Health transition research in the control of morbidity and mortality from acute respiratory infection.

Abstract

The essence of health transition research is its multidisciplinary character and openness to broad theory. Theories of health transition provide the context in which classic epidemiological studies can, most effectively, contribute to population health improvement. Acute respiratory infections are a leading cause of morbidity in all countries, and a major cause of premature death in countries where mortality is high. The international ARI control program in childhood sponsored by the World Health Organization is built on conventional biomedical foundations. Health systems in Australia and Pakistan continue to be driven by this conventional model which has contributed to changes in mortality but probably not exclusively. A health transition approach forces us to step back, and place the gains of the biomedical model in a social and historical perspective. Using that perspective to move public health policy forward in the modern nation state requires adventurous lateral thinking. We review here the problem of acute respiratory infections in Australian and Pakistani children. In Australia, we focus on the large differences in respiratory infection severity and outcomes between Aboriginal children and Caucasians. We also draw attention to our current ignorance on what differentiates children who are prone to respiratory infections from those who are not. In Pakistan, we highlight the problem of refocusing a health care system that is already seriously underfunded for the biomedical task. A major challenge for social scientists is to become involved more directly in the medical care system and devise health care interventions that can address social inequities, and can provide a better integration between social and biomedical views of the world. Show more