Scribd Logo
Fazer o upload

Bem-vindo(a) ao Scribd!

  • Aula 4 - Marden - Mortalidade - (14) Omran 1998 Thirty Years Laterworld Health Statistics Quarterly 98 PDF

    Enviado por

    Raíssa Couto
    12 visualizações22 páginas

    Título original

    Aula 4 - Marden - Mortalidade - [14] Omran 1998 thirty years laterWorld Health Statistics Quarterly 98.pdf

    Direitos autorais

    © © All Rights Reserved

    Formatos disponíveis

    PDF ou leia online no Scribd

    Você considera este documento útil?

    Este conteúdo é inapropriado?

    Denunciar este documento

    Direitos autorais:

    © All Rights Reserved
    Baixe no formato PDF ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    12 visualizações22 páginas

    Aula 4 - Marden - Mortalidade - (14) Omran 1998 Thirty Years Laterworld Health Statistics Quarterly 98 PDF

    Enviado por

    Raíssa Couto

    Direitos autorais:

    © All Rights Reserved
    Baixe no formato PDF ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    de 22
    Hodges Library Stacks RA651 .W65 vol.51 no.2-4 1998 TN: 681785 (AN 00 | ODYSSEY ENABLED jorid health statistics quarterly. Rapport trimestriel de This article ratstiques sanitaires mondiales. has been sent to you vo: 51 No: 2-3 by the DA: 1998, PG: 99-119 University of AU/TI: World Health Organization. Omran, AR; The Tennessee Epidemiologic Transition Theory Revisited 30 Years Later. TKN ‘TNUUTN ee Tu Lending String: Hodges Library *TKN,KLG)MUM,FDA,GUA Knoxville TN’ Tf Process: 20080621 ~8/22/08 Charges: No Charge 37996 Do not pay from this workform. lense send al 2 resend requests to Patron: Cossman, Jeralynn | i te m kek ): MFM Lending aria TO! MEM TN: 275413 3 or 7 . < Lending emai — Mississippi State University . = “trane you Library / Access Svs ee ee 3g #1 Hardy Street < Fax Mississippi State, MS 39762 | ecssrazms TATE g Lending Arie! 160.36.192.218 FAX Number: Email 662-325-3560 iislend@utk.edu Ariel Address: ariel. library.msstate.edu NOTICE: This material maybe Email: protected by blentine@tiorary.msstate-edu Copyright Law Request Number OCLC 45279515 (Title 17 US Code) The epidemiologic transition theory revisited thirty years later Abdel R. Omran Background “Aswearrive at thenewmillennium, documentingand reflecting on the past can guide the future. This is one of the functions of the Epidemiologic Transition, ‘Theory. The theory is based on the systematic appli- cation of epidemiologicinference tochanging health, ‘mortality, survival and fertility over time and place linked to their socio-economic, environmental, lifestyle, demographic, health care and technologi- cal determinants and/or correlatesin differentsoci- etal settings. There can be no doubt that a profound epidemiological change hasbeen taking place in the world over the last several centuries, albeit ata vary- ing pace and take-off time in different populations. ‘The purpose of this essay sto revisit che original 1971 presentation of the Epidemiologic Transition Theory, moving from a three-stage/three-model for- mulation toa five stage /fivemodel formulation. This will make use of the accumulation of information and insights over the last 80 years as partly demon- strated in Box 1, The epidemiologic transition Epidemiology is the study of health and disease patterns and their determinants and consequences in population groups. All of the transitions involved in both the dependent and independent variables are the subject of epidemiological study and, hence, are encompassed by the epidemiologic transition. Epidemiology incorporates the scientific capacity 10 analyze social, economic, demographic, health care, technological and environmental changes as they relate to health outcomes. Classifying all the changes in these variablesunder the “health wansition” would, however, be confusing. Health is a dependent vari- able of epidemiology, not vicewversa, Figure 1 dia- grammatically portrays the dynamics involved in the epidemiologic transition, Triggered by economic "This paper ian orginal esay by Abdel R. Omran, MD., De PH, Profewor in the Department of International Public Hetith, School of Public Health and Health Services, George ‘Washington Universi, Washington, D.C, USA. Dr Omran died in Apri 1999, Ar the time, be had completed the draft of this manuscript Several members ofthe facly of the Universiy feviewed the