Abstract

Abstract This chapter focuses on the changing pattern of health and disease worldwide. It first presents the ten leading causes of death globally, before narrowing the focus to the leading causes of death among children under five years old as an indicator of the most at-risk populations. Disease patterns in underdeveloped countries are compared with those of European countries in the nineteenth century and we see that many diseases that we now regard as ‘diseases of poverty’ were once prevalent in the northern hemisphere. Why is this so? Different theories have been put forward to explain the change in disease patterns that countries follow as they urbanise and modernise. Instead of poorer countries following the same epidemiological transition as rich countries, another type of transition is evolving. In this new transition, countries are struggling with more than one dominant disease pattern at the same time—there is often a double, triple and sometimes even a quadruple burden of disease. Importantly, this is increasingly polarised across income groups, occurring not only between rich and poor countries, but also across social classes within poor and rich countries.

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