Socio-economic development and the demographic and epidemiological transitions: effects on psychosocial circumstances and lifestyles
Diabetes mellitus, CHD, and ischaemic, but not haemorrhagic stroke, are closely linked to rising affluence and the accompanying changes in life expectancy and in lifestyles. These changes take place in the context of the demographic and epidemiological transitions. These phenomena could explain the rise in diabetes, CHD, and stroke in populations including South Asians but not why the rates of these diseases exceed those in populations who are already at an even more advanced stage in these transitions. Changes in psychosocial status, including the stresses of migration, social change, and work patterns and lifestyle accompanying these transitions have been especially rapid in the South Asian diaspora. The recent high-heat cooking hypothesis, which proposes South Asians’ cooking styles produce atherogenic substances including advanced glycation products and trans-fatty acids, illustrates how affluence and behaviours might influence disease. Together, these general explanations set the stage to examine specific risk factors.