Epidemiologic Transition Mortality Rates Infectious Diseases NCD

Death Rates for TB in England and Wales

TB Bacillus Identified Chemotherapy BCG Vaccination

Death Rates for Measles in Children in England and Wales

Immunization begun

Epidemiologic Transition Mortality Rates CA CHD NIDDM Trauma

CHD Death Rates Males, aged 45-54

Incidence of Stomach CA Males

Breast Cancer Incidence Females

Cirrhosis Death Rates, Males, aged 45-54

Death Rates for Stroke Males, aged 45-54

High Incidence of NCDs in Developed Countries ] Cardiovascular CHD CHD Deep Vein Thrombosis Deep Vein Thrombosis ] Respiratory Emphysems Emphysems Lung CA Lung CA ] Female Genital Endometriosis Endometriosis Endometrial CA Endometrial CA

High Incidence of NCDs in Developed Countries ] Breast Breast CA Breast CA Fibrocystic Disease Fibrocystic Disease ] Male Genital Prostrate CA Prostrate CA ] Metabolic NIDDM NIDDM

High Incidence of NCDs in Developing Countries ] Possible Infectious Etiology Macronodular Cirrhosis Macronodular Cirrhosis Hepatocellular Carcinoma Hepatocellular Carcinoma Rheumatic Heart Disease Rheumatic Heart Disease Iron deficiency anemia Iron deficiency anemia ] Related to Nutrition Deficiency Endemic Goiter Endemic Goiter Malnutrition Related Diabetes. Malnutrition Related Diabetes.

Back to Nature  Improved Physical activity  A Healthier Diet, less saturated fats, more fiber  Less Stress

Transition  Nomads  Farmers  Urban 45 yrs 60 yrs 70 yrs

1960 Urban Rural USA Developing Countries ruralurban

2003 Urban Rural USA Developing Countries rural urban

Life Expectancy in Developing Countries

Changing Life Expectancies

Causes of Death n Age Accidents Accidents CA CA CHD CHD n Age CHD CHD CA CA Accidents Accidents Age Accidents CHD CA Age CHD CA Accidents DevelopedDeveloping

Other Transitions  Agriculture  Forestry  Toxicity  Urbanization  Fossil Fuel  Nutrition

Systems Analysis Attempts to build a replica of the real world and experiment with it in order to obtain a better understanding of what is observed

Systems approach The Need for the Development of a systems approach to Epidemiology

EPI systems Interplay of factors that cause one disease to increase while another falls.