infectious diseases and epidemiologic transition in Victorian British

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1、SocialHistoryofMedicineVol.20,No.3pp.595606ResponseInfectiousDiseasesandEpidemiologicTransitioninVictorianBritain?DefinitelyGrahamMooney*Summary.FlurinCondrauandMichaelWorboysrecentlydeniedthatinfectiousdiseaseswerepartofthecommonexperienceoflifeanddea

2、thinVictorianBritainandthatepidemiologicaltransitioninthisperiodwasachimera.Thisresponsearguesthattheirdemolitionoftheseshibbolethsisitselfanapparition.AsubstantialbodyofliteratureonVictorianmortalitydemonstratesthatCondrauandWorboysscallforanalysesof

3、causesofdeathdisaggregatedbyplace,ageandsexisoutdated.Dis-putingCondrauandWorboyssnarrowdefinitionofinfection,evidencepresentedhereindicatesthatinfectiousdiseasesprobablyrepresentedabout40percentofalldeathsinEnglandandWalesinthe1850s.Thisproportioneasi

4、lyexceeded50percentintownsandcities,placeswherethemajorityofthepopulationlived.AttentionisdrawntopublishedworksonhealthgapmeasuresandhealthexpectancieswhichshowthatthedeclineofinfectiousdiseasesmadeasubstantialcontributiontoimprovedlifechancesovertheV

5、ictorianera.Thisshiftinmortalitypatternsisinterpretedasanintegralcomponentoftheepidemiologicaltransition.Keywords:infectiousdiseases;epidemiologicaltransition;AbdelR.Omran;healthtransition;healthgapmeasures;lifeexpectancy;lifetabledecomposition;Victor

6、ianBritain;EnglandandWalesFlurinCondrauandMichaelWorboysrecentlytookissuewiththecontinuingdominanceoftheepidemiologictransitionasadescriptiveschemaforunderstandingthecourseandpatternofmortalitydeclineandchange.UsingVictorianBritainastheircoreexample,t

7、heyfirstarguethatnationalepidemiccrises...werenotthatprevalentintheVictorian1era.Iwillhaverelativelylittletosayaboutepidemicsperseinthisreply.Rather,Iwanttoconcentrateonassemblingsomethingworthwhileoutoftherubblestrewnatthesceneoftheirsecondtarget,name

8、lythatinfectiousdiseaseswereneverthenormalcauseofdeathintheVictorianperiod.CondrauandWorboysdefinenormalasthemost2commonorprevalent.Theirdemolitionofthisparticularshibbolethleadsthemtopositthat,sinceinfectionswereinconspicuous,thentheepidemiolo