(Non) Communicable diseases
THE DEFINITION OF
Communicable diseases: spreads person-to-person
- Diseases that spread from person to person (through direct contact: respiratory
droplets, bodily fluids) or indirectly through other vectors (animals, environments)
- Vectors that increase the disease: lack of vaccination, international travel,
socioeconomic, behaviour
Non communicable diseases: doesn’t spread
- Diseases that don’t spread between people and are often related to lifestyle, genetic
and environmental factors
Infectious diseases: caused by germs (can spread or not)
- Diseases that are caused by pathogens/germs (bacteria, viruses, or fungi)
- Can be both communicable/noncommunicable
- Doesn’t necessarily need to spread from person to person. A person could get an
infectious disease from contaminated food or water
Chronic diseases: long-lasting, whether spreadable or not
- Long lasting conditions that often progress slowly (>1 year)
- Including noncummunicable and infectious diseases with chronic effects
OVERLAPS
Communicable & Infectious
● Contagious: can be transmitted from one person to another through direct contact
● All communicable diseases are infectious, BUT NOT ALL INFECTIOUS DISEASES ARE
COMMUNICABLE
Infectious & Noncommunicable
● Some infectious diseases are not communicable, they don’t spread person-to-person
● Example: tetanus, lyme disease (infectious because it’s caused by bacteria but it’s not
contagious)
Chronic & Communicable
● Some communicable diseases can cause chronic conditions (e.g. HIV/AIDS)
Chronic & Noncommunicable
● Many chronic diseases are noncommunicable (e.g. ashtma, diabetes)
HOW HAS PUBLIC HEALTH CHANGED OVER TIME
,NEW PUBLIC HEALTH → NPH an approach that emphasises a holistic view of promoting and
protecting health by addressing not only diseases but also the social, environmental, and
behavioral factors that influence health outcomes. It moves beyond just medical care and
recognises that health is influenced by a combination of various factors
Epidemiological transition
EPIDEMIOLOGICAL TRANSITION THEORY BY OMRAN
What → How patterns of disease and death change as a country develops (shift from high
mortality due to infectious diseases to higher life expectancy and more lifestyle related NCDs)
5 propositions of the theory
Proposition 1: Mortality and population dynamics
- Mortality is a factor in population dynamics (how populations grow & change)
- Pre-modern: high death rates from epidemics, wars, famines → population fluctuations
- Modern time: declining mortality and more stable death patterns → sustained
population growth
Proposition 2: The epidemiological transition (stages)
1) The Age of Pestilence and Famine → infectious diseases and starvation dominate
● High death rates, low life expectancy (20-40 years)
● Caused by infectious diseases, malnutrition, poor living conditions and childbirth
complications
2) The Age of Receding Pandemics → better PH, fewer people die from infection
● A decrease in mortality from infectious diseases and an increase in life expectancy
(30-50 years)
● Germ theory: advancements in sanitation, nutrition and healthcare
● People live longer, chronic diseases begin to surface more clearly
3) The Age of Degenerative and Man-Made diseases → people live longer, chronic illnesses
● Mortality rates are low, life expectancy is high (50+ years), birth rates decline
● Infectious diseases are mostly under control but new health issues emerge, chronic
diseases become more common
Proposition 3: Changes in health by age and gender
- Health improvements impact children and young women first (due to lower infant and
maternal mortality)
Proposition 4: Links between health, demographics and modernisation
- Improved socioeconomic status leads to better neutron and sanitation, which improve
health and reduce morbidity/mortality
Proposition 5: 3 models of epidemiological transition
- Classical (Western) model: slow, steady decline in mortality and fertility, driven by
socioeconomic progress and later medical advances
- Accelerated model: rapid mortality and fertility decline (e.g. Japan) due to PH measures
and population control strategies
- Contemporary (Delayed) model: declines in infectious diseases were more recent (e.g.
