The Health and Mortality Transition

1. The Health and Mortality
Transition
• NOOR SAEED WAZIR
• UNIVERSITY OF SARGODHA, PAKISTAN

2. Morbidity vs. Mortality
 Morbidity refers to the unhealthy state of an individual, while mortality
refers to the state of being mortal. Both concepts can be applied at the
individual level or across a population. For example, a morbidity rate
looks at the incidence of a disease across a population and/or geographic
location during a single year. Mortality rate is the rate of death in a
population. The two are often used together to calculate the prevalence of
a disease — e.g., measles — and how likely that disease is to be deadly,
particularly for certain demographics.

3. Health and Mortality change over
time
 Hunting and Gathering Society
 Agricultural Society
 The Roman era to the Industrial Revolution
 Industrial Revolution to the 20th century

4. Hunting and Gathering Society
 The population grew so slowly during the first 99% of human history.
 Principal causes of death were :-
 More than half of all children born well died before 5
 Poor nutrition
 Geronticide (killing of older people)

5. Agricultural Society
 Both birth and death rates probably went up.
 High Birth Rate Causes
 Death Rate Causes

6. High Birth Rate Causes
 proper food supply,
 living farming communities,
 domesticating Plants and animals,
 needs of workers for agriculture,
 religious beliefs

7. Death Rate Causes
 Closer contact with one another with animals and with human an animals
waste, would encourage the spread of diseases, communicable diseases.
 War

8. The Roman era to the Industrial
Revolution
 Life expectancy is 22 years.
 General people died at a younger rather than older age.
 The black death hit Europe in the 14th century.
 It is estimated that one third of population of Europe may have perished
from the disease between 1346-1350.

9. Industrial Revolution to the 20th
century
 Life expectancy in Europe and USA was approximately 40 years.
 Fertility rate is high.
(proper diet, proper clothing, better housing, vaccination…………..)
 Mortality rate is low.
(world war 1 and 2)

10. Lifespan and Longevity
ABDULLAH SAJJAD
BSOF14M011

11. Lifespan
 The length of time for which a person or animal lives.
 The duration of existence of individual

12. Theories of Lifespan
 Wear and Tear
 (Dr August Weismann, the use of one thing causes inefficiency in its
results, immune system)
 Planned Obsolescence
 (biological clock which have to still)

13. Longevity
 A long individual life; great duration of individual life.
 The length or duration of life.

14. Longevity
 Bangladesh and USA
 Twins
 35% life expectancy inheritance
 Social, Economical and Political infrastructure.
 Lifestyle

15. Causes of poor Health
and Death
ZAHEER ABBAS
BSOF14MO10

16. Types of causes
 Communicable Diseases
 Non-Communicable Diseases
 Injuries

17. Communicable Diseases
 Is one that is spread from one person to an other through a varitey of ways that
includes:-
 Physical contact with an infected person
(HIV, Hepatitis A, TB)
 Contact with Contaminated surface or object
(HIV, Hepatitis B, Cholera)
 Bites from insect or animals
(Malaria, Yellow Fever)
 Travel through the air
(Measles, Tuberculosis)

18. Non-Communicable Diseases
 Is a disease also known as chronic disease and even not pass from person to person.
Their duration is long, generally slow progression.

19. Types of Non-Communicable Diseases
 Diabetes
(limits the body ability to process glucose normally)
 Lung cancer
(causes malignant cell growth in the lung tissues,Smoking90%)
 Skin Cancer
(caused when ultraviolet rays damages the skin cells)
 Heart Diseases
(impact the circulatory system)

20. EPIDEMIOLOGY
 The study of the distribution and determinants of health-related states or events in specified
populations, and the application of this study to the prevention and control of health problems.

21. INTRODUCTION
 Epidemiology is a fundamental science of public health.
 Epidemiology has made major contributions to improving population health.
 Epidemiology is essential to the process of identifying and mapping emerging diseases.
 There is often a frustrating delay between acquiring epidemiological evidence and applying
this evidence to health policy.

22. HISTORY OF EPIDEMIOLOGY
 Circa 400 B.C. Hippocrates suggested that environmental and host factors such as
behaviors might influence the development of disease.
 John Graunt 1662 (London councilman): Published a landmark analysis and
quantify patterns of birth, death, and disease occurrence, noting disparities
between males and females, high infant mortality, urban/rural differences, and
seasonal variations.
 William Farr 1800: Systematically collecting and analyzing Britain’s mortality
statistics.

