Gaylin D S, Kates J
Lewin Group, Fairfax, VA 22031, USA.
Soc Sci Med. 1997 Mar;44(5):609-21. doi: 10.1016/s0277-9536(96)00212-2.
The epidemiologic transition theory presented first by Omran [Omram. A. R. (1971) The epidemiologic transition: a theory of the epidemiology of population change, Mildbank Quarterly 49(4), 509-538] was designed to explain global trends in the dynamic relationship between epidemiological phenomena and demographic change. This paper argues that universalizing this theory only partially serves to explain mortality declines over the last century and eclipses key epidemiologic differences between population subgroups based on socioeconomic status, race, and sex. This paper examines morbidity and mortality differentials between population subgroups and demonstrates important inconsistencies with the optimistic trends implied by the epidemiologic transition theory, an argument further developed using the HIV/AIDS pandemic as a case study. The paper argues that these differences should be brought from margins to center to present a more complex and comprehensive picture of how population subgroups experience epidemiologic transitions differently.
奥姆兰首次提出的流行病学转变理论[奥姆兰。A. R.（1971年）《流行病学转变：人口变化流行病学理论》，《米尔班克季刊》49(4)，509 - 538]旨在解释流行病学现象与人口变化之间动态关系的全球趋势。本文认为，将该理论普遍化仅部分有助于解释上个世纪死亡率的下降，并且掩盖了基于社会经济地位、种族和性别的人群亚组之间的关键流行病学差异。本文研究了人群亚组之间的发病率和死亡率差异，并证明与流行病学转变理论所暗示的乐观趋势存在重要不一致，这一观点通过以艾滋病毒/艾滋病大流行为例进一步展开论述。本文认为，应将这些差异从边缘地带带入核心，以呈现一幅更复杂、更全面的图景，说明人群亚组如何以不同方式经历流行病学转变。
