Turkey’s Epidemiological and Demographic Transitions: 1931-2013

Turkey’s Epidemiological and Demographic Transitions: 1931-2013

Background: The causes of death have changed with regard to the epidemiological and demographic events in society. There is no evidence of prior research into the epidemiological transition in Turkey. This transition in Turkey should be observed starting with the Ottoman Empire period (19th to early 20th century). However, information about the Ottoman Empire is quite limited. Aims: To discuss the epidemiological and demographic transitions in Turkey, using demographic, educational and urbanization data in our present study. Study Design: A descriptive archive study. Methods: Mortality statistics dating from 1931 and published by the Turkish Statistical Institute were analysed, and the causes of death were coded and classified according to ICD-10. Other data were obtained from the published reports and studies regarding the issue. Results: In the 1930s, Turkey’s life expectancy was low (aged 40 years), fertility and mortality rates were high (respectively 45% and 31%), and the main causes of death were infectious diseases. Nowadays, life expectancy is close to 80 years, the total fertility rate has dropped to 2.1 per woman, and the main causes of death are chronic diseases and cancer. The population rate in the urban areas has increased steadily from 24.2% in 1927 to 77.3% in 2012. level of education has also increased during this period. In 1935, less than 10% of women were literate, and in 2013 90% were literate. Qualitative and quantitative increase have been observed in the presentation and access of healthcare services compared to the early years of the Republic. Conclusion: Turkey has been undergoing a modernization period in the last 200 years, and it is believed that the epidemiological and demographic transitions result from this period. This process has led to urbanization and an increase in the level of education, as well as a decrease in premature deaths, lower fertility rates, and an increase in the elderly population and chronic diseases. It is therefore our conclusion that Turkey needs policies regarding the elderly population and the management of chronic diseases.

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  • 1. Caldwell JC. Population Health in Transition. Bull World Health Organ 2001;79:159-70.
  • 2. Canning D. The Causes and consequences of demographic transition. Popul Stud (Camb) 2011;65:353-61.
  • 3. Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Q 2005;83:731-57.
  • 4. Fişek NH, Shorter FC. Fertility Control in Turkey. Demography 1968;5:578-89.
  • 5. Shorter FC, Macura M. Türkiye’de Nüfus Artışı (1935-1975) Doğurganlık ve Ölümlülük Eğilimleri [Trends in Fertility and Mortality in Turkey 1935- 1975]. Yurt Publications, Ankara;1983. (Turkish)
  • 6. Koç İ, Eryurt MA, Adalı T, Seçkiner P. Demographic Transition in Turkey: Trends in Fertility, Family Planning, