Late stages of epidemiological transition : health status in the developed world

Drawing on the example of twentieth century Europe, this paper examines themes in the spatial development of the late stages of epidemiological transition in developed countries. A preliminary analysis of mortality trends for sample countries in four European regions (north, Scandinavia, south and east) suggests that, as the epidemiological transition progressed to its later stages during the period 1901–1975, spatial variability in the importance of classical infectious diseases increased. This trend was countered by a spatial convergence in the importance of disease groupings that typify late transition. An apparently new epidemiological phase in late transition, linked to the emergence and re-emergence of infectious and parasitic diseases, is illustrated with reference to tuberculosis and the acquired immunodeficiency syndrome (AIDS).