Applications of epidemiologic transition theory to modern infectious disease medicine and epidemiology

CONTEXT: Epidemiologic transition theory (ETT) enables holistic assessment of the evolution and ecology of human health, disease, adaptation, and evolution to diverse stressors (e.g. pathogens). Accordingly, ETT is paradigmatic in anthropology and many related fields, though notably not in epidemiology and clinical medicine. In an era of crumbling public health systems, vaccine hesitancy, and rising threats from both infectious and chronic and degenerative diseases, we encourage greater adoption of ETT in epidemiology and clinical medicine because of its potential research and practical applications. OBJECTIVE: Here, we briefly review ETT and its broadly accepted transitions. METHODS: We discuss select research insights, including the evolutionary origins of chronic inflammatory diseases (CIDs) and zoonoses, and differential vulnerability to epidemic and pandemic infectious disease. RESULTS AND CONCLUSION: Potential theoretical and practical benefits of greater adoption of ETT include experimental therapies for infectious diseases and CIDs anchored in evolutionary medicine; policy and practical guidance for reducing youth and maternal mortality in low- and middle-income countries (LMICs); better comprehension of both early life exposure to environmental microbes' role in differential vulnerability to CIDs and infectious diseases, and vaccine efficacy, and the interplay between survival of pandemic disease and differential vulnerability to CIDs; and historical drivers of vaccine hesitancy in high income countries (HICs).