ABSTRACT
Over the past half century the global health situation has signifi cantly improved in aggregate terms, with a continuous rise in life expectancy, albeit at slowing rates in the past two decades and with sharp reversals in the former Soviet Union and sub-Saharan Africa. The change in the pattern of disease from one where premature mortality is at high levels and communicable diseases predominate to one where premature mortality declines and noncommunicable causes account for the great majority of morbidity and mortality is referred to as the “health transition.” Transition, however, is a somewhat misleading term since, in many low-and middle-income countries (LMICs), a pattern has emerged in which communicable diseases persist as signifi cant contributors to overall disease burden, especially in poor communities, but coexist with high levels of noncommunicable diseases, including violent injury (Frenk, Bobadilla, Sepulveda, & Lopez Cervantes, 1989). Moreover, it is rapidly growing inequalities in health status indicators between and within countries that uniquely characterize the current global situation.
