Exposure, resistance, and recovery: a three-dimensional framework for the study of mortality from infectious disease

It has been suggested by several scholars that debates surrounding the study of mortality could benefit from a framework that integrates social and economic factors with the biological mechanisms of illness and death (Johannson and Mosk, Popul. Stud. 41 (1987) 207-236; Mosley, International Population Conference, Vol. 2, Florence, IUSSP, Liege, 1985. pp. 189-203; Mosley and Chen, in W. H. Mosley, L. C. Chen (Eds.), Child Survival: Strategies for Research, Population Council, New York, 1984, pp. 25-45; Murray and Chen, Soc. Sci. Med. 36(2) (1993) 143-155; Ruzicka, International Population Conference, Vol. 2, Florence, IUSSP, Liege, 1985, pp. 185-187). In this paper, I present a conceptual framework aimed at doing this for infectious disease mortality. The framework is built around three proximate processes: (1) exposure to potentially lethal pathogens, (2) resistance to disease pathogens after exposure, and (3) recovery from disease episodes after contraction. I apply this conceptual framework to morbidity and mortality from cholera across 41 less developed nations.