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At least 19 recordsLinked to original sources
PubMed2005

The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.

OBJECTIVE: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. DESIGN: The THUSA study was a cross-sectional, comparative, population-based survey. SETTING: The North West Province of South Africa. SUBJECTS: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. OUTCOME MEASURES AND METHODS: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. RESULTS: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day(-1)); dietary fibre, 15.8 to 17.7 g day(-1); calcium, 348 to 512 mg day(-1); iron from 8.4 to 10.4 mg day(-1); vitamin A from 573 to 1246 mug retinol equivalents day(-1); and ascorbic acid from 30 to 83 mg day(-1). Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4-34.8% of subjects in different groups and diabetes mellitus in 0.8-6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. CONCLUSIONS: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on health needs to be examined in more detail.

Adolescent↗
PubMed1998

Economic transition and health transition: comparing China and Russia.

Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.

China↗
PubMed2002

Producing what in the transition? Health messaging and cultural constructions of health in Tonga.

This paper asks: what have the health promotion campaigns in Tonga actually produced, and what does this imply for our understanding of the "health transition?" Examination of villagers' responses to health messaging reveals an efflorescence of ideas about health, including a re-conceptualizing of the formal Westernized terminology of health promotion messages into concepts more aligned with traditional Tongan ways of being well. This implies the need for a model of the health transition process in which mutual shifts in understanding must be recognized by all parties, traditional villager and medicalized health professional alike, before new ideas of 'health' are actualized.

Adult↗
PubMed1994

Dengue in the health transition.

The "Health Transition" describes the medical consequences which accompany the demographic transition and development. In many Asian countries, as the infectious diseases of infancy decline, such as diarrhea, acute respiratory disease, measles and malaria, so too, do infant mortality rates. As a consequence of falling infant mortality rates and declines in fertility, the age pyramid has become more rectangular. No longer is nearly half of the population under the age of 15 years. Diseases of adults are beginning to become predominant: trauma, heart disease, cancer, stroke and diabetes. Life expectancy has increased along with costs of the health care system. As a fraction of per capita gross domestic product, health care is beginning to become a major national expense. It is ironic that the one vector-borne infectious disease likely to bridge the health transition in tropical countries is dengue. As evidenced by the experience of Singapore and Taiwan, modern housing and commercial development provide more, rather than fewer breeding places for Aedes aegypti. Greater affluence often means less compliance with mosquito control programs. Meanwhile, the dengue viruses, heeding some unknown genetic imperative, cause ever more severe disease. Modern Asian societies must count dengue as a real and enduring threat. To prevent costly hospitalizations and a sense of social disorder, effective measures must be adopted to achieve a significant reduction of Aedes aegypti populations. Sustained dengue control requires source reduction which, in turn depends upon imaginative leadership, skilled man power, legislative authority, an authentic national research program and intersectoral cooperation. A leadership role beckons for new actors in the control of Aedes aegypti: large municipalities, environmental agencies and the private sector.

Adolescent↗
PubMed1993

Health transition: the cultural, social and behavioural determinants of health in the Third World.

The paper defines 'health transition' and outlines the development of recent research programmes. Evidence is reviewed as to the cultural, social and behavioural determinants of health in the Third World, and the extent to which they interact with the provision of health services in reducing mortality. Specific attention is given to the impact on mortality of education, and the historic experience of the now developed countries is compared with contemporary developing countries. Consideration is also given to the role of cultural factors and to radicalism, egalitarianism and the role of women in traditional society as well as fertility control and various forms of deleterious behaviour in contemporary society. The extent to which all these changes are facets of a single social transformation is discussed. Finally, the future of health transition research and its value for planned health interventions are summarized.

Cross-Cultural Comparison↗
PubMed2002

Living the health transition among the Chamorros of Guam.

Health transition in the Pacific islands reflects the richness of diversity created by varied socio-cultural, ecological, and politico-economic systems and, therefore, requires the inclusion of the local cultural context in health assessment, planning, and program development. This paper focuses on the health transition of the Chamorros of Guam, blending assessment of health trends with the cultural contexts associated with them. The review of health trends reveals that the Chamorros are experiencing a mixed transition, including a combination of infectious and chronic diseases, in addition to the increasing impact of health risk behaviors, which have led to increasing rates of injury-related mortality. The cultural review presents Chamorro perceptions and values in their extended, multigenerational family system, in traditions of caring and sharing within their communities, and in the continued use of their traditional healers. By paying attention to the Chamorro's cultural perspectives and concerns, a "window" is provided to understand the interaction of changing population trends with their actual lives as well as an opportunity to integrate culture and health in our understanding of the health transition.

Adolescent↗
PubMed2002

East Timor in transition: health and health care.

East Timor was liberated from 400 years of conquest and exploitation in an armed struggle that ended, in September 1999, in a conflagration that destroyed its social and physical infrastructures. For two years the territory has been under United Nations administration. Political conditions remain unstable as the result of many intrinsic and external factors. Its economy continues to depend upon infusions of funds from multilateral, bilateral, and private sources. Efforts by expatriates to introduce Euro-American cultural and technical models have been applied to the factors that determine health, with modest results. East Timor expects to be totally independent of foreign control early in 2002. Its future health will depend upon continuing collaboration between international and local leadership in evolving effective government, economy, and health services designed, managed, and executed by Timorese.

