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Epidemiological Transition

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Sabrina Chua

on 3 October 2013

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Transcript of Epidemiological Transition

Epidemiological Transition
By: Sabrina Chua
Stage 1
Omran's first proposition was “The theory of epidemiological transition begins with the major premise that mortality is a fundamental factor in population dynamics.” It meant that each time the birth rate is low, the death rate is too.
Stage 1's name is called The Age of Pestilence and Famine.
Most reasons of these diseases were from exposure of waste and the dependency on other organisms as food.
Usually fatalities from diseases were fluctuating which made the life expectancy between 20 to 40 years, but birth rates were high too, making the population increase.
The Bubonic Plague, or the Black Death, was the one of the most violent diseases in stage one.
Stage 2
Stage 2's name is The Age of Receding Pandemics. Omran's second proposition for this stage was: “During the transition, a long-term shift occurs in mortality and disease patterns whereby pandemics of infection are gradually displaced by chronic diseases as the chief form of morbidity and primary cause of death. Population growth is sustained and begins to describe an exponential curve."
Life expectancy is 30 to 50 years.
This occurs because of the changes between relationships in healthcare, family planning, economies, and more.
Allergy and cholera are examples of disease in this stage.
The Possible 5th
People suspect that some parts of the world are transitioning into a stage 5, "Age of reemergence of infectious and parasitic diseases”. Disease from before have returned with even worse sicknesses.
The last proposition is shown through three possible models of the epidemiological transition which are “peculiar variations in the pattern, the pace, and the determinants/consequences of population change.”
The following are three reasons why this stage is possible: evolution, poverty , and improved travel.
It shows a decline in population from low death and birth rates.
SARS, Avian Flu, N1H1, and Tuberculosis are all examples of diseases in stage 5.
What is the Epidemiological Transition?
Abdel R. Omran developed the original idea(using 4 stages) of the “epidemiological transition”.
The epidemiological transition is a generalized model of population structure for understanding the changes of fertility and mortality with modernization.
In this transition, it has four stages with different processes with a possible 5th stage.
There are two major units. This includes the developments in a population and its distribution and the changes in patterns of life expectancy and causes of death.
Before 1300, Europe's population rapidly increased more than cultivation of agriculture. In addition, temperatures did not favor the people with longer, colder winters and wetter summers; this caused crops to be rotten and unripened. This began The Great Famine.
By 1317, all of society were suffering, especially the lower classes. To make it worse, from 1319 to 1321, an unknown disease killed a large number of livestock.
At least 1 of every 10 people had died from famine.
Spread of the Black Death in Europe
High birth rate; rapid fall in each upward age group due to high death rates; short life expectancy
High birth rate; fall in death rate as more living in middle age; slightly longer life expectancy
The Demographic Transition Model
Cholera's Symptoms include: diarrhea, vomiting, intense abdominal cramps, thirst, and fever.
Cholera has killed millions of people originating from the filthy water in India in the early 1800s.
The first outbreak was during 1817-1823, and spread to all most of Asia.
During the second cholera pandemic, the illness had reached Europe, including London and Paris in 1832. In London, there were 6,536 victims; in Paris, about 20,000 out of 650,000 were killed with about 100,000 deaths in all of France.
Between 1849–51, an large number of cities were affected. St. Louis' casualties were 4,557, Cincinnati's was 5,969, and Detroit's was 700. It affected 5–10% of the population.
AIDS/HIV are a relatively new discovered disease.
The spread of this illness was believed to have started around the 1960s. It became noticed in the 1970s. HIV is thought to originate from Africa by being infected by chimpanzees who had the illness.
In 1981, AIDS/HIV had a large number of reported clustered or increased situations of sarcoma (type of cancer) and pneumonia. The conditions mostly infected the elderly or people with weak immune systems.
Throughout the years, people began to worry more and tried to find vaccines for this disease.
In 2000, there were 34.3 million cases of HIV worldwide. Most were in Africa.

