It is commonplace now to criticize the hopeful assertions of 30 years ago that infectious diseases were on the wane. These incorrect prognostications were based on a bias towards the developed world as well as a lack of understanding of the extant information on the social epidemiology of infectious diseases in North America and northwestern Europe. One of the key contributions of this book is the description and analysis of how these incorrect assertions were and remain incorrect in the contemporary world. The chapters embrace a more balanced human ecological perspective to diseases that includes many levels of analysis required for accurate recording and understanding of the current status of human health and disease.
This book, the result of the Society for the Study of Human Biology's 43rd Symposium, reflects mostly the human population biology, biological anthropology and biomedical and public health perspectives and studies of many of the authors. But the themes and perspectives in the book will also prepare the reader for the increasingly more standardized and influential area of scholarship known as the global burden of disease (Murray and Lopez 1996). One of the key elements of the burden of disease analysis is the quantification of human morbidity and mortality into costs of illness over the lifespan. The familiar disability-adjusted life years (DALYs) has allowed the estimation of the reduction in quality of life at the individual and societal level. Comparisons of the DALYs from different disease conditions may allow rational decisions about resource allocation. For example, in an African developing nation what might be the financial costs and reductions in DALYs attributable to community-level child deworming compared to the purchase of an advanced imaging machine in a capital city tertiary care hospital?
The second key insight from the global burden of disease studies is the growing importance of non-communicable diseases as a source of burden in developing nations (Murray and Lopez 1996). The face of illness in developing nations is no longer childhood preventable diseases. The success of the child survival activities of the 1970s and 1980s, especially oral rehydration and immunizations, has changed the age structure of these populations as many individuals live into their middle adult years (Jamison et al 1993). Thus lifestyle diseases due to alcohol intake and cigarette smoking as well as obesity related metabolic and cardiovascular diseases and cancers are now exerting a major impact on illness, quality of life