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PubMedDate not supplied

[Local health systems: a transition of the organized social response].

This paper discusses the transition of the organized social response in health with emphasis on local health systems. After reviewing a few basic definitions (health system, local health system, health care system, institutional system of health services), the author discusses the health transition (transition of the concept health-disease, technological transition, epidemiological transition, demographic transition, health care system transition) and the importance attributed to local health systems in Mexico.

Delivery of Health Care↗
PubMedDate not supplied

[Demographic-epidemiologic transition in Chile, 1960-2001].

BACKGROUND: In Chile, the demographic structure and the causes of morbidity and of mortality among the population have undergone major changes within a relatively short period of time. These changes have taken place within a framework of processes referred to respectively as demographic transition and epidemiological transition. This study is aimed at providing evidence as to the demographic transition and epidemiological transition which took place in this country within the 1960-2001 period. METHODS: This is a time-series study gathering demographic and death rate-related information from Chile throughout the 1960-2001 period. The data was taken from the Demographic Yearbooks of the National Institute of Statistics, from information produced by the Department of Prospective Studies under the Ministry of Planning and Cooperation and the Chilean Ministry of Health. RESULTS: In 1960, 39.6% of the population had less than 14 years old, natality rate was 36.3 per 1000, general mortality rate 12.3 per 1000 and Infant Mortality rate 120 per 1000. 44% of causes of decreases were by infectious and newborn's diseases. In 2001, 28% of the population has less than 14 years old, natality rate is 18.3 per 1000, General Mortality rate 5.4 per 1000 and Infant Mortality rate 8.9 per 1000. 68% of causes of diseases are by chronic diseases. CONCLUSIONS: Based on the results, it can be said that Chile is currently in a late stage of demographic transition as well as epidemiological transition. Ascertaining Chile's actual situation will provide information to those Latin American countries which are currently in early stages of these types of transitions.

Adolescent↗
PubMed1994

[The epidemiological transition and the conquest of plague].

In 1971, Abdel R. Omran, the epidemiologist, launched the concepts the epidemic transition and the demographic transition. Assuming that the epidemic and demographic structures of all preindustrial societies were similar, Omran attached these concepts to the epidemic and demographic transitions of the nineteenth century. He indicated that these were the only epidemic and demographic transitions in history. In this paper, it is argued that this assertion is untenable. Historically, there have been many societal transitions implying concurrent and interactive epidemic and demographic transitions. Two major historical events have been selected for illustrative purposes. The emergence of the western demographic system and the advent of plague in 1347 had dramatic impacts on epidemic and demographic conditions. Successful combat of plague, first in Italy, was organized with increasing efficiency from the second half of the fifteenth century on the basis of miasmatic-contagionist epidemiological notions. The antiepidemic organizations developed in this combat were efficient also against most other important epidemic diseases. The rise of antiepidemic organizations contributed to transitional change in epidemic and demographic structures with substantial impact on broader societal processes of modernization. These transitions preceded and conditioned the transitional processes referred to by Omran.

Communicable Disease Control↗
PubMed2001

Population pressure and fertility in pre-transition Thailand.

Before the demographic transition in Thailand, fertility was high, but not uniformly so. As in other pre-transition settings, Thai fertility responded to pressures and opportunities created by socioeconomic structure and land availability. Drawing upon provincial data from the 1947 and 1960 censuses of Thailand, we find a strong 'frontier effect' on Thai fertility in the 1950s. Fertility was higher in sparsely settled frontier provinces and lower in provinces with higher population density relative to cultivatable land. This finding is robust and holds up with controls for agricultural employment, land quality, and the sex ratio (an indicator of sex-selective migration). The effect of population pressure lowers the likelihood of marriage and of marital fertility. The findings from Thailand are consistent with the research of Easterlin on the nineteenth century United States and with other pre-transition societies. We suggest how demographic transition theory might be broadened to include fertility dynamics in pre-transition societies.

Fertility↗
PubMed2006

Fertility rates and future population trends: will Europe's birth rate recover or continue to decline?

Europe has long completed its demographic transition from high birth and death rates to low birth and death rates. But the demographic transition paradigm that has been very useful for explaining global demographic trends during the 20th century and that still has strong predictive power when it comes to projecting future trends in countries that still have high fertility, has nothing to say about the future of fertility in Europe. The currently popular notion of a 'second demographic transition' is a useful way to describe a bundle of behavioural and normative changes that recently happened in Europe, but it has no predictive power. The social sciences have not yet come up with a useful theory to predict the future fertility level of post-demographic transition societies. We even do not know whether the trend will be up or down. Given the lack of a predictive theory, this paper will try to do two things: (i) Summarize different substantive arguments that would either suggest the assumption of a recovery of fertility rates in Europe or alternatively, imply further declines. (ii) Convert this discussion of the uncertainty of future fertility trends into probabilistic population projections for Europe, thus highlighting the implications of alternative fertility levels over the coming years. We will also discuss trade-offs between fertility and immigration, and the phenomenon that Europe now has entered a period of negative momentum of population growth.

Birth Rate↗
PubMed1990

The role of environmental and occupational hazards in the adult health transition.

In the course of economic development from the pre-industrial to the post-industrial stages, human communities go through major social and economic transitions. The demographic transition, a long established concept, refers to the change from a stage of high birth rates and mortality rates to one of low birth rates and mortality rates. The mortality rates have always decreased before the birth rates, giving rise to a period of rapid population growth in each society. The recently-coined term "health transition" provides a more detailed view of the different aspects of the mortality decline and of the changes in morbidity and causes of morbidity which also accompany economic development. The health transition is associated with major changes in exposure to environmental and occupational health hazards. The traditional hazards of the pre-industrial stage include unsafe drinking-water, poor sanitation, infected food, tropical disease vectors, indoor air pollution from biomass smoke, and accidents in agriculture and fishing. Gradually these are replaced by or overlap with the modern hazards, such as urban air pollution, tobacco smoking, pesticides, occupational hazards in new industries and traffic accidents. The health impact of these hazards depends very much on the preventive measures taken. For some hazards there is an increasing health risk, in parallel with the increasing occurrence of the hazard, which is followed by a decreasing health risk as preventive actions become effective. This intervention transition does not occur automatically with economic development, but requires specific policies and plans, as well as community involvement. The adult age group (15-59 years) is likely to be at particular risk for environmental and occupational hazards which emerge during the health transition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Alternative approaches to fertility transition.

"Using anomalies of the Italian case as the basis, the aim of this article is to verify how the theoretical framework [of demographic transition] put forward by Lesthaeghe can be interpreted.... While the changes in mores in the Italy of the economic boom were a component of the large-scale processes of secularization, rationalization and modernization specific to the [first demographic transition], the practices, values and models of the collective imagination characterizing the second phase of Lesthaeghe's [second demographic transition] are marked by a state of mind that cannot be put down to the 'spirit of the age' during the years of large-scale modernization, but to the emancipatory and 'rational' falling away of many of the barriers to the unfolding of individual life destiny over and above that based on class, gender and age."

Demography↗
PubMed1989

Population growth and economic development: a case study of Yugoslavia.

The paper deals with the relationship between the population growth and economic development in Yugoslavia and its republics, covering the period after the 2nd World War. Yugoslavia is a developing country with a specific demographic and economic structure which makes it unique in Europe. Its territory is comprised of both relatively developed regions where demographic transition is over, and underdeveloped regions with high natural increase of population where the demographic transition is only just beginning. Correlation and regression methods were used to quantify this relationship. The economic development and structural changes are discussed, relating to human factor. An adequate population policy through family planning is stressed as important in obtaining an increased return to scale with a more positive role of demographic factor.

Birth Rate↗
PubMed2001

Age transition of tuberculosis incidence and mortality in Brazil.

