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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 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

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  1. 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

  2. Food Fest Food Fest

  3. Imhotep, the "father of medicine". The word "Imhotep" means "he who comes in peace'

  4. Prevention in Egypt Herodotus, after his visit to Egypt in the Vth century B.C., stated that Egyptians were, with the Libyans, the healthiest people. This must have implied a good deal of sanitation. Cleanliness, was religious as well a hygienic obligation.

  5. Medicine is a science from which one learns the states of the human body with respect to what is healthy and what is not, in order to preserve good health when it exists and restore it when it is lacking Ibn Sina, the opening to the Qanun fi al-tibb

  6. Medicine is a science from which one learns the states of the human body with respect to what is healthy and what is not,in order to preserve good health when it existsand restore it when it is lacking Ibn Sina, the opening to the Qanun fi al-tibb

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

  8. Epidemiology • Psychiatric Epidemiologists • Diabetes Epidemiology • Cardiovascular Epidemiology • Cancer Epidemiology • Infectious Disease Epidemiology

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

  10. 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.

  11. 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...

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

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

  14. 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

  15. Epidemiologic Transition in Developing and DevelopedCountries

  16. 14 years 35 years

  17. 5 yrs 20 yrs Changing Life Expectancies

  18. 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

  19. Global Homogenety of Mortality Patterns

  20. Infectious Diseases NCD Mortality Rates Epidemiologic Transition

  21. Death Rates for TB in England and Wales

  22. Death Rates for TB in England and Wales TB Bacillus Identified Chemotherapy BCG Vaccination

  23. Death Rates for Measles in Children in England and Wales

  24. Death Rates for Measles in Children in England and Wales Immunization begun

  25. NIDDM CHD Trauma CA Mortality Rates Epidemiologic Transition

  26. Importance of Geographic Patterns

  27. Incidence of Stomach CAMales

  28. Breast Cancer IncidenceFemales

  29. CHD Death RatesMales, aged 45-54

  30. Cirrhosis Death Rates,Males, aged 45-54

  31. 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.

  32. 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

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

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

  35. 1960 Urban Rural rural urban Developing Countries USA

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