CENTURY OF EPIDEMIOLOGIC TRANSITION IN UNITED-STATES
CENTURY OF EPIDEMIOLOGIC TRANSITION IN UNITED-STATES
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DOI：
10.1016/0091-7435(77)90003-2
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发表时间：
1977-01-01
影响因子：
5.1
通讯作者：
OMRAN, AR
中科院分区：
文献类型：
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作者：
OMRAN, AR
本文应用流行病学转变理论描述了美国上个世纪的人口与健康动态。所提供的数据表明，美国的经验属于所谓的“古典”模式。美国的死亡率下降发生在世纪后期，标志着从传染病大流行到退行性疾病和人为疾病的转变。这种转变对儿童比老人更有利，对女性比男性更有利，对白人比非白人更有利。世纪美国的死亡率下降与医疗进步、卫生措施或有组织的卫生服务无关。更重要的决定因素是生活水平的提高、个人卫生、营养、住房和某些疾病的生态衰退。美国的生育率在世纪末开始下降，这种下降主要是由社会决定的。然而，近几十年来，有组织的因素变得明显。流行病学转变的理论也可以应用于其他人群，并有助于确定控制人口增长的努力方向。这一理论区分了三种不同的转型模式，这一事实提醒人口学研究者和决策者注意将一种模式的人口动态和解决方案应用于属于不同模式的国家的谬误。
In the present paper, the theory of the Epidemiologic Transition is applied to describe the population and health dynamics in the United States during the last century. The data presented indicate that the U.S. experience belongs to what is referred to as the “Classical” model. The mortality decline in the U.S. occurred during the latter 19th century and marked a shift from pandemics of infection to degenerative and man-made diseases. The transition favored children more than the old, females more than males, and whites more than nonwhites. Mortality decline in 19th century U.S. owed little to medical progress, sanitation measures, or organized health services. More important determinants were improvements in living standards, personal hygiene, nutrition, housing, and ecologic recession of certain diseases. Fertility in the U.S. started to decline toward the end of the 19th century, a decline that was primarily socially determined. In recent decades, however, the organized element has become visible. The theory of the Epidemiologic Transition can be applied to other populations as well and can be helpful in determining the directions to take in efforts to control population growth. The fact that the theory distinguishes three different models of the transition alerts population students and policymakers to the fallacy of applying the population dynamics and solutions of one model to countries belonging to a different model.