Sociology 674, 10/04/05, page 1Epidemiologic Transition1) Definition (associated with Omran)2) Demography, population health, epidemiology3) Focus not only on mortality but also on morbidity4) Stagesa. Age of pestilence and famineb.Age of receding pandemicsc. Age of degenerative & man-made diseasesd.Age of delayed degenerative diseases?Sociology 674, 10/04/05, page 2Change in levels of mortalityStage 1 Stage 2 Stage 3 Stage 4CDR 30-50 ≈30 <20 ≈10e0 30 50 65-70 70+Sociology 674, 10/04/05, page 3Features of epidemiologic transition1) Decrease in volatilitya. “Crisis” and “background” mortality both high in past2) Shift in causes of death3) Shift in age pattern of mortality4) Favors women over men5) Emergence of socioeconomic differentialsSociology 674, 10/04/05, page 4Explanations1) Economic development – e.g., housing2) Advances in medical, scientific technology3) Improved sanitation and hygiene 4) Improved food supply and nutritionSociology 674, 10/04/05, page 5Change in cause of deathSociology 674, 10/04/05, page 6Continued decline in death due to degenerative diseases1 01 0 01 , 0 0 01 0 , 0 0 0D e a t h s p e r 1 0 0 , 0 0 0 p o p u la ti o n (l o g s c a le )F i g u r e 2 5 . D e a t h r a t e s f o r l e a d i n g c a u s e s o f d e a t h f o r a l l a g e s :U n i t e d S t a t e s , 1 9 5 0 - 2 0 0 2N O T E S : R a t e s a r e a g e a d j u s t e d . C a u s e s o f d e a t h s h o w n a r e t h e f i v e l e a d i n g c a u s e s o f d e a t h f o r a l l a g e s i n 2 0 0 2 . C L R D i s c h r o n i c l o w e r r e s p i r a t o r y d i s e a s e s . S t a r t i n g i n 1 9 9 9 , d a t a w e r e c o d e d a c c o r d i n g t o I C D - 1 0 . S e e D a t a T a b l e f o r d a t a p o i n t s g r a p h e d a n d a d d i t i o n a l n o t e s .S O U R C E : C e n t e r s f o r D i s e a s e C o n t r o l a n d P r e v e n t i o n , N a t io n a l C e n t e r f o r H e a l t h S t a t is t i c s , N a t io n a l V i t a l S t a t i s t ic s S y s t e m . A ll c a u s e sH e a r t D i s e a s eY e a rC a n c e rS t r o k eU n i n t e n t io n a l in j u r ie sC L R D1 9 5 01 9 6 0 1 9 7 01 9 8 01 9 8 51 9 9 0 1 9 9 52 0 0 2Sociology 674, 10/04/05, page 7Age distribution of death1) Shift from young ages to older ages2) Reflects changing causes of death3) Increased survivorship4) Major implications for population growthSociology 674, 10/04/05, page 8Variation in Epidemiologic Transition1) Early vs. later transitionsa. Role of SES improvements vs. technological improvements. b. Endogenous vs. exogenous changec. Relative economic circumstancesSociology 674, 10/04/05, page 9Recent trends1) Regional variationa. Africa and AIDSb. Eastern Europe/Russia – East-West Gap2) US and other developed countriesa. Smokingb.
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