Communicable Diseases↗
PubMed2004

Transitional health care for offenders being released from United States prisons.

Ex-offender managed health care can enhance post-release continuity of care by increasing access, decreasing acute-care episodes, controlling the spread of communicable diseases, and reducing the financial impact on public health-care systems. This study describes transitional health care for inmates with AIDS, tuberculosis (TB), hepatitis, mental illness, and substance abuse. The relationship between size of prison system and coordination of care was also investigated. A mail survey was completed by 33 chief medical officers of prison systems in the United States. Transitional health-care programs for ex-offenders vary widely and no significant relationship was found between number of inmates released per state annually and state coordination of transitional health care for supervised ex-offenders. All respondents reported some type of transitional health-care planning, usually either 1 month or 6 months prior to release. This included provision of post-release medication, referral to community health agencies, scheduling of appointments, and instruction in prevention of transmission. The majority of respondents reported that transitional health-care planning was coordinated by registered nurses. Specific measures for inmates with HIV/AIDS,TB, mental illness, and substance abuse were reported. Information about existing transitional health-care programs can help nurses and other health-care providers identify trends in transitional health-care planning and ensure continuity of care for released offenders.

Communicable Disease Control↗
PubMedDate not supplied

[Health transition in Spain from 1900 to 1990].

BACKGROUND: The concept of health transition is intended to define, from a plural point of view, the changes in health conditions that have contributed to a decrease in mortality associated with the demographic transition. The purpose of the study is to analyse the health transition in Spain during this century (1900-1990). METHOD: The study of the different components of the health transition (epidemiological transition, risk transition and health care transition) has been based on historical series relating to Natural Population Changes. Annual Statistics and Housing Census Reports. RESULTS: Overall Mortality and Child Mortality rates have tended to decrease over the entire period: overall mortality has decreased by 70%, while child mortality has dropped by 96%. Life expectancy has increased by 42 years from 1900 (35) to 1990 (77), which in relative terms represents an increase of 120%. There has been a 95% decrease in infectious disease-related deaths and a 134% increase in non-infectious disease-related deaths. It can therefore be said that the epidemiological transition in Spain concluded in the fifties with the end of the previous pattern, mainly characterised by a high mortality rate (especially with respect to children), when the main cause of death was due to infectious diseases, then giving way to a new situation in which mortality rates dropped considerably and non-infectious diseases became the main cause of death (the turning point was in 1945). CONCLUSIONS: The new epidemiological trend that took place over the period studied appears to be the result of improved sanitary infrastructure and increased spending as well as better medical services, however also includes new health problems related to working conditions, massive urban development (particularly as of the sixties) and changes in lifestyle.

Adult↗
PubMed2002

Health transitions, fast and nasty: the case of Marshallese exposure to nuclear radiation.

The concept of health transitions assumes that health status improves with the introduction of western medicine. In this paper I demonstrate that the health of the people of Rongelap, Marshall Islands, has undergone serious damage as a result of nuclear testing, and that women in particular have suffered unduly. Exposure to nuclear radiation over a period of almost fifty years has been recognised by US authorities as a major contributory cause to the high rates of cancers and birth defects suffered by the Rongelap people. Women's reproduction has been severely affected, as evidenced by the many stillbirths and small stature of children born alive. Two generations have been exposed to both background radiation and to radiation ingested with the local foods on which they rely in the absence of other food sources. Clean up has commenced only after this and other communities sought compensation from the United States. The Rongelap people will live with the effects of radiation for generations to come. This transition to ongoing health problems is thus a negative outcome of modern health transition.

Abnormalities, Radiation-Induced↗
PubMed2000

Unintentional injury mortality and socio-economic development among 15-44-year-olds: in a health transition perspective.

Injury imposes one of the greatest health risks in terms of mortality and morbidity among 15-44-y-olds. There is evidence that socio-economic development (SED) is related to injury risk, but the findings are inconsistent. We aimed to study the magnitude, pattern and relative importance of unintentional injury mortality (UIM) in relation to SED in this age group. Cross-sectional data on UIM by age-sex specific groups were obtained for 54 countries from the World Health Statistics Annuals 1993-1995. The relationship between UIM and SED (measured in gross national product (GNP) per capita) was studied using two methods: (1) with regression analysis, and (2) by categorizing the data into four income-based country groups and then comparing the differences in their mean values. The results were: (1) UIM rates were inversely correlated with GNP per capita and the relationship became stronger with increasing age (r=-0.22 for both sexes in the 15-24-y-olds, r=-0.65 for males, r=-0.54 for females in the 35-44-y-olds); (2) there was an increase in UIM rates between low-income and lower-middle-income countries (LoMIC), but a decrease between LoMIC and upper middle-income (UpMIC), and finally also a significant decrease between UpMIC and high-income countries in most age-sex groups (ie P<0.005 for males, P<0.05 for females in the 35-44-y-olds). The highest rates of UIM were in LoMIC for all age-sex groups. Male rates were consistently higher than female in all age groups. In conclusion, SED was inversely related to UIM. There was an initial positive relation between GNP per capita and UIM, which became negative with increasing GNP per capita. We also found a health transition that had taken place in all country groups.

