Paul Andrew Bourne, B.Sc. (Hons.); Dip. Edu.
Caldwell (2001) encapsulates the monograph of Abdel Omran, a Co-coordinator for National Centre for Epidemiology and Population Health, Australian National University, in a succinct matter in an article titled ‘Population Health in Transition’. He chides Omran’s ‘epidemiologic transition’ as lacking in depth and limited in scope, but equally agrees that diseases may result in mortality and he also forego the explanation of an epidemiologic transition. Not that Caldwell wants to remove the homage paid to Omran by the scientific community or for that matter the lofty appeal that which was created by the public health community but that he (Caldwell) theorizes that this was in keeping with the mandate of the Public Health sector of wanting to address ‘man-made diseases and that “degenerative and man-made diseases had replaced infectious ones” which were in keeping with health situations at the time, and that this was already established in mortality patterns in demographic transition.
Caldwell in wanting to laud Omran for his contribution to the health discourse - Epidemiologic transition, identified “…replacement to mortality decline and changing age structure” as a pivotal landmark in explaining a segmented epidemiological transition into certain time zone. It appears that Caldwell is not convinced that this theorizing should be labelled with the name of Omran as he argues that “Thomas McKeown also did this, though only his first two historical papers were published before Omran” (Caldwell 2001, 159). Despite this social fact, he believes that Omran integrated and used a demographic theory – fertility and mortality decline, and mortality patterns - in justifying a social theory and made the scientific community cognizant of the socio-biologic and economic factors’ role in health care. Equally, he notes that this is simply not nothing new, as this is more demographic than epidemiologic in nature – ‘changing causes of the pattern of illnesses’.
According to Caldwell, Omran did not provide a rationale for the shifting of the disease pattern but he (Caldwell) explains that much of these are due to eco-biological and socio-economic factors, post World War II; and not because of that which was revealed in statistics used for Sweden, England and Wales. This is explained further in Caldwell writing which states that “Doctors may have had only limited curative powers but they appear to have given leadership in improving hygiene, midwifery training and child care” (Caldwell 2001, 160).
In concluding, he (Caldwell) praises Omran for laying that premise, upon which scientific inquiry has sought and investigates curative medical care, but he reiterates that the epidemiologic transition theory is more demographic theory than the changing patterns of causes of illnesses. And he decries the theory for delimiting itself to social change, eco-biological and environmental changes than emphasizing the value of medical technology and scientific inquiry.
Reference
Caldwell, John, C. 2001. “Population health in transition.” Bulletin of the World Health Organization, 79(2):159-170.