Key Public Health Challenges for Health-EDRM in the Twenty-First Century: Demographic and Epidemiological Transitions

Abstract

The phenomenon of demographic transition suggests that societies experiencing modernization transform from pre-modern demography of high fertility and high mortality to a post-modern one in which both are low. An increase in life expectancy and the aging of populations also lead to an epidemiological transition that shifts disease profile from communicable diseases to non-communicable diseases (NCDs) in many countries. With aging populations and the increasing behavioral health risk factors associated with rapid urbanization and lifestyle modernization in many developing countries, the mortality and disease burden in developing countries will continue to shift from communicable disease-based to predominantly NCD-related in the remaining decades of this century. Globally, over 60% of all deaths in 2005 were caused by chronic NCDs such as hypertension and diabetes mellitus. While these chronic NCDs constituted significant disease burden in developed countries, more than 80% of the NCD-related deaths occurred in low-income and middle-income countries. For many low-income countries experiencing these double transitions in the twenty-first century, a double burden of disease poses a major and severe public health challenge during disasters. In a disaster context, due to limited resources, many aid agencies overlook the importance of addressing both acute and underlying disease patterns (such as NCDs) of the affected community. As a result, disaster victims may have issues in accessing therapies and medicines that may potentially reduce morbidity and mortality.