Health/ill-health transition in less privileged populations: what does the future hold?

Changes in health/ill-health in response to alterations in environmental factors are recognised. While the phenomenon has been extensively investigated in Western populations, the extent and sequelae of transitions in less privileged populations are less well appreciated. Examples of changes are given, first for Western populations as a comparison but, more particularly, for rural and urban Africans, for African-Americans, and also for Australian Aboriginals, whose mortality rates for chronic degenerative diseases now exceed those of white Australians. Discussion of the likely future of these populations indicates that a lessening of proneness to Western diseases is unlikely.