work including Dr Ayman El Mobandes, Dr Glen (Geelhood, Dr Daniel Hoffman, Dr Gilbert Kombe, Dr Richard Southby and Dr Wiliam Witers The final article was completed by Dr Rosalia Rodriguez Garcia, Profesor and Chait, and De [ames Banta, Profestor of the Deparment of tnternational Public Health, Thanks are extended abo to Susna De for her asiance in compleing the atl Wid hth statist. quart, 1 (1996) Boxt Evolution ofthe epidemiologic transition theory CConcaved by Oman nthe mid-1960s (1), the theory was published in its original form in 1971 (2). Subsequent applications (3), summaries (4) and a preliminary update (6jtolowed. Since then efforts for amore definitive update have been undertaken. This has been prompted further by ‘growing interest in the epidemiologic transition in the demographic (6), health 7,89) and soca science Iitera- ture (10), Additional, several papers nave used the righ ral 1971 version or its preliminary update in scholarly applications to specific populations (11,12). Papers by Dishansky and Ault in 1986 (13) and by Rogers and Hackenberg 14) suggested aFourt stage based primarily fn the experience of the USA. Frenk eta. (1989) (76) suggested a model for intermediate economies based pr- marly on the experience of Mexico. Constructive and insightful a5 these recommendations are, the definitive ‘update must perforee incorporate experiences based on wider geographic, temporal and conceptual inputs. The ravisied formulation wasbrieti describedin 1989 (76)and was applied more recenty tothe ransionsinthe Americas ia 1996 document commissioned bythe Pan American Health Organization (PAHO) (17) ‘and social development, the epidemiologic wansi- tion encompasses the changing disease and health patterns (the health transition), the changing fertik ity and population age structure leading to ageing (partsof the demographic transition), the changing lifestyles (the lifestyle transition) the changing health ‘care patterns (the health care transition), the medi- ‘cal and technological evolutions (the technologic transition), and the environmental and ecological changes (the ecological transition) ‘The relative role of mortality and fertility experi- ences in the transition dynamics is discussed under Proposition 1. The long-term dynamics of the tran- sition are classified into atleast five transition stages, which are described under Proposition 2. The par ticular determinants of mortality and fertility changes. are given thereafter, Different kinds of inequities are noted during the transition and are captured ‘under Proposition 3, Transition models characteriz- ing the dynamics, timing of the transition take-off, and subsequent changes in different country groups are briefly discussed in Proposition 4. Proposition 1: Relative role of mortality and ferility in the transition Within the complex dynamics of the epidemiologic transition, mortality is a most fundamental force, 9 Fig. 4 ‘The epidemiologic transition dynamics sTaget powieyetange _s-Oreipaete Merge. __ Fame enenceand Receding Dogenaatve, sess, Dedinirg CVD ‘spire ually of fanine pagers Spd armade mortally. ageing and wh peste sieeaes ‘urging seeses—_nequalies Wealth anton changing pats of Heath, Determinants of disease and motalty change sur Disease. and Moray Detarminats ot fer decline “SOCIO-ECONOMIC DEVELOPMENT AND/OR INDUSTRIALIZATION Lifestyle and edueation ‘eanlton erty, igh ten cies. truce, young ten older ‘DEMOGRAPHIC "TRANSITION Heath care ston Contaues ¢ynamie change wth chraiy pls merging disease czeding to raeston mo ‘eetne i CDs: actual (Wes!) for poteial in non-western models ol ‘QUALITY OF LIFE FOR ALL Teholoneal Environments "ronson actos ow fine Taniton exerting its influence through rss in premodern | cee ve chrough declinesia modern times. Feri fpiisa potent co-azable staying atahigh evel in he | aries, then declining and becoming virtually re acceter of population grovth, Reversal oF stg | the Pace tthe traniuon is posible during economic, | Matteal environmental, morbidity or other eres.) vataliy The absence of continuows and tei ai Te at moray and ety | in premodern times and in preandustrial countries | we eeadee determininuestaements about thei ea Pre demographic impact. An asessment of ie Pos | ase came of variations in mortals, fertiiy, dix se Tagrern and age structure does allow |

    Você também pode gostar