OBJECTIVE: Before the Aids pandemic, demographic transition and control programs prompted a shift in the age of incidence of tuberculosis from adults to older people in many countries. The objective of the study is to evaluate this transition in Brazil. METHODS: Tuberculosis incidence and mortality data from the Ministry of Health and population data from the Brazilian Bureau of Statistics were used to calculate age-specific incidence and mortality rates and medians. RESULTS: Among reported cases, the proportion of older people increased from 10.5% to 12% and the median age from 38 to 41 years between the period of 1986 and 1996. The smallest decrease in the incidence rate occurred in the 30 - 49 and 60+ age groups. The median age of death increased from 53 to 55 years between 1980 and 1996. The general decline in mortality rates from 1986 to 1991 became less evident in the 30+ age group during the period of 1991 to 1996. A direct correlation between age and mortality rates was observed. The largest proportion of bacteriologically unconfirmed cases occurred in older individuals. CONCLUSIONS: The incidence of tuberculosis has begun to shift to the older population. This shift results from the decline in the annual risk of infection as well as the demographic transition. An increase in reactivation tuberculosis in older people is expected, since this population will grow from 5% to 14% of the Brazilian population over the next 50 years. A progressive reduction in HIV-related cases in adults will most likely occur. The difficulty in diagnosing tuberculosis in old age leads to increased mortality.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Life expectancy in the former USSR and mortality dynamics by cause of death: regional aspects.

"The purpose of our paper is to present recent trends of mortality in the former USSR in terms of demographic transition theory.... Analysis of data on mortality dynamics by age and cause of death allows us to consider some features of the progress of the demographic transition.... The principal causes of the discrepancy between the former USSR and Western countries appear to follow first of all from considerably lower living standards.... The second principal cause of unfavourable patterns of mortality was an unhealthy environment in the workplace and at home." The focus is on the 1980s.

Cause of Death↗
PubMed1996

[20 years of research in epidemiology of human reproduction].

During the last two centuries, humanity has gone through two major transitions:first a demographic transition and second an epidemiological transition. In this moving environment, attention has been placed on a better understanding of the conditions of human reproduction. The role of epidemiology, a quantitative discipline, situated at the interface between biology, medicine and social sciences, has largely contributed to favoring advances in knowledge and rational use of data, with the aim of improving the health of the general population. Inversely, the new problems involved in the complex situation of human reproduction, of which using two individuals as the basic statistical unit for procreation is not of the least importance, have certainly contributed to the advancement of epidemiology.

Contraception↗
PubMed1990

[From twentieth to twenty-first century: Europe and its population after the year 2000].

The model of demographic transition predicts that in the final stages of the transition, the population will become stationary. However, during the past 20 years or so, the birth rate in the majority of industrialized countries has fallen below the death rate, and a continuation of this trend will ultimately result in a declining population. In the UN recent projections of world population growth, an attempt was made to salve the transition model by assuming that when faced with a reduction in numbers, couples will wholeheartedly respond by increasing their family size. The author presents a theoretical model in which he showed that during the final stages of the transition, it is likely that there are built-in mechanisms which will result in low birth rates, and that it is unlikely that fertility will return to replacement level. In addition to the scenario presented by the UN, there is another in which the birth rate remains below the death rate indefinitely. This catastrophic scenario would ultimately result in the disappearance of the human species. The author presents and compares both of these scenarios. Using some calculations by J.N. Biraben, he calculates the number of humans that would have been born between the beginning and end of the human species, as described by the catastrophic scenario and estimates this to be at 100 billion. In order to end on a more upbeat note, he than imagines a new demographic transition in which biologists have succeeded in extending the duration of a woman's reproductive life. They could then engage in 2 fertile unions during their lifetimes and thus save the species.

Birth Rate↗
PubMed1994

Fertility decline in East Asia.

With the fall of fertility in China to near or below replacement levels in the early 1990s, the whole of East Asia may now be said to have completed a demographic transition. Its experience lies between that of the West and the many developing countries in which demographic transition is now under way. The main features and possible underlying causes of the fertility declines in Japan, Taiwan, South Korea, and China during this century are discussed. Fertility decline in East Asia is interesting both in its own right, as a chapter in the history of human reproduction, and for the light it may shed on fertility decline in the rest of the world.

China↗
PubMed1993

Consequences of rapid fertility decline in the Republic of Korea: issues and solutions.

