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Epidemiologic Transition
Mor
tali
ty R
ates
Infectious Diseases
NCD
Death Rates for TB in England Death Rates for TB in England and Walesand Wales
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1840 1855 1875 1895 1915 1935 1948 1958 1968
Death Rates for TB in England Death Rates for TB in England and Walesand Wales
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1840 1855 1875 1895 1915 1935 1948 1958 1968
TB Bacillus Identified
Chemotherapy
BCG Vaccination
Death Rates for Measles in Death Rates for Measles in Children in England and WalesChildren in England and Wales
0
200
400
600
800
1000
1200
1400
1850 1870 1890 1910 1930 1950 1970
Death Rates for Measles in Death Rates for Measles in Children in England and WalesChildren in England and Wales
0
200
400
600
800
1000
1200
1400
1850 1870 1890 1910 1930 1950 1970
Immunization begun
Epidemiologic Transition
Mor
tali
ty R
ates
CA
CHDNIDDM
Trauma
CHD Death RatesCHD Death RatesMales, aged 45-54Males, aged 45-54
0 500 1000 1500
Thailand
Guatamala
Japan
Egypt
Italy
Bulgaria
US
UK
Scotland
Finland
Incidence of Stomach CAIncidence of Stomach CAMalesMales
0 20 40 60 80 100
Nigeria
India
US White
US NW
UK
Finland
Iceland
Columbia
Japan
Breast Cancer IncidenceBreast Cancer IncidenceFemalesFemales
0 5 10 15 20 25 30
Japan
Nigeria
Brazil
Singapore
Jamaica
Poland
UK
US NW
US Whites
Cirrhosis Death Rates,Cirrhosis Death Rates,Males, aged 45-54Males, aged 45-54
0 10 20 30 40 50 60 70 80 90
UK
Scotland
Hong Kong
US
Japan
Italy
France
Death Rates for StrokeDeath Rates for StrokeMales, aged 45-54Males, aged 45-54
0 10 20 30 40 50 60 70 80
Egypt
US
Thailand
UK
Italy
Scotland
Finland
Japan
High Incidence of NCDs in High Incidence of NCDs in Developed CountriesDeveloped Countries
CardiovascularCardiovascular
CHDCHD
Deep Vein ThrombosisDeep Vein Thrombosis RespiratoryRespiratory
EmphysemsEmphysems
Lung CALung CA Female GenitalFemale Genital
EndometriosisEndometriosis
Endometrial CAEndometrial CA
High Incidence of NCDs in High Incidence of NCDs in Developed CountriesDeveloped Countries
BreastBreast
Breast CABreast CA
Fibrocystic DiseaseFibrocystic Disease Male GenitalMale Genital
Prostrate CAProstrate CA
MetabolicMetabolic NIDDMNIDDM
High Incidence of NCDs in High Incidence of NCDs in Developing CountriesDeveloping Countries
Possible Infectious EtiologyPossible Infectious Etiology
Macronodular CirrhosisMacronodular Cirrhosis
Hepatocellular CarcinomaHepatocellular Carcinoma
Rheumatic Heart DiseaseRheumatic Heart Disease
Iron deficiency anemiaIron deficiency anemia Related to Nutrition DeficiencyRelated to Nutrition Deficiency
Endemic GoiterEndemic Goiter
Malnutrition Related Diabetes.Malnutrition Related Diabetes.
Back to NatureBack to Nature
Improved Physical activityImproved Physical activity A Healthier Diet, less saturated A Healthier Diet, less saturated
fats, more fiberfats, more fiber Less StressLess Stress
TransitionTransition
NomadsNomads FarmersFarmers UrbanUrban
45 yrs45 yrs
60 yrs60 yrs
70 yrs70 yrs
1960
Urban Rural
USA DevelopingCountries
rural urban
2003
Urban Rural
USA DevelopingCountries
ruralurban
Life Expectancy in Developing Life Expectancy in Developing CountriesCountries
0
10
20
30
40
50
60
70
1950 1975 1985 1995
Changing Life ExpectanciesChanging Life Expectancies
0
10
20
30
40
50
60
70
Africa India Latin America
1950
1990
Causes of DeathCauses of Death
Age 15-44Age 15-44 AccidentsAccidents
CACA
CHDCHD
Age 45-54Age 45-54 CHDCHD
CACA
AccidentsAccidents
Age 15-44Age 15-44 AccidentsAccidents
CHDCHD
CACA
Age 45-54Age 45-54 CHDCHD
CACA
AccidentsAccidents
Developed Developing
Other TransitionsOther Transitions
AgricultureAgriculture ForestryForestry ToxicityToxicity UrbanizationUrbanization Fossil FuelFossil Fuel
NutritionNutrition
Systems AnalysisSystems Analysis
Attempts to build a replica of the real Attempts to build a replica of the real world and experiment with it in order world and experiment with it in order
to obtain a better understanding of to obtain a better understanding of what is observedwhat is observed
Systems approachSystems approach
The Need for the Development of a The Need for the Development of a systems approach to Epidemiologysystems approach to Epidemiology
EPI systemsEPI systems
Interplay of factors that cause one disease Interplay of factors that cause one disease to increase while another falls.to increase while another falls.
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