identified

Chemotherapy

BCG Vaccination



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Death Rates for Measles in Children in England and Wales primarily related to changing SES.

Immunization begun


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NIDDM primarily related to changing SES.

CHD

Trauma

CA

Mortality Rates

Epidemiologic Transition


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Importance of primarily related to changing SES.

Geographic Patterns


Incidence of stomach ca males l.jpg
Incidence of Stomach CA primarily related to changing SES.Males


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Breast Cancer Incidence primarily related to changing SES.Females


Chd death rates males aged 45 54 l.jpg
CHD Death Rates primarily related to changing SES.Males, aged 45-54


Cirrhosis death rates males aged 45 54 l.jpg
Cirrhosis Death Rates, primarily related to changing SES.Males, aged 45-54


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High Incidence of NCDs in Developing Countries primarily related to changing SES.

  • Possible Infectious Etiology

    Macronodular Cirrhosis

    Hepatocellular Carcinoma

    Rheumatic Heart Disease

    Iron deficiency anemia

  • Related to Nutrition Deficiency

    Endemic Goiter

    Malnutrition Related Diabetes.


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High Incidence of NCDs in Developed Countries primarily related to changing SES.

  • 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


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Back to Nature primarily related to changing SES.

  • Improved Physical activity

  • A Healthier Diet, less saturated fats, more fiber

  • Less Stress


Transition l.jpg

Nomads primarily related to changing SES.

Farmers

Urban

45 yrs

60 yrs

70 yrs

Transition


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1960 primarily related to changing SES.

Urban

Rural

rural

urban

Developing

Countries

USA


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2006 primarily related to changing SES.

Urban

Rural

urban

rural

Developing

Countries

USA


Causes of death l.jpg

Age 15-44 primarily related to changing SES.

Accidents

CA

CHD

Age 45-54

CHD

CA

Accidents

Age 15-44

Accidents

CHD

CA

Age 45-54

CHD

CA

Accidents

Causes of Death

Developed

Developing


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