The Global Transition

Demographic & Epidemiological Change

 AIMS

• To explore the global transition

relation to a number of core
demographic & epidemiological
changes
• To examine the leading causes of
global mortality
• To identify the leading risk
factors in disease burden (GBD)
 GLOBAL
TRANSITION

• Demographic Transition:
Population trends in
• Birth rates
• Death rates
• Epidemiological Transition:
Change in patterns of
• Disease
• Risk

• Nutrition Transition
 CHANGES
•What causes demographic change?
•What causes high death rates and low
life expectancy?
•What causes high birth rates?
•Why do we have an ageing population?
DEMOGRAPHIC
TRANSITION

European model
DEMOGRAPHIC TRANSITION

Stage 1 Stage 2 Stage 3 Stage 4

Birth rate

Natural
increase

Death rate

Time

Note: Natural increase is produced from the excess of births over deaths.
 POPULATION CHANGE
• https://www.youtube.com/watch?v=QwfH1gYkXTw
• https://www.youtube.com/watch?v=RLmKfXwWQtE
Can you explain what is
happening in the
pyramids?
Focus on sex
What is happening?
EPIDEMIOLOGICAL
TRANSITION
• https://www.youtube.com/watch?v=nt3d4oMmByI
• Watch the short video and observe
• How the epidemiological transition is defined
• What does the process entail
 EPIDEMIOLOGICAL TRANSITION

Increasing
Change in degenerative Increasing life
Linked to the Communicabl
patterns of or non- expectancy
demographic e disease -
disease and communicabl and ageing
changes Pandemics
health risks e diseases population
(NCD’s)
OMRAN’S THESIS
3 Key Factors
1. Changes in mortality is key to population
change
2. Shifts in mortality and disease patterns
3. Relative risks of mortality by age and sex
SHIFTS IN MORTALITY AND DISEASE
PATTERNS: 3 AGES
• The ‘Age of Pestilence and Famine’ = high mortality which impacts on
population growth. Low LE between 15-40 years
• The ‘Age of Receding Pandemics’ = mortality declines and the average
LE increases to 30- 50 years + population increases
• The ‘Age of Degenerative and Man-Made Diseases’ (NCD’s) =
mortality decreases significantly and the average life expectancy rises
and exceeds 50+ years. ‘It is during this stage that fertility becomes
the crucial factor in population growth’.
• Theory that death rates and increasing life expectancy dictates
fertility rates and population growth
(see Omran 2005 - reprint)
GLOBAL BURDEN OF
DISEASE

• 1990-2000, 2000-2011,
2013(Global Health Estimates)
• Global data on all diseases and
injuries
• Best estimates of disease/injury
incidence, prevalence, &
associated mortality
• http://www.healthdata.org/
• See Global Health Observatory
http://www.who.int/gho/en/in
dex.html
MAJOR GLOBAL
HEALTH PROBLEMS

• Communicable disease
• Non-communicable disease
• Accidents/injuries
• Violence
• Mental ill health
• http://www.who.int/featur
es/factfiles/global_burden/f
acts/en/index.html
 • Traditionally 4 main diseases
and 4 risk factors
‘The United Nations high level
meeting on NCD’s, held in
September 2018, signalled a
5 NCD’S shift from this four-by-four
approach to a five-by-five
&5 response, adding mental health
RISKS conditions and key
environmental risk factors to
the lists’ (Linou, et al. 2018, p.1)
• Important shift to broader
determinants and to move
away from lifestyle obsession!
5x5 HEALTH RISKS AND NCD’S
http://www.who.int/healthinfo/global_burd
en_disease/projections/en/
SUMMARY

Changing demographics & ageing populations

Communicable diseases remain problematic, especially for

children linked to unacceptable high child mortality rates

Non-communicable diseases on the increase

Double burden (triple) of disease for many low/middle

income countries
Global transition easier to understand with improved data
collection methods and visualisation