Revising epidemiologic transition theory: Accounting for nonlinear, multidirectional transition and dual disease burden in historical epidemiologic tr

本计画旨在修正流行病学转变理论，以更好地反映当代和过去流行病学转变的现实。本研究将重新审视5个案例研究阿卜杜勒R。奥姆兰（1971）用来制定的理论，试图证明其原来的说明借鉴了有缺陷的假设，并未能充分反映这些情况下的现实。奥姆兰的基本理论中的缺陷并没有被那些后来从事或发展它的人充分解决，因为大多数人要么强调这些问题，因为这些问题是该理论不适用于特定情况的原因，要么通过扩展它来发展该理论。还没有人质疑奥姆兰理论所基于的假设。分析Omran使用的5个案例研究，采用了一系列人口和统计技术，包括生命表创建/分析、分解分析和回归。本项目将研究这5种流行病学转变是否具有双重疾病负担的特征（Frenk，1991），正如在许多当代正在进行的转变中所观察到的那样。这种负担的存在将使人们对奥姆兰理论所依据的单向线性的基本假设产生疑问，并为修改基本理论提出了明确的理由。这将提高其在解释影响过去、现在和未来社会的疾病和死亡率的复杂模式方面的效用。

This project aims to revise the epidemiologic transition theory to better reflect the reality of contemporary and past epidemiologic transitions. This study will revisit the 5 case studies Abdel R. Omran (1971) used to formulate the theory in an attempt to prove its original elucidation drew on flawed assumptions and failed to fully reflect the reality of these cases. The flaws in Omran's base theory have not been adequately addressed by those who have since engaged with or developed it as most have either highlighted these issues as reasons why the theory does not apply in specific cases or have developed the theory by expanding it. No one has yet questioned the assumptions on which Omran's theory is based.This project will address this oversight by re-analysing the 5 case studies Omran used employing a range of demographic and statistical techniques including lifetable creation/analysis, decomposition analysis and regression. This project will examine the possibility that these 5 epidemiologic transitions were characterised by a double burden of disease (Frenk, 1991) as observed in a number of contemporary ongoing transitions. The presence of such a burden would call into question the underlying assumptions of unidirectional linearity underpinning Omran's theory and present a clear rationale for revising the base theory. This would improve its utility in explaining complex patterns of disease and mortality that shape societies, past, present and future.