1. The Epidemiologic Transition
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2. Morbidity
 Sickness
 Case fatality rate
 Classifications
 Communicable (Infectious)
 Degenerative (Non-communicable)
 Epidemiologic Transition
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3. Epidemiologic Transition
 Reductions in overall mortality levels
 The role of communicable or degenerative diseases in
overall death rates
 Accompanied by a significant rise in the average life
expectancy of those involved
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4. The Epidemiologic Transition Dynamics
STAGE: 1 2 Overlap of stages 3 Overlap of stages 4 Merging with… 5 Future stages
Pestilence and Receding Epidemics Degenerative, Declining CVD Aspired quality
Famine stress & mortality, of life with
Health transition man-made ageing & persistent
Determinants of Changing patterns of: diseases emerging inequalities
disease and Health survival diseases
QUALITY OF LIFE FOR ALL
mortality change disease, & mortality
Continued dynamic change
Fertility: With chronicity plus
Determinants of High then declines emerging diseases
Fertility decline Age structure: According to transition model
Young, then older Decline in CVDs: actual (West)
DEMOGRAPHIC or potential non-western models
TRANSITION
& Aging
Lifestyle and
education Health care Technical Environmental
transition transition transition factors
Flow of the Transition can be disrupted or reversed under crises or may accelerate
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under strikingly favorable conditions. Source:World Health Statistics Quarterly, 51(No.2/3),1998

5. Epidemiologic Transition
 Three basic models
 Classic or Western model
 Western societies
 The last 200 years
 Accelerated model
 Japan, Eastern Europe, & the Soviet Union
 Delayed model
 Most LDCs
 Since the end of WWII
 Hybristic stage
 Personal behavior and lifestyle
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8. Causes of Death
MDCs LDCs
 Age 15 to 44  Age 15 to 44
 Accidents  Accidents
 Cancer  Coronary Heart Disease
 Coronary Heart Disease (CHD)
(CHD)  Cancer
 Age 45 -54  Age 45 -54
 Coronary Heart Disease  Coronary Heart Disease
(CHD) (CHD)
 Cancer  Cancer
 Accidents  Accidents
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9. Epidemiologic Transition
 Causes of death based on immediacy
 Proximate
 Immediate
 Cancer
 Murder
 Non-proximate
 Not immediate
 Chemical pollution
 Smoking
 Crime rate of area of residence
 Obesity
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10. Infectious and Parasitic Diseases
 Human settlements provided a good environment for
infectious disease
 Denser populations
 Poor sanitation
 Trade between settlements
 19th and 20th Centuries – lowered incidence of infectious
diseases
 Improvements in
 Housing
 Sanitation
 Nutrition
 Public health interventions
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11. Infectious and Parasitic Diseases
 Main causes of death
 TB
 Bronchitis
 Pneumonia
 Influenza
 Measles
 1950s
 Effects of advances in medical technology on mortality could
be seen
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14. Re-emergence of Infectious and Parasitic
Diseases (IPDs)
 Ebola
 Multi-drug resistant TB
 Malaria
 Meningitis
 New forms of cholera
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15. Re-emergence of Infectious and Parasitic
Diseases (IPDs)
 Reasons for re-emergence
 Change to the natural environment
 Misuse of antibiotics
 Agricultural practices and their effects on the environment
 Population movement
 Breakdown in provision of public health
 Civil strife
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