Lecture 4

Population-health thinking

• no

• social, environmental

According to Thomas McKeown:

• Medical measures such as immunization and treatment played _______ role in the improvements in health evident in western European populations since 1700

• This sharp decline in mortality was entirely due to changing ______ and ______ factors (ex: the availability and affordability of more diverse and nutritionally rich foods)

health

Thomas McKeown’s argument is that factors other than health care have far more impact on the _______ of populations

• As a place becomes more affluent (more income), death rates drop

• Birth rates remain high initially, causing the population to grow very rapidly

• As death rates continue to decline and income continues to rise, birth rates begin to fall

• Birth rates may decline to match or even end up lower than the death rates

What is the demographic transition?

The change from infectious and parasitic diseases in poorer places to chronic diseases in richer ones

What is the epidemiologic transition?

• Individual responsibility: health inequalities are the outcome of differences in how people make choices

• Social determinism: individual choices arise out of constrained and unfair circumstances

What are the differences between an “individual responsibility” and “social determinism” perspective?