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HTiming for pellagra is for Southern and South-eastern Europe
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GScarlet fever, measles, whooping cough, diphtheria What does the fact that so many diseases have become more common, reveal about their causes? What explains the fact that most diseases have, after a longer or shorter period, retreated? And what are the implications of this phenomenon for the theory of the epidemiological transition? I will end with a few words on how the current pandemic of COVID-19 fits into this story 1.īApproximate start of fall (or peak-year) for North-western Europe onlyĬPeak in frequency of war (not in war deaths)ĮIn Europe, the Neolithic or first Agricultural revolution started in the Aegean around 6500 BCE
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In this essay I will first illustrate that many diseases have shown a pattern of rise-and-fall, and then discuss some implications of this generalized phenomenon. This amazing phenomenon of ‘rise-and-fall’ of diseases has often been noted, but has only rarely been discussed systematically. Complete setbacks, such as temporary declines in life expectancy, were rare, but at all times the speed of progress in population health depended on the balance between declining diseases on the one hand, and rising diseases on the other hand (pp. 45–48). In a kind of ‘procession of Echternach’ Europeans often took a few steps forward, by overcoming some diseases, and then a step back again, when a new disease emerged. This theory has since been criticized and expanded, but it is certainly true that over the last few centuries there has been a remarkable succession of diseases that rose and then went down again. He pointed out that we live longer because-to put it simply-we have exchanged infectious diseases, which take their toll at a young age, for chronic diseases such as cardiovascular disease and cancer, from which we mainly die at an older age. The explanation of the tremendous decline in mortality underlying this increase in life expectancy is complex, and is partly captured by the theory of the “epidemiological transition” which was proposed by Abdul Omran (1925–1999) in the early 1970s. And not only do we live longer, we also live much longer in good health than our ancestors in the nineteenth century. For example, in the Netherlands average life expectancy at birth rose from about 40 years in the 1860s to about 80 years in the 2010s. In many European countries life expectancy trends can be traced back to the nineteenth century, and show that since then life expectancy has doubled. The rise of life expectancy is one of the most important, if not the most important, event in human history.