Epidemiological transition: model or illusion? A look at the problem of health in Mexico

This paper discusses the validity of the epidemiological transition model to interpret changes in the structure of mortality and morbidity. Epistemological and political questions are posed. The case of Mexico is used to illustrate the limitations its use imposes on understanding the constellation of components explaining the epidemiological profile, and the problems involved in designing a public health policy on the basis of this sort of misinterpretation. It is suggested that the illusory certainty of a pre-determined destiny distorts the prospective that would enable to construct scenarios; what is actually happening remains hidden by the model and health policies are designed without adequate parameters for evaluating their effective impact. We conclude with some remarks on the usefulness of constructing alternative forms of interpretation for understanding changes in the epidemiological profile, one of the most important inputs for designing better policies to face the challenges posed by health care and dealing with illness in modern-day societies.