| Abstract: | The general theory of epidemiologic transition is explained. The theory hypothesizes that long-term changes in health and disease patterns in any society are related to the demographic and social conditions in that country. Mortality is considered to be the major factor in population change. The theory is illustrated by a detailed consideration of birth and death trends in the U.S. Mortality decline began in the U.S. in the middle of the nineteenth century. Associated with this decline was a gradual shift from death due to infectious disease to mortality caused by degenerative, man-made, and stress-related diseases. The transition favored women, children, and whites. Medical progress was less responsible for the change than were improvement in living conditions and changes in the nature of certain diseases. The magnitude of this decline in mortality is illustrated by an analysis of 5 specific indicators of mortality. Changes in the U.S. fertility patterns were also unplanned and attributable to socioeconomic factors rather than to medical advances. Comparison of the transition in the U.S. with the same movement in England shows that the U.S. experience fits the Western or Clasical Model of the epidemiologic transition theory. This experience cannot be used as a model for the transition occurring now in the Third World. In those countries, programs organized in the context of general social development projects could be expected to influence trends in mortality and fertility. |
