1. Why Do Some Regions Face Health Threats?
Chapter 2 Key Issue 4

2. The Epidemiologic Character of Population Phenomena
epi, upon; demos, people; logos, study
Epidemiology is the study of what “comes upon” groups of people.
Epidemiology is concerned with the distribution of disease and death, and with their determinants and consequences in population groups.

3. 1. Epidemiological transition
Concept
Focuses on changes over time in the causes of mortality affecting certain populations:
Health conditions.
Disease patterns.
Result in a decline in death rates and an increase of life expectancy.
The society goes through a transition from communicative diseases to degenerative diseases.

4. 1. Epidemiological Transition
Age of communicative diseases
Age of receding pandemics
Age of degenerative and man-made diseases
Degenerative diseases
Share of mortality
Low Fertility
Low Mortality
High Fertility
High Mortality
LI=70 years
LI=30 years
LI=50 years
Communicative diseases
High Fertility
Decreasing Mortality
Time

5. The Epidemiologic Transition

6. The Epidemiologic Transition Stage 1: Pestilence and Famine
Infectious and parasitic diseases
Epidemics
Example Black Plague
High CDR

7. The Epidemiologic Transition Stage 2: Receding Pandemics
Improved sanitation, nutrition, & medicine during Industrial Revolution
Rapidly Declining CDR

9. Cholera in London, 1854
Fig. 2-23: By mapping the distribution of cholera cases and water pumps in Soho, London, Dr. John Snow identified the source of the water-borne epidemic.

10. Epidemics and Pandemics in Popular Literature
Stephen King’s book, The Stand
Brad Pitt, Bruce Willis & Madeline Stowe in the movie “The Twelve Monkeys”
Albert Camus’ novel, The Plague
Charlton Heston in “Omega Man” & Vincent Price in “The Last Man on Earth” based on Richard Matheson’s novel, I Am Legend
Edgar Allan Poe’s short story “The Masque of the Red Death” (also a Vincent Price movie)

11. The Epidemiological Transition Stage 3 – Degenerative & human-created diseases
Chronic Disorders associated with aging
Cardiovascular diseases (hear attacks) & cancer
Moderately Declining CDR

12. The Epidemological Transition Stage 4: Delayed degenerative diseases
Cardiovascular diseases and cancers
BUT life expectancy of older people extended through medical advances
Cancer growth retarded or removed
Bypass to repair cardiovascular system
High Obesity rates
Non-nutritious food/sedentary lifestyle
Low but increasing CDR

14. Sprawl & Obesity

15. Sprawl and Health Concerns
Because this study is ecologic and cross-sectional in nature, it is premature to imply that sprawl causes obesity, hypertension, or any other health condition.
Our study simply indicates that sprawl is associated with certain outcomes.
Future research using quasi-experimental designs is needed to tackle the more difficult job of testing for causality.
“Relationship Between Urban Sprawl and Physical Activity, Obesity, and Morbidity” by Reid Ewing, Tom Schmid, Richard Killingsworth, Amy Zlot, Stephen Raudenbush in the American Journal of Health Promotion, Inc., September/October 2003, Vol. 18, No. 1

16. Sprawl, Weight and Blood Pressure

17. The Epidemiological Transition Stage 5 – Reemergence of infectious & parasitic diseases
Evolution
Antibiotics and genetic engineering
Emergence of new strains of viruses and bacteria
Poverty
Unsanitary conditions in developing countries
Increased Connections
Spreads from Developing to developed countries

20. Global Warming & Disease Spread
It is possible that if global warming occurs, the occurrence and range of infectious disease might shift significantly.
Areas previously not prone to widespread outbreaks of malaria, might experience a significant increase in its incidence.

21. Avian Flu,
Fig. 2-25: The first cases of avian flu in this outbreak were reported in Southeast Asia.

23. HIV/AIDS Prevalence Rates, 2005
Fig. The highest HIV infection rates are in sub-Saharan Africa. India and China have large numbers of cases, but lower infection rates at present.

24. Health Care Indicators of Health Provision of Health Care
Infant Mortality rate
Life Expectancy
Provision of Health Care
Health Care expenditures
Available Medical Services

25. Infant Mortality Rates
Fig. 2-10: The infant mortality rate is the number of infant deaths per 1000 live births per year. The highest infant mortality rates are found in some of the poorest countries of Africa and Asia.

26. Life Expectancy at birth
Fig. 2-11: Life expectancy at birth is the average number of years a newborn infant can expect to live. The highest life expectancies are generally in the wealthiest countries, and the lowest in the poorest countries.

27. Health Care per Capita

28. Government Expenditures on Health Care