Trends in Infectious Disease Mortality in the United States During the 20th Century

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Abstract
Over the last 100 years, North America and Europe have experienced a substantial decline in mortality and an increase in life expectancy. The "theory of epidemiologic transition" attributes these trends to the transition from an "age of pestilence and famine," in which the mortality pattern was dominated by high rates of infectious disease deaths, especially in the young, to the current "age of degenerative and man-made diseases" in which mortality from chronic diseases predominates.1,2 According to estimates from the Global Burden of Disease Study, infectious diseases now account for only 4.2% of all disability-adjusted life years lost (DALYs, a measure of the burden of diseases and injuries) in countries like the United States with established market economies, whereas chronic and neoplastic diseases account for 81.0%.3