The factors contributing to "epidemiological transition" and its consequences in the organization of health care services and the development of health policy

This paper addresses the mechanisms involved in, and the indices that demonstrate, changing patterns of diseases, and explores the reforms in the health care systems which are necessary to cope with the changes. The epidemiological model has moved away from the infectious disease based model in previous centuries, due to a series of socio-economic changes responsible for the demographic, and consequently for the epidemiological transition. Demographic changes, socio-economic differences, medical progress, globalization, environmental pollution, and unhealthy lifestyle are among the most important factors involved in this transition. As a result, there has been an increase in chronic diseases, mental disorders and substance abuse but there is also the emergence of new, or re-emergence of old infectious diseases. An increase in expenditure for long-term care and treatment has taken place. The prevention of new threats to health and the early identification of the factors that cause them, pose new challenges and achievable policy objectives in public health. Today, the medical/therapeutic science model is no longer sufficient to cope with the consequences of diseases. Based on modern perceptions and policies, the center of gravity of health policy has now moved from one-sided care of the disease to multilateral health promotion. For this reason, the formulation of policy should focus on implementation of an integrated program of primary health care. The new measures to be taken must be based on new objectives, including: upgrading the quality of life of the elderly, modernization of social protection systems, demographic renewal through facilities and family benefits, appropriate immigration policies, upgrading of the physical and social environment, and adoption of a healthier lifestyle through health education.