Morbidity and mortality during the health transition: a comment on James C. Riley, ‘Why sickness and death rates do not move parallel to one another over time’

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    Abstract

    Throughout most parts of the world, mortality rates have fallen dramatically since
    the mid-nineteenth century, but morbidity rates appear to have risen.1 James
    Riley's article is the latest in a series of attempts to explain this paradox. It breaks
    new ground, in relation to the author's previous work, in its use of a mathematical
    model to explain the relationship between morbidity and mortality, and in the
    deployment of new data from the Abthorpe, Ashboume, Llangeitho, and Morcott
    Friendly Societies.2 However, despite the undoubted importance of Riley's
    article, many of his conclusions remain open to question.
    In endeavouring to explain 'why sickness and death rates do not move parallel to
    one another over time', Riley raises four major issues, which may be summarized
    as follows:
    1. What is the practical significance of the equation P = / X D?
    2. To what extent has Riley succeeded in demonstrating the robustness of the
    friendly society data as objective indicators of health status?
    3. What do the data reveal about sickness and health among members of the four
    societies?
    4. What are the implications of Riley's findings for our understanding of the
    relationship between morbidity and mortality during the period of the 'health
    transition'?
    This comment will attempt to highlight the questions raised by Riley's article
    under each of these headings.
    What is the practical significance of the equation P= IX D?
    To what extent has Riley succeeded in demonstrating the robustness of the
    friendly society data as objective indicators of health status?
    What do the data reveal about sickness and health among members of the four
    Societies?
    What are the implications of Riley's findings for our understanding of the
    relationship between morbidity and mortality during the period of the 'health
    transition'?
    Original languageEnglish
    Pages (from-to)125-131
    Number of pages7
    JournalSocial History of Medicine
    Volume12
    Issue number1
    Publication statusPublished - 1999

    Keywords

    • mortality
    • health transition
    • morbidity
    • sickness
    • death rates

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