During the last 3 decades, efforts to deal with population problems in Korea have focused largely on reducing population growth. The national population control program has been a major means of achieving this goal. Between the early 1960s and 1990, evidence from a national survey indicates that the percent of current use of contraception rose from about 12% to 80% and the total fertility rate fell to 1.6. representing 1 of the most rapid fertility transitions in the developing world. In conjunction with this rapid reduction in fertility, mortality also improved significantly during this period. Thus, Korea has virtually completed the demographic transition from high birth and death rates to low birth and death rates during the same period. It is widely recognized that Korea has reached demographic maturity and has also achieved remarkable economic development at the same time. The world's demographic history shows that the demographic transition which almost every industrialized country has gone through from a predominantly rural, illiterate society with high birth and death rates, to a predominantly rural, illiterate society with high birth and death rates, to a predominantly urban, educated society with low birth and death rates usually takes well over a century, but in Korea, that process has taken only a few decades. On the other hand, the consequences of a rapid fertility decline bring about various demographic and social issues which we have to take into consideration for future socioeconomic development policy concerning the well-being of the Korean people. Some of issues for policy consideration can be broadly summarized as follows: 1) gradual imbalance of sex ratio at birth due to traditional son preference behavior; 2) latent effect of inevitable population aging and increasing dependency burden on behalf of the elderly for the public sector; 3) changes in family life cycle and rapid transformation form a large to a small family; 4) increasing demand for now social roles for women, supported by easing of child care burdens within households.

Asia↗
PubMed1995

Economic transition and demographic change in Russia, 1989-1995.

The author "reviews recent population changes in Russia, relating trends in fertility, mortality, natural increase, and migration to the social and economic effects of the transition to a market economy. Significant trends (a precipitous drop in fertility, an extraordinary increase in mortality--especially among middle-aged males--and a consequent decline in natural increase) are identified and analyzed, with dislocations caused by the uncertainties of economic and political transition suggested as the principal causes. The effect of net in-migration to Russia (probably mainly ethnic Russians from the Near Abroad countries) in partially offsetting the natural population decrease is examined as well."

Demography↗
PubMed1999

The importance of human ecology at the threshold of the next millennium: how can population growth be stopped?

Ecology is defined as the set of complex interactions between the biotic and abiotic environments. Human ecology concerns principally the population ecology "only" of Homo sapiens, but it also includes all aspects of global ecology because humans are the most important species. Human demography is characterized by a recent decline in mortality and fertility rates. These demographic transitions have largely been completed in industrialized countries, but not in the 140 developing countries. Approximately 100 countries are following the same demographic pattern as industrialized countries, however with a time delay of several generations. China has effectively reduced its population increase by means that would be unacceptable in Western democracies. Some 44 developing countries still show increasing population growth and no detectable demographic transition in birth rate. Thus one part of the world shows limited (and, in the long run, shrinking) population growth, and another continues with a strong increase. All populations are limited in their development by their sustainability by their environment, for example, food and energy resources, and the extent of pollution which the use of these resources produces. It is argued that in the case of human population the limits of sustainability have already been reached with the 6 billion humans alive today, since at least 20% of these suffer from hunger, natural resources are overexploited, and biodiversity is threatened. In the coming 200 years it is more likely that the total population will substantially oscillate rather than approach the predicted 12 billion. The most important goal of human ecology should therefore be to slow population growth as far as possible.

Demography↗
PubMed2000

[Aging and health: a change in paradigm].

The aging of the population due to increasing life spans requires a reevaluation of the health care models that prevail in the countries of the Region of the Americas, given that the illnesses typical of old age make up an ever-increasing share of the morbidity burden. The countries in the Region are in an intermediate stage of demographic transition. They face the challenge of balancing priority care for the health problems characteristic of developing countries along with care for the chronic and debilitating diseases that afflict the elderly. An even greater challenge is gauging, in a timely manner, the health, social, and economic consequences of the demographic transition over the next millennium, to allow the countries to respond to these consequences through an in-depth restructuring of their health and social services. The extension of human life imposes a new vision of the health of the elderly that is oriented toward self-sufficiency, economic independence, and living life to its fullest. It will not be easy to integrate this new paradigm into the countries' health services, which are now primarily oriented toward curative care and are structured to fulfill the requirements of an epidemiological scenario that is undergoing a rapid transformation. The challenge is even greater because of the wide range of needs that the elderly have across countries with varying degrees of development. Nevertheless, sooner or later the governments of all the countries of the Region will be forced to adopt concrete measures to deal with the problems posed by the population's gradual aging.

Age Factors↗