Epidemiologic transition theory exceptions

Abdel Omran’s 1971 theory of epidemiological transition is an attempt to account for the extraordinary advances in health care made in industrialized countries since the 18 century. According to Omran, all societies experience three "ages" in the process of modernization: the "age of pestilence and famine", during which mortality is high and fluctuating, with an average life expectancy under 30 years; the "age of receding pandemics", during with life expectancy rises considerably, from under 30 to over 50; and the "age of degenerative and man-made diseases", during which the pace of the mortality decrease slackens, while the disappearance of infectious diseases increases the visibility of degenerative diseases, while man-made diseases become more and more frequent. At the time Abdel Omran was developing his theory of epidemiologic transition, the most competent specialists, along with United Nations experts, saw life expectancies as generally converging towards a maximum age, the most advanced countries seeming very close to it. According to the United Nations World Population Prospects, the point of convergence was 75 years (United Nations, 1975).. And as things now stand in the most advanced countries, the increase in life expectancy has slowed down since the 1960s and in some countries has even halted, in particular as concerns men. The "cardiovascular revolution" of the 1970s launched a new period of progress. However, Jay Olshansky and Brian Ault (1986), followed by Richard Rogers and Robert Hackenberg (1987), without criticizing the basic premises of the theory of epidemiologic transition, introduced the idea of a "fourth stage" during which the maximum point of convergence of life expectancies would seem to increase thanks to achievements in the treatment of cardiovascular diseases. Jay Olshansky et al. (1990) set this new maximum at 85 years, the same as that chosen by the United Nations at the end of the 1980s for all countries (United Nations, 1989).