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Special Issue: Epidemiological Transitions - Beyond Omran's Theory

Understanding epidemiological transition in India

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Article: 23248 | Received 02 Nov 2013, Accepted 03 Feb 2014, Published online: 15 May 2014
 

Abstract

Background

Omran's theory explains changing disease patterns over time predominantly from infectious to chronic noncommunicable diseases (NCDs). India's epidemiological transition is characterized by dual burden of diseases. Kumar addressed low mortality and high morbidity in Kerala, which seems also to be true for India as a country in the current demographic scenario.

Methods

NSS data (1986–1987, 1995–1996, 2004) and aggregated data on causes of death provided by Registrar General India (RGI) were used to examine the structural changes in morbidity and causes of death. A zero-inflated poisson (ZIP) regression model and a beta-binomial model were used to corroborate the mounting age pattern of morbidity. Measures, namely the 25th and 75th percentiles of age-at-death and modal age-at-death, were used to examine the advances in mortality transition.

Objective

This study addressed the advances in epidemiological transition via exploring the structural changes in pattern of diseases and progress in mortality transition.

Results

The burden of NCDs has been increasing in old age without replacing the burden of communicable diseases. The manifold rise of chronic diseases in recent decades justifies the death toll and is responsible for transformation in the age pattern of morbidity. Over time, deaths have been concentrated near the modal age-at-death. Modal age-at-death increased linearly by 5 years for females (r 2=0.9515) and males (r 2=0.9020). Significant increase in modal age-at-death ascertained the dominance of old age mortality over the childhood/adult age mortality.

Conclusions

India experiences a dual burden of diseases associated with a remarkable transformation in the age pattern of morbidity and mortality, contemporaneous with structural changes in disease patterns. Continued progress in the pattern of diseases and mortality transition, accompanied by a linear rise in e x , unravels a compelling variation in advances found so far in epidemiological transition witnessed by the developed nations, with similar matrices for India.

Responsible Editors: Nawi Ng, Umeå University, Sweden; Barthélémy Kuate Defo, University of Montreal, Canada.

This paper is part of the Special Issue: Epidemiological Transitions – Beyond Omran's Theory. More papers from this issue can be found at http://www.globalhealthaction.net

Responsible Editors: Nawi Ng, Umeå University, Sweden; Barthélémy Kuate Defo, University of Montreal, Canada.

This paper is part of the Special Issue: Epidemiological Transitions – Beyond Omran's Theory. More papers from this issue can be found at http://www.globalhealthaction.net

Notes

Responsible Editors: Nawi Ng, Umeå University, Sweden; Barthélémy Kuate Defo, University of Montreal, Canada.

This paper is part of the Special Issue: Epidemiological Transitions – Beyond Omran's Theory. More papers from this issue can be found at http://www.globalhealthaction.net