the changing disease-scape in the third epidemiological transition第三流行病学变化disease-scape过渡.pdf

Int. J. Environ. Res. Public Health 2010, 7, 675-697; doi:10.3390/ijerph7020675 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 /journal/ijerph Review The Changing Disease-Scape in the Third Epidemiological Transition Kristin Harper 1,* and George Armelagos 2 1 Robert Wood Johnson Health Society Scholar Program, Columbia University, New York, NY 10032, USA 2 Department of Anthropology, Emory University, Atlanta, GA 30309, USA; E-Mail: antga@ * Author to whom correspondence should be addressed; E-Mail: kh2383@; Tel.: +1-212-305-9776; Fax: +1-212-342-5169. Received: 30 December 2009 / Accepted: 16 February 2010 / Published: 24 February 2010 Abstract: The epidemiological transition model describes the changing relationship between humans and their diseases. The first transition occurred with the shift to agriculture about 10,000 YBP, resulting in a pattern of infectious and nutritional diseases still evident today. In the last two centuries, some populations have undergone a second transition, characterized by a decline in infectious disease and rise in degenerative disease. We are now in the throes of a third epidemiological transition, in which a resurgence of familiar infections is accompanied by an array of novel diseases, all of which have the