developing countries)
Importance → To study changes in health and its determinants, speculate future changes
(determine research focus for future needs) and describe population age distribution
Flaws
- Oversimplifies: assuming linear stages from infectious to chronic diseases, which
doesn’t always apply especially in LIC
, - Overlooks other factors: overlooks the role of social factors (poverty, inequality,
education) and environmental factors (climate change)
- Fails to account for re-emergence of infectious diseases: assumes that infectious
diseases are entirely replaced by chronic diseases in developed societies
- Unclear beginning and end
- Generalisability: the theory was based on Western data, doesn’t account for the diverse
health transitions in non Western countries. LMIC can face a “double burden” of disease
(infectious diseases persist even as NCDs increase)
Revision: added more stages
4) The Age of Delayed Degenerative Diseases: people live even longer and degenerative
diseases are managed better with medical advancements
5) The Age of Obesity and Inactivity: increasing levels of weight gain and obesity
6) The Age of Emerging Infectious Diseases: the reappearance of infectious diseases due to
factors like antibiotic resistance, global travel, environmental changes
HEALTH STATUS & DIFFERENCES (EASTERN, CENTRAL, AND WESTERN)
General health gains
- Life expectancy & mortality: generally has increased
- Healthy life expectancy: Central and Eastern have shorter healthy life expectancies than
Western
- Avoidable mortality: high in Romania & Hungary
Chronic diseases
- Heart diseases: the main causes of death in the EU
- Cancer trends: lung cancer the most common, breast cancer among women. (highest in
Hungary and Czech)
- Other: diabetes, respiratory diseases, liver diseases (risen in the UK & Finland)
Mental health: a priority, making up around 20% of the total health burden
Communicable diseases: TB & HIV in Baltic states, AMR
Injuries and accidents
- Road accidents: have declined due to stricter policies but still high in CEE
- Domestic accidents: common among the elderly and disadvantaged groups
Preventable risk factors: lifestyle-related risks (smoking, unhealthy diets, alcohol consumption,
physical inactivity), obesity (over 50% of adults in the EU), illicit drug use
East-West health gap → a significant health gap between Eastern and Western Europe
- After WWII (early 1960s), life expectancy in Eastern Europe improved quickly
- Collapse of Soviet Union, adult mortality rose dramatically, peaking between 1992-1994
with over 1 million premature deaths
- Since the 1990s, rapid improvement in life expectancy
THE DEFINITION OF
Communicable diseases: spreads person-to-person
- Diseases that spread from person to person (through direct contact: respiratory
droplets, bodily fluids) or indirectly through other vectors (animals, environments)
- Vectors that increase the disease: lack of vaccination, international travel,
socioeconomic, behaviour
Non communicable diseases: doesn’t spread
- Diseases that don’t spread between people and are often related to lifestyle, genetic
and environmental factors
Infectious diseases: caused by germs (can spread or not)
- Diseases that are caused by pathogens/germs (bacteria, viruses, or fungi)
- Can be both communicable/noncommunicable
- Doesn’t necessarily need to spread from person to person. A person could get an
infectious disease from contaminated food or water
Chronic diseases: long-lasting, whether spreadable or not
- Long lasting conditions that often progress slowly (>1 year)
- Including noncummunicable and infectious diseases with chronic effects
OVERLAPS
Communicable & Infectious
● Contagious: can be transmitted from one person to another through direct contact
● All communicable diseases are infectious, BUT NOT ALL INFECTIOUS DISEASES ARE
COMMUNICABLE
Infectious & Noncommunicable
● Some infectious diseases are not communicable, they don’t spread person-to-person
● Example: tetanus, lyme disease (infectious because it’s caused by bacteria but it’s not
contagious)
Chronic & Communicable
● Some communicable diseases can cause chronic conditions (e.g. HIV/AIDS)
Chronic & Noncommunicable
● Many chronic diseases are noncommunicable (e.g. ashtma, diabetes)
HOW HAS PUBLIC HEALTH CHANGED OVER TIME
,NEW PUBLIC HEALTH → NPH an approach that emphasises a holistic view of promoting and
protecting health by addressing not only diseases but also the social, environmental, and
behavioral factors that influence health outcomes. It moves beyond just medical care and
recognises that health is influenced by a combination of various factors
Epidemiological transition
EPIDEMIOLOGICAL TRANSITION THEORY BY OMRAN
What → How patterns of disease and death change as a country develops (shift from high
