Health impacts of epidemiological environment change: measurement issues

Epidemiological environment (EE) could be denned as a set of conditions and processes, both physical and social, that influence the interaction between human beings and disease agents. The human epidemiological environment is shaped by various aspects of development and global change, viz. the influences of human population size, mobility, geographic distribution, urbanization, and nutrition status; modernization (macro-and microeconomic enterprise); loss of indigenous medicinal knowledge; microbial evolution of antibiotic resistance; land conversion and biodiversity loss; agricultural intensification; stratospheric ozone depletion; and climatic change (Daily and Ehrlich, 1995). Health status is affected greatly not only by economic development (e.g. by policies influencing per capita income and its distribution), but also through changes in EE.