...we are left with the so-called diseases of affluence - the degenerative cardiovascular diseases and cancers.
As we described in Chapter I, when infectious diseases lost their hold as the major causes of death, the industrialized world underwent a shift, known as the 'epidemiological transition', and chronic diseases, such as heart disease and cancer, replaced infections as the major causes of death and poor health.
But it is not true, as Suzuki seems to assume, that cancer's rise to leading killing means cancer is killing more people. It is possible that heart disease is killing fewer people. And that turns out to be the correct explanation. Statistics Canada reported that the death rates of both cardiovascular disease and cancer are falling but 'much more so for cardiovascular disease'.
We can compare a developing country with a richer developed country for an example. In 2009, the leading causes of death for males in England and Wales were as follows:
1) Ischaemic heart diseases 17.4%
2) Malignant neoplasm (cancer) of trachea, bronchus and lung 7.2%
3) Cerebrovascular diseases 7.1%
Comparing this with male deaths in South Africa we see that cancer drops way down the list:
1) HIV/AIDS 23.5%
2) Interpersonal violence 8.4%
3) Tuberculosis 6.8%
...13) Trachea, bronchus and lung cancer 1.7%
Someone could observe that lung cancer is the thirteenth highest cause of death for men in South Africa, but the second highest cause in England and Wales, and guess that Britons face greater danger from cancer than South Africans do. But the truth is that England and Wales are protected from TB, violence, AIDS and a range of other causes of death. In South Africa many people never get the chance to age long enough to develop cancer or heart disease.
So The Spirit Level's description of a 'shift' of risk from infectious disease to cancer and heart disease seems a little unclear. Rather than a shift there was a decisive decline in many lethal diseases, letting people grow old enough to develop other ailments. That's a 'shift' we should celebrate.