Теория эпидемиологического перехода: взгляд 30 лет спустя
Аннотация
Теория эпидемиологического перехода основана на систематическом применении эпидемиологического подхода к анализу изменений во времени и пространстве состояния здоровья, уровня смертности, дожития и рождаемости в их связи с социально-экономическими и экологическими факторами, образом жизни, демографическими, медицинскими и технологическими детерминантами и/или коррелятами при различных социальных условиях. Нет сомнения, что на протяжении нескольких последних столетий в мире происходили глубокие эпидемиологические изменения, хотя у разных групп населения они начинаются в разное время и идут с неодинаковой скоростью. Цель этого очерка – по-новому взглянуть на первоначальное представление теории эпидемиологического перехода 1971 г. и перейти от трехстадийного / трехмодельного описания перехода к пятистадийному / пятимодельному.
В частности, в Положении 1 рассматривается относительный вклад смертности и рождаемости в динамику перехода, а в Положении 2 описываются этапы эпидемиологического перехода. Кроме того, в процессе перехода обнаруживаются разные виды неравенства, на которые указывается в Положении 3. Модели перехода, характерные для динамики, сроков перехода и последующих изменений в разных странах обсуждаются в Положении 4. В заключительной части статьи рассматриваются возможные сценарии изменения здоровья на пятой стадии перехода и за ее пределами.
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