Shiro Horiuchi's Epidemiological Transitions

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  • 0:01 Mortality &…
  • 1:04 Epidemiological Transitions
  • 2:24 Horiuchi's Five…
  • 5:49 Lesson Summary
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Lesson Transcript
Instructor: Christopher Muscato

Chris has a master's degree in history and teaches at the University of Northern Colorado.

Disease has been a major part of human history, and different diseases have impacted us at different times. Explore this relationship through the epidemiological transitions of Shiro Horiuchi, and test your understanding with a brief quiz.

Mortality and Epidemiological Transitions

Death and taxes. According to Benjamin Franklin, these are the only two things that simply cannot be avoided. Well, both of these have received a considerable amount of study as we try to make sense of them and what they have meant to human history. But today, we're just focusing on the less frightening of the two. So, death. Studying human mortality across history can help us understand how diseases in particular have affected human populations. Researchers have noted that the relationship between disease and mortality seems to change as nations develop industrial technology. In the world of medical research, a period associated with a change in the major cause of death within a population due to demographic, economic, industrial, and sociological factors is called an epidemiological transition.

Epidemiological Transitions

The basic idea came from a man named Abdel Omran in the early 1970s, who pointed to three epidemiological transitions. Another look came from professor and demographer Shiro Horiuchi in the early 2000s. Horiuchi's model focused more specifically on causes of death, and it outlined five major periods of epidemiological transition. Three of these are in the past, and two of them are predicted trends for the future.

But before we get into the actual transition periods, let's talk about what these really mean. Each epidemiological transition is a period in history where the relationship between disease and mortality greatly changed, and while there are patterns in this process, it is not universal. In some places, all the transitions happened rather quickly, while in others it has taken decades or centuries. In most areas, this is also not a simple, continuous process. Trends have reversed, repeated, or jumped around as new changes in lifestyles or the emergence of new diseases occurred. So, these transitions are not a law of nature, however, they are useful for predicting health issues across the world.

Horiuchi's Five Epidemiological Transitions

In Shiro Horiuchi's model, there are five periods of epidemiological transition. Each one is associated with a change in the major cause of death and relates to the development of industrial technology. The first epidemiological transition occurred when human populations became sedentary, or developed settled societies. Before that, the greatest cause of death was physical injuries, but by settling down, humans reduced their dependence on hunting and their risk of injury. But, settled societies meant that more people lived in the same area, and the risk of infectious diseases increased. So, the first epidemiological transition was the change in the major cause of death from physical injury to infectious disease as a result of developing settled societies. An infectious disease is pretty much any sort of viral or bacterial infection: things like colds, chicken pox, or the flu and can include infections from parasites as well.

That's Horiuchi's first transition point. The second was much later, with the development of industrial technology and scientific medicine in the 19th and 20th centuries. This social change resulted in medicine that could combat infectious disease, so the major cause of death was replaced by degenerative diseases, things that aren't generally curable with basic medicine. Diseases such as multiple sclerosis, diabetes, and cancer all fit into this category. That's epidemiological transition number two, the change from infectious to degenerative disease as the main cause of death.

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