Weisz George, Olszynko-Gryn Jesse
Social Studies of Medicine, McGill University, Montreal, Quebec, Canada.
J Hist Med Allied Sci. 2010 Jul;65(3):287-326. doi: 10.1093/jhmas/jrp058. Epub 2009 Dec 22.
In 1971 Abdel R. Omran published his classic paper on the theory of epidemiologic transition. By the mid-1990s, it had become something of a citation classic and was understood as a theoretical statement about the shift from infectious to chronic diseases that supposedly accompanies modernization. However, Omran himself was not directly concerned with the rise of chronic disease; his theory was in fact closely tied to efforts to accelerate fertility decline through health-oriented population control programs. This article uses Omran's extensive published writings as well as primary and secondary sources on population and family planning to place Omran's career in context and reinterpret his theory. We find that "epidemiologic transition" was part of a broader effort to reorient American and international health institutions towards the pervasive population control agenda of the 1960s and 1970s. The theory was integral to the WHO's then controversial efforts to align family planning with health services, as well as to Omran's unsuccessful attempt to create a new sub-discipline of "population epidemiology." However, Omran's theory failed to displace demographic transition theory as the guiding framework for population control. It was mostly overlooked until the early 1990s, when it belatedly became associated with the rise of chronic disease.
1971年，阿卜杜勒·R·奥姆兰发表了他关于流行病学转变理论的经典论文。到20世纪90年代中期，这篇论文已成为被广泛引用的经典之作，并被理解为一种关于从传染病向慢性病转变的理论阐述，这种转变据说是伴随现代化而来的。然而，奥姆兰本人并非直接关注慢性病的兴起；他的理论实际上与通过以健康为导向的人口控制项目加速生育率下降的努力紧密相关。本文利用奥姆兰大量已发表的著作以及关于人口与计划生育的一手和二手资料，将奥姆兰的职业生涯置于相应背景中，并重新解读他的理论。我们发现，“流行病学转变”是将美国和国际卫生机构重新导向20世纪60年代和70年代普遍存在的人口控制议程这一更广泛努力的一部分。该理论对于当时世界卫生组织将计划生育与卫生服务相结合的有争议努力至关重要，同时也与奥姆兰创建“人口流行病学”这一新子学科的未成功尝试密切相关。然而，奥姆兰的理论未能取代人口转变理论成为人口控制的指导框架。直到20世纪90年代初它才大多被忽视，当时它姗姗来迟地与慢性病的兴起联系在一起。
