Lecture 5- ch 6 epidemiologic profiles of global health and disease. Virtually all societies have gone through a transition from high mortality, high fertility to low mortality, low fertility. Stage 1: high birth rate, high but fluctuating death rates. Stage 2: declining death rates and continuing high birth rates. Stage 4: low death rates and low but fluctuating birth rates. Thomas r. malthus: an essay on the principles of population (1798): Poverty is the result unless there is moral restraint. Each mode of production has its corresponding mode of reproduction. The more offspring a family had, the more product it will produce. Shift from subsistence agriculture to factory means smaller family size needed. Higher marginal cost of extra child in urban setting / decline of multi-family households. More women educated and in paid labour force. Don"t need to depend on your child to take care of you at your old age. Long workdays/ shift work = less leisure time.