Postmodern epidemiology: public health informed by evidenceBMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2379 (Published 04 June 2019) Cite this as: BMJ 2019;365:l2379
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Epidemiological patterns are models of morbidity-mortality or ways of measuring sickness and death that are more prevalent in a given society at specific historical moments. These models are made up of the three key components of epidemiology--that is, the causes and types of the disease, its effects and the populations involved.
Since the end of the eighteenth century this set of knowledge and practices accumulated to deal with the disease has been formalized and systematized, thus taking shape what we know today as epidemiology and public health, sciences dedicated to the study and cure of diseases and their consequences in populations. Currently, social changes are transforming both epidemiological patterns and the scientific and political ways of managing them.
Since the mid-twentieth century a new epidemiological transition has been taking place that generates new epidemiological, postindustrial or postmodern patterns.
There has been a reduction in avoidable morbidity and mortality and a consequent increase in the quality of life related to the health and general welfare of the population in all developed countries and in many developing countries. At the same time, new morbidities arise that progressively acquire an important specific weight.
In general, this new epidemiological profile can be characterized:
• Regarding the most prevalent types and causes of diseases, there has been a spectacular increase in cancer, avoidable accidents (traffic accidents, work accidents), cardiovascular diseases closely related to consumption patterns in general, and food consumption in particular, and the emergence of numerous mental health problems.
• Period of decreasing mortality and high prevalence of chronic and degenerative diseases that draw a state of pluripathologic patterns.
• The populations involved or affected are now local and global at the same time, both because of the new population recomposition that the global migratory phenomenon implies and because of the global nature of the risks of the contemporary world.
A series of causes explain the change towards these postmodern epidemiological profiles. They include the new mode of production and its unavoidable risks, the extraordinary increase in life expectancy in Western societies, the increase in health education levels of the population, the improvement in the quality and efficiency of health care services, the important work of public health devices for the rigorous investigation of the health situation and the design of intervention campaigns, the improvement of the training of professionals, the political action or the cultural exigencies that place the individual human welfare in the apex of ideals.
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Competing interests: No competing interests