Epidemiological Transition Flashcards
(14 cards)
what is the epidemiological transition?
theory that explains how mortality conditions went from:
young deaths caused by parasitic and infectious diseases to older deaths caused by degenerative and chronic conditions
what are the 3 (+1) stages of ET
pestilence and famine
receding pandemics
man-made & degenerative diseases
…
delayed degenerative & man-made diseases
describe stage 1: pestilence and famine
high and fluctuating fertility and mortality, little natural increase, high IMR
life exp. of 20-40, death caused by parasites, infectious disease, malnutrition and poor urban conditions
describe stage 2: receding pandemics
declining mortality (specifically IMR) and maternal deaths; life exp. of 50
advances in sanitation, water filtration, vaccines, and germ theory
parasitic illness declined, while death from non-infectious diseases increased … except for tuberculosis during industrialization period
describe stage 3: man-made and degenerative diseases
low mortality and declining fertility, life exp. above 50
economic growth, science advancement, penicillin & antibiotics in 1930s and 1940s
degenerative and man-made diseases became leading causes of death
what was miasma theory
the belief that infectious diseases were caused by ‘bad air’ released by decaying organic matter & waste
later germ theory was accepted (in stage 2), as illness was tied to spread of germs from poor sanitation
what is the ‘4th’ stage of ET: delayed degenerative and man-made diseases
describes current world with low fertility and mortality (stabilized)
dominance of death caused by degenerative and chronic diseases
lifestyle behaviours causing increased illness (man-made) … hubristic stage
e.g. obesity, drug use
what is the rectangularization of the survival curve
explains the change in shape of ASDR curves over time … as IMRs and old-age death rates have declined
when comparing two curves (one from 1900 and one from today), together they form a rectangular shape
what is the entropy of the life table
explains the distribution of deaths over age ranges
low entropy: deaths are tightly concentrated at select levels (very high and low ages)
high entropy: deaths are evenly dispersed across age ranges, more uncertainty when a person will die
“attenuated survival probabilities once a country reaches a high level of life expectancy”
… explain this
given that most of the improvement in IMRs have been realized, the only place to further improve life expectancy is through old-age mortality
what are the 3 critiques of ET?
unidirectional, linear progression
overemphasis on economic growth
neglect of within country variation
explain critique 2: overemphasis on growth
ET argues that modernization is the primary driver of movement between stages, yet many countries have improved health conditions with economic growth
ET underplays the role of female education, medical advancement, sanitation as key drivers
explain critique 1: unidirectional, linear progression
assumes that countries move only up and always follow stage 1, 2, 3
some countries have reverted (Soviet Union) by exhibiting higher mortality conditions and spread of infectious diseases
explain critique 3: neglect of within-country variation
fails to recognize how mortality rates differ between race and sex
lifestyle factors and sociocultural conditions influence mortality rates
e.g. Blacks lower life exp., males have worse mortality than women
