Copyright notice This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. This article has been cited by other articles in PMC. Abstract Objectives To examine the geographical relation between mortality and deprivation in England and Wales at the start of the 20th and 21st centuries.
Prev Chronic Dis ;9: This focus on a predominant cause of infections ie, microbial pathogens ultimately led to medical and public health advances eg, immunization, pasteurization, antibiotics. However, the resulting declines in infections in the 20th century were matched by a rise in chronic, noncommunicable diseases, for which there is no single underlying etiology.
Top of Page Introduction Throughout history, infections have posed the biggest challenge to human health. This challenge changed in the 19th and 20th centuries because of economic development and improvements initiated largely by the Industrial Revolution — public health and hygiene, the advent of antibiotics and vaccinations, and, driving these, the consolidation of the germ theory of disease 1.
Midth—century optimism, however, was dampened by the reality of an epidemiological transition 2 that occurs with economic development. Chronic diseases and conditions are defined here as those that are noncommunicable, lasting, recurrent, and without a primary microbial cause.
The same transition is occurring now in rapidly developing countries, such as China and Mexico, and is predicted in late-developing countries, such India and Bangladesh 1.
Harris 1Anderson 5and others have charted the differences in thinking these changes have brought to modern epidemiology, emphasizing the difficulties in assigning causality when shifting from a mono-causal focus promoted by the germ theory to address infectious disease to a multi-causal focus to address chronic disease.
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No equivalent of the germ theory has provided a unifying understanding of chronic disease etiology. The aging of the population and the dysmetabolism associated with aging has affected the prevalence of chronic disease; however, the increase in the prevalence of chronic diseases and associated risk factors and behaviors among all age groups limits aging as a sole explanation.
Genetic influences and gene—age interactions are also incomplete explanations, in light of the sudden increase in and other known causes of chronic diseases.
Many behaviors and environmental factors have been implicated, but a unifying theoretical underpinning has not been identified. The discovery of a form of otherwise unrecognized inflammation in the early s 6 and its widespread presence in many chronic diseases 7 led to the suggestion that many, if not all, such diseases may have this type of inflammatory basis 8.
Top of Page Inflammation and Disease For more than 2, years, classical inflammation has been recognized by the symptoms identified by the Roman physician Aurelius Celsus as pain dolorredness ruborheat calorand swelling tumorwith the more recent addition of loss of function torpor.
This form of classical inflammation is typically a short-term response to infection and injury, aimed at removing the infective stimulus and allowing repair of the damaged tissue, ultimately resulting in healing and a return to homeostasis.
However, inresearchers discovered a different type of prolonged, dysregulated, and maladaptive inflammatory response associated with obesity, which they suggested may explain the disease-causing effects of excessive weight gain 6.
In essence, although classical inflammation has a healing role in acute disease, metaflammation, because of its persistence, may have a mediating role, helping to aggravate and perpetuate chronic disease. The difference between these 2 forms of inflammation is illustrated in Figure 1.
The scale of difference of immune reaction between the 2 forms ie, approximately fold is not shown.
Possible reasons for these associations include facilitation of atherosclerosis 11development of insulin resistance 12endoplasmic reticular stress 13and changes in gut microbiota Metaflammation may be part of a causal cascade, including endoplasmic reticular stress and insulin resistance, or simply a defensive reaction to persistent stimuli that induce chronic disease.
However, mounting evidence suggests metaflammation may develop as an intermediate immune system response to certain inducers, which, if maintained, can lead to the development and maintenance of dysmetabolic conditions and chronic disease 7,9.
A commonly expressed view is that obesity is a prerequisite for metaflammation to occur or that metaflammatory inducers are necessarily either nutritional overload or nutrient-based.
Top of Page Metaflammation and Anthropogens An increasing number of pro- or anti-inflammatory biomarkers for measuring metaflammation have recently been identified 16and several avenues of research have sought to identify their nutritional, behavioral, and environmental inducers 10, Many inducers have been identified Table.The fight against infectious disease advanced dramatically with the consolidation of the germ theory in the 19th century.
This focus on a predominant cause of infections (ie, microbial pathogens) ultimately led to medical and public health advances (eg, immunization, pasteurization, antibiotics). These changes are linked to a major change in causes of death. Modern causes are dominated by cancers, which contributed % of all deaths in , ischaemic heart diseases (%), and stroke (%).
Respiratory diseases are also a major contributor, accounting for % of deaths, of which pneumonia caused % of the overall total. Diseases Caused By Deprivation In The 20th Century Essay Sample Introduction The 20 th century will go down in the history of world as one of the most successful period of human development and civilization.
The fight against infectious disease advanced dramatically with the consolidation of the germ theory in the 19th century.
This focus on a predominant cause of infections (ie, microbial pathogens) ultimately led to medical and public health advances (eg, immunization, pasteurization, antibiotics.
The 20th century has seen a dramatic decline in mortality, but, despite this, the link between mortality and deprivation across England and Wales remains as strong today as it was a century ago. Housing is an important determinant of health, and substandard housing is a major public health issue.1 Each year in the United States, million nonfatal injuries occur in and around the home,2 people die in house fires,3 and 2 million people make emergency room visits for asthma.4 One million young children in the United States have blood lead levels high enough to adversely affect.