Accidents↗
PubMed1987

Correlations of Mini-Mental State and modified Dementia Rating Scale to measures of transitional health status in dementia.

Information regarding the relationships of the Mini-Mental State (MMS) and a modified Dementia Rating Scale (mDRS) to measures of change, that is, "transitional" health status, in dementia would be potentially useful in the evaluation and care of demented patients. In a longitudinal study of demented outpatients, MMS and mDRS at entry and at 1- to 2-year follow-up were significantly correlated with five measures of physician- and advocate-rated transitional health status and change in living arrangement during this interval (p less than .01). MMS and mDRS at follow-up also predicted mortality during a subsequent year of follow-up (p less than .01). Estimated change in MMS and mDRS was significantly correlated with all transition variables, except for MMS and results suggest MMS, mDRS, and estimated change in them reflect these aspects of transitional health status in dementia.

Aged↗
PubMed1992

The health transition in developing countries: a role for internists from the developed world.

Demographic and epidemiologic changes that have occurred in the past five decades in many developing countries provide new opportunities for internists from developed countries to contribute to improvements in international health. These changes, called the "health transition," are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the chronic diseases that occur in these age groups. The health transition is the result of concentrated national and international efforts to improve maternal and child health by emphasizing primary care and community-organized outreach services. In many developing countries, such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; and a vigorous therapeutic approach to infantile diarrhea and respiratory infection, which, in turn, have resulted in the reduced infant mortality and the increased life expectancy that defines the health transition. These changes, often accompanied by increasing urbanization and industrialization, are creating health problems similar to those seen in the "developed" world but are occurring in countries that have far fewer resources. Internists interested in working in developing countries can therefore bring their skills, experience, and perspective to bear on these problems, primarily by working within well-structured programs, the aim of which is to strengthen the capacity of the organizations and institutions within these countries to cope with the rising tide of chronic adult diseases.

Delivery of Health Care↗
PubMed2002

Reconstruction and resistance: cultural responses to living the health transition in French Polynesia.

This paper highlights Tahitian healing in response to rapid cultural change in French Polynesia. First, I examine the reconstruction and adaptation of Tahitian healing to cultural, economic, political, and health transitions in the past 40 years. Second, I address the issue of resistance by non-urban healers to the transformations of Tahitian healing in the urban context. Specifically, I argue that the reluctance of village healers to collaboration, association, and government legitimation (urban transitions) suggests that the status of Tahitian healing is a contested issue. The experiences of contemporary Tahitian healers challenge the unilinear health transition framework, which suggests that indigenous medicine will submit to globalization pressures and absorb a biomedical epistemology.

Culture↗
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↗
PubMed1991

Elements for a theory of the health transition.

This article presents the basic elements for developing a theory of the health transition. Such elements include the definition of concepts, the specification of a framework on the determinants of health status, the analysis of the mechanisms through which health change occurs in populations, the characterization of the attributes that allow us to identify different transition models, and the enumeration of the possible consequences of the transition. The propositions are presented with a sufficient level of generality as to make them applicable to different contexts; at the same time, an attempt is made to provide them with the necessary specificity to account for different national experiences, thus opening a space for future comparative research efforts. Through the systematization exercise presented in this article, we hope to contribute to the progress of a topic that has grown in importance during recent years. Such importance is due to the enormous potential that health transition theory has for understanding and transforming the growing complexity of our times.

Demography↗
PubMed2002

Health transition among Pacificans: unpacking imperialism.

What and who defines health? In the Pacific at least, health is not only an individual's state of well-being. It also refers to the positive state of the social body i.e. how people within a community interact with each other and with their environment to produce positive and desired effects. Even death can be viewed as a positive stage in human life if it facilitates the achievement of well-being as one transit or translocates to the next stage of 'eternal bliss'. The pursuit of health and well-being has resulted in many challenges over time in many communities. Health transition has been seen as a phenomenon that can be defined by the various eras of disease occurrence. Various morbidity and mortality indicators are used to measure these. According to health transition theorists, this phenomenon is linear and similar for all societies. However, this linear approach is not cognizant of the many dimensions of social, mental, physical and spiritual well-being that encompasses the life and death of Pacificans. This paper attempts to tease out the various forces that have influenced the health transition phenomenon in the Pacific. Specifically, it argues that the forces of imperialism, colonialism and globalization have largely influenced health transition in the Pacific in a manner that is to some extent, both unfavorable and oppressive. It raises the difficulty of using morbidity and mortality as measures of transition in societies where people do not die but are believed to just translocate to another life. The paper ends by suggesting alternate ways of looking at the multidimensional processes of health changes in the Pacific.

Attitude to Health↗