Extending epidemiologic transition theory: A new stage

Abstract

The epidemiologic transition theory focuses on the changing patterns of morbidity and mortality and postulates that mortality by cause will evolve from a predominance of acute and infectious diseases to a predominance of chronic and degenerative diseases. The epidemiologic transition theory comprises three stages: the age of pestilence and famine (lasting until 1875), receding pandemics (from 1875 to 1930), and degenerative and man‐made diseases (from 1930 to the present). Recent information suggests that developed societies have entered a new stage in the transition. This fourth stage, which we term the hybristic stage, is increasingly influenced by individual behaviors and life‐styles. In this paper, we examine the epidemiologic transition theory, substantiate the need for a new stage, and discuss current cause‐specific trends in mortality and the social and demographic implications of such trends.