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Milbank Q. 1986;64(3):355-91.

The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases.


Gains in longevity in the United States since the mid-nineteenth century occurred as a result of an epidemiologic transition: deaths from infectious diseases were replaced by deaths from degenerative diseases. Recent trends in cause-specific mortality suggest a distinct new stage, one of postponement of degenerative diseases. Projections based on these data must be applied cautiously; their implication for health and social policies are likely to be profound.

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