23. HISTORY OF EPIDEMIOLOGY
 John Snow 1854 (father of the field of epidemiology): Epidemiological studies of
chronic diseases began around the mid‐19th century.
 In the mid- and late-1800s, epidemiological methods began to be applied in the
investigation of disease occurrence.

24. HISTORY OF EPIDEMIOLOGY
 In the 1930s and 1940s, epidemiologists extended their methods to noninfectious
diseases.
 The period since World War II has seen an explosion in the development of
research methods and the theoretical underpinnings of epidemiology.
 Epidemiology has been applied to the entire range of health-related outcomes,
behaviors, and even knowledge and attitudes.

25. HISTORY OF EPIDEMIOLOGY
 During the 1940s and 1950s, several studies were initiated to examine the possible
link between smoking and lung cancer. One of them was conducted by Doll and
Hills.
 During the 1960s and early 1970s health workers applied epidemiologic methods
to eradicate naturally occurring smallpox worldwide.
 In the 1980s, epidemiology was extended to the studies of injuries and violence.
 In the 1990s, the related fields of molecular and genetic epidemiology and took
roots.

26. HISTORY OF EPIDEMIOLOGY
 Today, public health workers throughout the world accept and use epidemiology
regularly to characterize the health of their communities and to solve day-to-day
problems, large and small.

27. HISTORY OF EPIDEMIOLOGY
 The last decade there has been increasing concern expressed about the
limitations of the risk factor approach, and considerable debate about the
future direction of epidemiology.
 it has been argued that there has been an overemphasis on aspects of
individual lifestyle, and little attention paid to the population-level
determinants of health.

28. EPIDEMIOLOGICAL TRANSITION
Definition:
 Changing in mortality and morbidity over the time and place, referred as epidemiological
transition.

29. EPIDEMIOLOGICAL TRANSITION
 Epidemiological transition theory:
 First model presented by Omran in 1970s.
 Theory focuses on the “complex change in the pattern of health and disease and on the interaction between
these pattern and their demographic, economic and sociologic determinants and consequences”.
 Transition linked to improvement and advances in nutrition, hygiene and sanitation and medical knowledge
and technology.
 Health care transition refers to the changes in organized social response to health needs of the population and
deals with the way the health care system is organized to deliver its services.

30. EPIDEMIOLOGICAL TRANSITION
 STAGES
1. The age of pestilence and famine:
 Fluctuating mortality in response to epidemic, famines and war
 Crude Death rate was 30- 50 from per 1000 population
 Birth rate was low
 Average age was 20-40
 Leading causes of death was infectious and parasitic disease such as influenza, diarrhoea, and tuberculosis.
2. The age of receding pandemics:
 Death rate decreases and was 30 from per 1000 population
 Birth rate increases
 Average age counted was 55 year.
 Improve sanitation, hygiene and nutrition
 Later advance in medicine and public health programs
3. The age of degenerative man-made diseases:
 Mortality decline until death rate become 20 from per 1000
 Birth rat increase an d life expectancy become 70 years
 Major causes of death was chronic degenerative and man mad diseases related to radiation, accidents, food additives, occupational hazards and
environmental pollution.

31. EPIDEMIOLOGICAL TRANSITION
 Hybristic stage:
 In addition to previous stages by Roger and Hackenberg in 1987.
 He felt that original theory lacked reference to violence and accidental death and death due to behavioral
causes.
 Morbidity and mortality affected by man made diseases, individual behavior and potentially distractive
lifestyle.
 Individual behavior includes physical inactivity, unhealthy diet, excessive drinking and cigarette smoking.
 Potentially distractive lifestyle example is HIV/AIDS.

32. EPIDEMIOLOGICAL TRANSITION
 The age of delayed degenerative disease proposed by Olshansky and Ault in 1986.
 Rapid mortality decline in advance ages that are caused by postponement of the ages at which
degenerative disease tend to kill.
 It is a result of public health measure and advance in medicine technology.

33. EPIDEMIOLOGICAL TRANSITION
 Models
 Western or classical model
 Transition start in 19th century and was accuplained by a process of modernization, and industrial and
social change.
 Accelerated model by Japan
 Change was based on general social improvement such as nutrition, sanitation and medical advance.
 Delayed model
 Occur in developing countries
 Mortality decrease by modern medicine technology.