Epidemiologic and demographic transition as drivers of NCDs

Abstract

This chapter describes epidemiologic and demographic transition and what it means for NCDs, both in the past but also in the future. Epidemiologic and demographic transition refers to changing disease and demographic patterns in populations along with socioeconomic development. Trends in epidemiologic and demographic patterns explain why, for example, total numbers of deaths from NCDs such as CVD or lung cancer can markedly increase in a population (e.g. because of population growth and aging) while the age-standardized mortality rates (which express risk irrespective of population growth and age structure) decrease, as is observed in high-income countries and an increasing number of low- and middle-income countries. The different stages of demographic transition are explained. The chapter describes the implications of demographic and epidemiologic transition for NCD policy and planning. This includes the importance of primary prevention to reduce modifiable NCD risk factors and their determinants (to decrease the incidence of diseases at the population level) and the need to strengthen the healthcare system (to curb disease progression and reduce case fatality at the individual level).