In demography and medical geography, epidemiological transition is a theory which "describes changing population patterns in terms of fertility, life expectancy, mortality, and leading causes of death." For example, a phase of development marked by a sudden increase in population growth rates brought by improved food security and innovations in public health and medicine, can be followed by a re-leveling of population growth due to subsequent declines in fertility rates. Such a transition can account for the replacement of infectious diseases by chronic diseases over time due to increased life span as a result of improved health care and disease prevention. This theory was originally posited by Abdel Omran in 1971. Omran divided the epidemiological transition of mortality into three phases, in the last of which chronic diseases replace infection as the primary cause of death. These phases are: The Age of Pestilence and Famine: Mortality is high and fluctuating, precluding sustained population growth, with low and variable life expectancy vacillating between 20 and 40 years. It is characterized by an increase in infectious diseases, malnutrition and famine, common during the Neolithic age. Before the first transition, the hominid ancestors were hunter-gatherers and foragers, a lifestyle partly enabled by a small and dispersed population. However, unreliable and seasonal food sources put communities at risk for periods of malnutrition. The Age of Receding Pandemics: Mortality progressively declines, with the rate of decline accelerating as epidemic peaks decrease in frequency. Average life expectancy increases steadily from about 30 to 50 years. Population growth is sustained and begins to be exponential. The Age of Degenerative and Man-Made Diseases: Mortality continues to decline and eventually approaches stability at a relatively low level. Mortality is increasingly related to degenerative diseases, cardiovascular disease (CVD), cancer, violence, accidents, and substance abuse, some of these due primarily to human behavior patterns.
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