Stage 3
This is termed the "Age of Degenerative and Man-made Disease". It is theorized that degenerative diseases replace the chronic diseases which means that there is a larger amount of elderly being affected. Deterioration and loss of function in the organs (or tissue) become more common due to age. There are also anthropogenic types where pollutants or human activity can create diseases.
Even though there more deaths in older people, the life expectancy still increases to 50 or higher since medicine has improved.
Proposition three states that “During the epidemiological transition the most profound changes in health and disease patterns obtain among children and young women.” This shows the fall in birth rates.
Death rates decline, and fertility rates decrease in this stage.
Examples of diseases in this stage: Alzheimer, heart disease, and some types of cancer
Heart Disease
The first historical record of the plague is in Central Asia around 1338, reaching China and India by 1346.
In November 1347, a ship was returning from the Black Sea and on its way home brought the "pestilence" or "great mortality".
The Black Death arrived at England in August 1348; then it arrived at Norwich by January 1349, Dublin by the summer, and Edinburgh early in 1350.
Modern scholars say that about 25 million people died in Europe from the Black Death and worldwide about 50 to 70 million. Before the famine and disease, the world population was only about 500 million.
Black Plague
Across all populations in the U.S., heart disease is a leading cause of deaths. This disease is usually from overeating and inactivity.
In the 1960s-1970s were the years that the mortality rates in the U.S. from the cardiovascular disease were at their peak. Since the 1960s, hypertension, high cholesterol, and smoking have also generally decreased the adult population.
After the highest peak, the death rates have fallen about 2-3% each year. Africa is similar here.
Heart disease in Asia accounts for 25.3% of all deaths. They also have a decline in deaths from the disease.
Stage 4
This stage is the Delayed Degenerative Diseases.
S. Jay Olshansky and Brian Ault extended the transition to stage four. The proposition says that “The shifts in health and disease patterns that characterize the epidemiological transition are closely associated with the demographic and socioeconomic transitions that constitute the modernization complex.”
Life expectancy is higher from better medical technology, but degenerative diseases from stage 3 still stay.
It is connected to stage 3, but differences between the stages are improvement of technology to improve lifestyles and the increase in life expectancy from 50 to 70.
Some examples of disease in this stage are Alzheimer, heart disease, and some types of cancer (same as stage 3).
As said before the epidemiological transition is based off of the demographic transition model. We look at the death rates and see how the diseases in each stage affected the population.
Many people infected with "King Cholera"
Declining birth rate; low death rate; more people living to old age.
Blood blocked from moving (from aging), causing a heart attack
Alzheimer slowly affects areas of the brain that control thought, memory, and language. After a while, they start to have a hard time remembering events that happened recently or names of people they know.
Often times, it starts after the age of 60, and the risk of getting the disease goes up as you keep aging.
During the early 1900s, a physician named Alois Alzheimer had examined his patient and found that areas around certain areas of the brain were surrounded by gray matter.
The term which soon caught on came from Emil Kraepelin who had written it in his book.
It didn’t gain too much attention after a few decades until a greater amount of people became affected with the disease.
Increased attention in the 1990s led to new discoveries and a better understanding of the disease. Several drugs were created from the information to treat the symptoms.
It is listed as the primary cause of death.
Low birth rate; low death rate; higher dependency ratio; longer life expectancy
Someone suffering with the Alzheimer's disease
Better medical technology to help with the diseases (neuroimaging)
The End
Avian Flu
Also called bird flu because it is an infectious viral disease of birds with no signs of illness (comes from migrating fowl)
began in 1997 from a poultry outbreak in Hong Kong SAR, China
It reemerged in 2003 and 2004 to spread from Asia to Europe and Africa. This pandemic has almost affected all the poultry in the poultry countries.
In November 2007, there were about 335 confirmed cases in Asian countries with a death rate of 206 deaths.
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