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

该项目旨在修订流行病学过渡理论，以更好地反映当代和过去流行病学过渡的现实。本研究将重温Abdel R.Omran(1971)用来阐述这一理论的5个案例研究，试图证明其最初的阐释基于有缺陷的假设，未能充分反映这些案例的现实。后来从事或发展奥姆兰基础理论的人没有充分解决奥姆兰基础理论中的缺陷，因为大多数人要么强调这些问题，作为该理论不适用于具体案例的原因，要么通过扩展该理论来发展该理论。还没有人质疑奥姆兰理论所基于的假设。这个项目将通过重新分析奥姆兰使用的5个案例研究来解决这一疏忽，使用了一系列人口统计学和统计技术，包括生命表创建/分析、分解分析和回归。本项目将审查这5个流行病学转变的可能性，如在许多当代正在进行的转变中观察到的那样，表现为疾病的双重负担(Frenk，1991)。这种负担的存在将使支撑欧姆兰理论的单向线性的基本假设受到质疑，并为修订基本理论提供一个明确的理由。这将提高它在解释塑造过去、现在和未来社会的复杂疾病和死亡模式方面的有效性。

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.