Regional Demographic and Epidemiologic Transitions(cont...)

While progression of both transitions is predictable, the rate of progression is not, and can be highly variable—as evident in the South Asia region. These transitions are unfolding at a pace where a substantial residual burden remains from communicable diseases, MCH issues, and nutrition causes—an important point from at least two angles. First, evidence is emerging that links MCH and nutrition issues to NCD risk later in life.

Example

undernutrition during fetal gestation and early childhood, and low rates of consistent breastfeeding, both common in South Asian populations, are associated with increased risk for chronic NCDs in adult life. Second, individuals with both an NCD and an infectious disease tend to have worse outcomes compared to having either alone.

Aging as a result of these transitions will in itself increase the prevalence of NCDs because they are more common with increasing age. Other factors—including lifestyle changes that may be associated with urbanization and globalization—can also increase the risk of NCD onset at younger ages. In the context of development, the impact of these two transitions is substantial because of the demographic dividend, that is, where developing countries’ working and nondependent population increases and per capita income thus rises (Figure 1.2).