ABSTRACT
This selection expands on the historical changes in mortality described in the previous selections. By comparing disease patterns and their human contexts across four periods (Paleolithic, Neolithic, Industrial Revolution, and contemporary), the authors outline three epidemiologic transitions. The first epidemiologic transition was associated with the adoption of agriculture by populations that formerly made a living by foraging (see selection 20). This means that “the” epidemiologic transition, involving a rapid decline in mortality rates and a shift from infectious to chronic diseases as major causes of death, is really a second major transition and one that is not and can never be complete. Microbes are a constant feature of human existence. Indeed, many “emerging” diseases such as tuberculosis are new only in the sense that they are drawing increasing attention because of their renewed presence in wealthy countries (see selections 22, 34; Farmer 1999).