mortality due to infectious diseases to higher life expectancy and more lifestyle related NCDs)
5 propositions of the theory
Proposition 1: Mortality and population dynamics
- Mortality is a factor in population dynamics (how populations grow & change)
- Pre-modern: high death rates from epidemics, wars, famines → population fluctuations
- Modern time: declining mortality and more stable death patterns → sustained
population growth
Proposition 2: The epidemiological transition (stages)
1) The Age of Pestilence and Famine → infectious diseases and starvation dominate
● High death rates, low life expectancy (20-40 years)
● Caused by infectious diseases, malnutrition, poor living conditions and childbirth
complications
2) The Age of Receding Pandemics → better PH, fewer people die from infection
● A decrease in mortality from infectious diseases and an increase in life expectancy
(30-50 years)
● Germ theory: advancements in sanitation, nutrition and healthcare
● People live longer, chronic diseases begin to surface more clearly
3) The Age of Degenerative and Man-Made diseases → people live longer, chronic illnesses
● Mortality rates are low, life expectancy is high (50+ years), birth rates decline
● Infectious diseases are mostly under control but new health issues emerge, chronic
diseases become more common
Proposition 3: Changes in health by age and gender
- Health improvements impact children and young women first (due to lower infant and
maternal mortality)
Proposition 4: Links between health, demographics and modernisation
- Improved socioeconomic status leads to better neutron and sanitation, which improve
health and reduce morbidity/mortality
Proposition 5: 3 models of epidemiological transition
- Classical (Western) model: slow, steady decline in mortality and fertility, driven by
socioeconomic progress and later medical advances
- Accelerated model: rapid mortality and fertility decline (e.g. Japan) due to PH measures
and population control strategies
- Contemporary (Delayed) model: declines in infectious diseases were more recent (e.g.
developing countries)
Importance → To study changes in health and its determinants, speculate future changes
(determine research focus for future needs) and describe population age distribution
Flaws
- Oversimplifies: assuming linear stages from infectious to chronic diseases, which
doesn’t always apply especially in LIC
, - Overlooks other factors: overlooks the role of social factors (poverty, inequality,
education) and environmental factors (climate change)
- Fails to account for re-emergence of infectious diseases: assumes that infectious
diseases are entirely replaced by chronic diseases in developed societies
- Unclear beginning and end
- Generalisability: the theory was based on Western data, doesn’t account for the diverse
health transitions in non Western countries. LMIC can face a “double burden” of disease
(infectious diseases persist even as NCDs increase)
Revision: added more stages
4) The Age of Delayed Degenerative Diseases: people live even longer and degenerative
diseases are managed better with medical advancements
5) The Age of Obesity and Inactivity: increasing levels of weight gain and obesity
6) The Age of Emerging Infectious Diseases: the reappearance of infectious diseases due to
factors like antibiotic resistance, global travel, environmental changes
HEALTH STATUS & DIFFERENCES (EASTERN, CENTRAL, AND WESTERN)
General health gains
- Life expectancy & mortality: generally has increased
- Healthy life expectancy: Central and Eastern have shorter healthy life expectancies than
Western
- Avoidable mortality: high in Romania & Hungary
Chronic diseases
- Heart diseases: the main causes of death in the EU
- Cancer trends: lung cancer the most common, breast cancer among women. (highest in
Hungary and Czech)
- Other: diabetes, respiratory diseases, liver diseases (risen in the UK & Finland)
Mental health: a priority, making up around 20% of the total health burden
Communicable diseases: TB & HIV in Baltic states, AMR
Injuries and accidents
- Road accidents: have declined due to stricter policies but still high in CEE
- Domestic accidents: common among the elderly and disadvantaged groups
Preventable risk factors: lifestyle-related risks (smoking, unhealthy diets, alcohol consumption,
physical inactivity), obesity (over 50% of adults in the EU), illicit drug use
East-West health gap → a significant health gap between Eastern and Western Europe
- After WWII (early 1960s), life expectancy in Eastern Europe improved quickly
- Collapse of Soviet Union, adult mortality rose dramatically, peaking between 1992-1994
with over 1 million premature deaths
- Since the 1990s, rapid improvement in life expectancy
