Frenk J, Frejka T, Bobadilla J L, Stern C, Lozano R, Sepúlveda J, José M
Instituto Nacional de Salud Pública de México, Morelos.
Bol Oficina Sanit Panam. 1991 Dec;111(6):485-96.
The concept of health transition is considered to include two interrelated processes: transition of health care and epidemiological transition. The latter encompasses three basic processes: (a) replacement of the common infectious diseases by noncommunicable diseases and injuries as the leading causes of death; (b) a shift in peak morbidity and mortality from the young to the elderly; and (c) change from a situation in which mortality predominates in the epidemiological panorama to one in which morbidity is dominant. Latin America is characterized by a heterogeneous health profile in which different countries are in various stages of epidemiological transition. However, in most of them, the transition experience is unlike that of the developed countries and is distinguished by: (a) a simultaneous high incidence of diseases from both the pre- and post-transitional stages; (b) a resurgence of some infectious diseases that had previously been under control; (c) a lack of resolution of the transition process, so that the countries appear to be caught in a state of mixed morbidity; (d) a peculiar epidemiological polarization, not only between countries but also in the different geographical areas and between the various social classes of a single country. This experience is called a "prolonged polarized model."
卫生保健转型和流行病学转型。后者包括三个基本过程：(a) 非传染性疾病和伤害取代常见传染病成为主要死因；(b) 发病和死亡高峰从年轻人转向老年人；(c) 从流行病学图景中死亡率占主导的情况转变为发病率占主导的情况。拉丁美洲的特点是健康状况参差不齐，不同国家处于流行病学转型的不同阶段。然而，在大多数国家，转型经历与发达国家不同，其特点是：(a) 转型前和转型后阶段的疾病同时高发；(b) 一些先前得到控制的传染病再度流行；(c) 转型过程缺乏解决办法，以至于这些国家似乎陷入了混合发病状态；(d) 一种特殊的流行病学两极分化，不仅存在于国家之间，也存在于单个国家的不同地理区域和不同社会阶层之间。这种经历被称为“长期两极分化模式”。
