Epidemiological dissertation

The majority of the literature on the epidemiological transition that was published since these seminal papers confirms the context-specific nature of the epidemiological transition: while there is an overall all-cause mortality decline, the nature of cause-specific mortality declines differs across contexts. Increasing obesity rates in high-income countries are further confirming the epidemiological transition theory as the epidemic leads to an increase in NCDs. The picture is more nuanced in low- and middle-income countries, where there are signs of a protracted transition with the double burden of communicable and noncommunicable disease. A recent review of cause-specific mortality rates from 12 low- and middle-income countries in Asia and sub-Saharan Africa by Santosa and Byass (2016) shows that broadly, low- and middle-income countries are rapidly transitioning to lower total mortality and lower infectious disease mortality. [14] A more macro-level analysis from the Global Burden of Disease data conducted by Murray and others (2015) finds that while there is a global trend towards decreasing mortality and increasing NCD prevalence, this global trend is being driven by country-specific effects as opposed to a broader transition; further, there are varying patterns within and between countries, which makes it difficult to have a single unified theory of epidemiological transition. [15]

Recent evidence from large prospective US and European cohort studies and from meta-analyses of epidemiological studies indicates that the long-term consumption of increasing amounts of red meat and particularly of processed meat is associated with an increased risk of total mortality, cardiovascular disease, colorectal cancer and type 2 diabetes, in both men and women. The association persists after inclusion of known confounding factors, such as age, race, BMI, history, smoking, blood pressure, lipids, physical activity and multiple nutritional parameters in multivariate analysis. The association has not always been noted with red meat, and it has been absent with white meat. There is evidence of several mechanisms for the observed adverse effects that might be involved, however, their individual role is not defined at present. It is concluded that recommendations for the consumption of unprocessed red meat and particularly of processed red meat should be more restrictive than existing recommendations. Restrictive recommendations should not be applied to subjects above about 70 years of age, as the studies quoted herein did not examine this age group, and the inclusion of sufficient protein supply (e. g. in the form of meat) is particularly important in the elderly.

When disease outbreaks or other threats emerge, EIS officers are on the scene. They support over 100 public health investigations each year in the . and worldwide. Physicians, veterinarians, scientists, and other health professionals serve our country while learning to apply epidemiology to solve public health problems through a 2-year, on-the-job training and service fellowship. After a month-long orientation, new EIS officers begin assignments as ready responders in infectious and noninfectious diseases, global health, injury prevention, environmental health, and occupational health.

Epidemiological dissertation

epidemiological dissertation

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