Mortality, Epidemiological, and Health Transitions

Abstract

Of all the advances of the twentieth century, the global decline in mortality rates is one of the most impressive. Three transitions—the mortality transition, the epidemiological transition, and the health transition—provide the frameworks within which demographers attempt to explain our past, understand our present, and improve our future. The mortality transition and the fertility transition together make up the so-called demographic transition, which describes the historical process whereby mortality and fertility rates declined from the high and approximately compensating levels of the past to the low and approximately compensating levels that they exhibit in rich countries today. The epidemiological transition refers to shifts in causes of death from infectious and communicable diseases when mortality is high to degenerative diseases when mortality is low. In contrast to the previous two, the health transition is not an empirical generalization, but refers to the changes over time in a society's health. Health-transition research addresses the cultural, social, and behavioral determinants of health, and thus has a wider focus and a broader disciplinary base than has until recently been usual in demographic research on mortality.