Doctoral Dissertation Research: Assessing the Potential Causes of a Second Epidemiological Transition

University Of Missouri-Columbia, Columbia MO

Investigators

Abstract

The work of anthropologists, demographers, and other social scientists contributes to understanding the factors that influence health and well-being. While public health researchers focus on identifying the immediate biological causes of disease, social scientists also step back to examine the larger cultural, social, economic, and political context that mediates people's disease exposure and susceptibility. Historically, such factors have produced major shifts in mortality patterns and health outcomes. One such transition is associated with the rise of epidemic infectious diseases that occurred in the wake of the rise of a sedentary, agricultural way of life, millennia ago. More recently, industrialization saw a decline in infectious diseases and major reductions in infant and childhood mortality. This second transition has now been followed by a third, when non-communicable diseases replaced infectious ones as the major cause of human adult mortality. Interestingly, however, the factors underlying these shifts are not clear. Was it improvement in personal hygiene and general sanitary conditions? Advances in medical science? Economic and political stability? A variety of scenarios and factors have been proposed. The research supported by this award takes advantage of a unique opportunity to determine the most influential of these many potential drivers by looking at a case of delayed transition in the 20th. century for which there are a number of untapped data sources. With the guidance of University of Missouri anthropologist, Dr. Lisa Sattenspiel, co-PI and doctoral student Dana M. Schmidt, will examine the patterns of health and mortality corresponding to 20th century industrialization in Newfoundland and Labrador. She will focus on specific drivers known to be of some importance in the region at this time, including access to health care, improvements in sanitation, nutritional programs, and overall improvements in socioeconomic status although with variation in urban and rural locales. Research questions include: To what extent do improvements in sanitation reduce infectious disease prevalence or mortality? How effective were quarantines at preventing disease? Does incentivized migration from rural to urban areas improve living standards and have positive impacts on health? Addressing questions of this nature in a historical population has practical implications for the implementation of social policies and assessing their efficacy at improving health and reducing disparity in current populations. The island of Newfoundland is an ideal study location to address these topics because the island underwent significant political changes as it went from a struggling British Colony to self-governing Dominion to Canadian province during the first half of the 20th century. Such changes produced new economic and social climates for the population with concomitant demographic and health effects. The researchers will collect data from vital statistics records, death registers, and archival resources from the Provincial Archives of Newfoundland and Labrador, including newspaper articles, government papers regarding health policy and reform, and diaries. These data will allow the researchers to assess the timing of the transition, its pace, and the driving factors for observed health changes. Findings from this research will contribute to understanding epidemiological transitions in non-industrial and industrializing nations. By examining the implementation of social policies and their efficacy at improving health and reducing disparity in this case with its abundant data sources, conclusions can be drawn that will be of interest to scholars studying any context where the relation between policy and population health and wellbeing is of concern.