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Kristie Ebi

Health Transitions

Population health and health systems are at a juncture. The last 150 years have seen substantial advances in human health: life expectancy has increased, infant mortality has declined, undernutrition is less widespread, and the burden of infectious diseases has reduced.

Much of this gain stems from public works such as potable water and sewage systems, improved housing and nutrition, and vaccination and other healthcare advances.  Overall, we are healthier and live longer than our ancestors.  These advancements in human health have proved critical in helping much of the world’s population escape extreme poverty, leading to today’s unprecedented high life-expectancy and improved survival rate for children under the age of five. 

Despite this overall progress, substantial improvements are still required.  Massive health inequalities may be widening.  The median age is increasing worldwide as global fertility rates continue to decline and life expectancies lengthen, leading to changing health-risk profiles.  Worldwide, the largest contributions to premature morbidity and mortality are from non-communicable diseases, which are often associated with unhealthy behaviors and metabolic factors linked to diet. These factors have proven resistant to change. 

At the same time, accelerating global environmental changes are exacerbating current health risks and creating new ones which threaten to stall, or even reverse the progress made. These risks include urbanization; globalization of ideas, goods, services, and human movement; and increases in the human exploitation of energy and resources. Another threat is the growth of anthropogenic impacts including climate change; biodiversity loss; land use changes; altered nitrogen and phosphorus cycling; the decline in fisheries; and environmental loading of toxic chemicals and air pollutants.  In addition, policies designed to reduce risks of global environmental change may not only result in health co-benefits, but co-harms too.

The Health Transitions section of Global Transitions seeks papers exploring system-based approaches to protecting and promoting population health in the context of emerging and projected health-related changes, both within and outside health systems. Submissions should identify risks and opportunities and propose pathways to transition to a more resilient and sustainable future.


Health Transitions, Editor-in-Chief

Kristie Ebi, University of Washington, Seattle, USA
Kristie Ebi, University of Washington, Seattle, USA
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