Infections, Chronic Disease, and the Epidemiological Transition

December 2014
65 black and white, 24 line illustrations
352 pages
9x6 in
Rochester Studies in Medical History
ISBN: 9781580465083
Format: Hardback
Library eBook
University of Rochester Press
BISAC MED039000, MED022000, MED022090

Infections, Chronic Disease, and the Epidemiological Transition

A New Perspective

Alexander Mercer

Examines the ongoing, worldwide epidemiological transition from acute infectious diseases to chronic diseases as the predominant causes of death, presenting a new theory on how chronic diseases have developed.
Since the eighteenth century, chronic diseases have superseded acute infectious diseases as the predominant cause of morbidity and mortality; age at death has shifted from childhood to older adult ages; and life expectancy, population, and the proportion of older people continue to increase. This transition constitutes a fundamental change in the human condition, and thus an understanding of the historical process behind it is of major importance.
This book is the first to document this ongoing, worldwide epidemiological transition in a single country, drawing on records of cause-specific mortality since the eighteenth century in England and comparative data from other Western countries. Alexander Mercer discusses possible causes of specific disease trends, reassessing the relative importance of "health interventions" and "standard of living" as determinants of increased life expectancy, and presents a new theory of how chronic diseases have developed. Showing that specific microorganisms are causal agents in some chronic diseases, the study suggests that a new conceptualization of the epidemiological transition is required, one that takes into account interrelationships between infectious diseases, between infections and chronic diseases, and between disorders underlying different chronic diseases.

Alexander Mercer is an independent researcher.

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Table of Contents

Theoretical Framework, Data, and Study Outline: The Concept of Epidemiological Transition
A New Infectious Disease Environment
Mortality Decline, Food, and Population Growth: "Standard of Living" and Nutrition
Typhus, Typhoid, Cholera, Diarrhea, and Dysentery
Infant Mortality
Child Mortality
Respiratory Diseases
Cardiovascular Disease
Other Chronic Diseases
Epidemiological Transition: A New Perspective


Mercer's comprehensive account of how infections may influence and cause many 'man-made' diseases is something that has been missing from most discussions of historic changes in mortality. [His] new perspective is a welcome addition to the literature. By emphasizing the complex interactions between infectious diseases and the link between infections and chronic disorders it adds to our understanding of the epidemiological transition. LOCAL POPULATION STUDIES

[A] comprehensive overview of the epidemiological transition, synthesising an enormous amount of knowledge and adding new analysis. SWISS JOURNAL OF THE HISTORY OF MEDICINE AND SCIENCES (GESNERUS).

Infections, Chronic Disease, and the Epidemiological Transition offers a fascinating reworking of transition narratives. The data-especially the comparative material-are rich, and the work offers an excellent introduction into the debates on shifting mortality dynamics. THE ECONOMIC HISTORY REVIEW

[The book's] originality lies in bringing together scholarship around the epidemiological transition with that around the McKeown Thesis, well known to historians. This results in a lengthy book that summarizes a huge body of work on changing disease patterns in a way that many readers will find useful. BULLETIN OF THE HISTORY OF MEDICINE

[H]istorians of medicine and population change will be grateful to Alexander Mercer for providing an accessible and stimulating guide to an important body of expanding scientific literature. The perspectives of eco-epidemiology pose crucial questions for historians to reconsider about how to interpret the epidemiological evidence of the dramatically changing health patterns we have been living through for the last three centuries. SOCIAL HISTORY OF MEDICINE

This book will be very useful for researchers, students, and public health policy makers who are interested in understanding the causes of the epidemiological transition in disease patterns and predicting future disease trends. CLINICAL INFECTIOUS DISEASES

"Infections, Chronic Disease, and the Epidemiological Transition is an outstanding contribution to understanding one of the most important episodes in human history." - Samuel Preston, Professor of Sociology, University of Pennsylvania

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