Int J Health Serv. 2014;44(2):273-84. doi: 10.2190/HS.44.2.f.
A popular explanation of the epidemiological transition is that the germs that caused infectious disease mortality were defeated by the "magic bullets" of mainstream medicine over the course of the 20th century, permitting the population to get old enough to get the chronic diseases of heart disease and cancer. This explanation is false. The most important causes of infectious disease were the political and economic structures that favored capital at the expense of labor so blatantly that it left a large portion of the working population virtually at death's door. This was remedied only when resistance by labor created a more livable workday, child labor laws, and a higher wage, resulting in improvements in nutrition and housing. Chronic disease increased as firms transformed the production process by introducing more mechanized and chemically intensive production processes. This has transformed our food, water, air, and work processes in unprecedented ways and created a historically unique chronic disease pattern.
一种流行的说法是,在 20 世纪,主流医学的“灵丹妙药”战胜了导致传染病死亡的病菌,从而使人口得以长寿,进而患上心脏病和癌症等慢性病。这种说法是错误的。传染病最重要的原因是那些明显偏向资本而牺牲劳动的政治和经济结构,使很大一部分劳动人口几乎处于死亡边缘。只有当劳工的抵制创造了一个更适宜居住的工作日、童工法和更高的工资时,这种情况才得到改善,从而改善了营养和住房条件。随着企业通过引入更多机械化和化学密集型生产过程来改变生产过程,慢性病的发病率也在上升。这以前所未有的方式改变了我们的食物、水、空气和工作过程,并创造了一种具有历史独特性的慢性病模式。