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

点击翻译按钮获取中文摘要

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.