This is a good introduction to the so-called "epidemiologic
transition" that occurred throughout the past 160-200 years. It
is from the Millbank Quarterly. If you can't access it from the
link to the electronic library, then try cutting and pasting the
following URL into your web browser:
THE HISTORY OF HUMAN MORTALITY
(Note: much of the information in the following sections is from John
Cairns' book "Matters of life and death: perspectives on public health,
molecular biology, cancer, and the prospects for the human race",
published by Princeton University Press, 1997.)
Recall from lecture one the first of our first principles of health research and
practice: human health status can change over time. Few of you would argue
against the proposition that health status can change over an individualʼs lifetime.
Obviously, we acquire more health problems at certain times of our lives, and all
of you have probably heard already that we consume most health care resources
during the last few years, months, or even weeks, of our lives.
But what about human health in general? Has it changed over the centuries? If
so, in what way has it changed? What factors contributed to the change? This is
an important question for anyone who strives to play a leadership role in health.
Understanding the reasons human health changed in the past can lead to greater
ability to change human health in the future. Therefore, weʼll spend a bit of time
briefly reviewing the history of human mortality.
1/ PALEOLITHIC ERA
— 40,000 - 10,000 years ago (also known as the upper paleolithic era)
— humans lived predominantly as hunter/gatherers
— evidence of health status obtained from gravesites
— generally, evidence suggests that they were well nourished (good
protein nutrition, appropriate fat intake, good complex