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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. Abdel Omran Evolution of Disease. Charles Darwin Evolution of Species.

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epidemiologic transition changes of fertility and mortality with modernization

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

slide2

Abdel Omran

Evolution of Disease

Charles Darwin

Evolution of Species

the new ncd epidemiology and prevention
The New NCD Epidemiology and Prevention
  • Systems approach
  • Disease Monitoring
  • Telecommunications Backbone
  • Deming approaches to Prevention
epidemiology
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

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.

slide8

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...

age of pestilence and famine

Age of Pestilence and Famine

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

age of receding pandemics

Age of Receding Pandemics

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

slide11

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

stages of the epidemiologic transition
Stages of the Epidemiologic Transition
  • Pestilence and Famine
  • Receding Pandemics
  • Degenerative and man-made diseases
slide21

14 years

35 years

slide26

Increasing Life Expectancy and

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

slide34

Infectious Diseases

NCD

Mortality Rates

Epidemiologic Transition

death rates for tb in england and wales36
Death Rates for TB in England and Wales

TB Bacillus

Identified

Chemotherapy

BCG Vaccination

slide39

NIDDM

CHD

Trauma

CA

Mortality Rates

Epidemiologic Transition

high incidence of ncds in developed countries
High Incidence of NCDs in Developed Countries
  • Cardiovascular

CHD

Deep Vein Thrombosis

  • Respiratory

Emphysems

Lung CA

  • Female Genital

Endometriosis

Endometrial CA

high incidence of ncds in developed countries52
High Incidence of NCDs in Developed Countries
  • Breast

Breast CA

Fibrocystic Disease

  • Male Genital

Prostrate CA

  • Metabolic

NIDDM

high incidence of ncds in developing countries
High Incidence of NCDs in Developing Countries
  • Possible Infectious Etiology

Macronodular Cirrhosis

Hepatocellular Carcinoma

Rheumatic Heart Disease

Iron deficiency anemia

  • Related to Nutrition Deficiency

Endemic Goiter

Malnutrition Related Diabetes.

back to nature
Back to Nature
  • Improved Physical activity
  • A Healthier Diet, less saturated fats, more fiber
  • Less Stress
transition
Nomads

Farmers

Urban

45 yrs

60 yrs

70 yrs

Transition
slide56

1960

Urban

Rural

rural

urban

Developing

Countries

USA

slide57

2003

Urban

Rural

urban

rural

Developing

Countries

USA

causes of death
Age 15-44

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

other transitions
Other Transitions
  • Agriculture
  • Forestry
  • Toxicity
  • Urbanization
  • Fossil Fuel
  • Nutrition
systems analysis

Systems Analysis

Systems approach

The Need for the Development of a systems approach to Epidemiology

Attempts to build a replica of the real world and experiment with it in order to obtain a better understanding of what is observed

EPI systems

Interplay of factors that cause one disease to increase while another falls.

slide63

Questions for readers of Epidemiologic Transition lecture by RonLaPorte(developed by Supercourse Team)

What might the epidemiologic transition tell us about the evolution of chronic diseases?

Over the past 100 years, life expectancy and causes of death have become homogenous world wide. Why is this important?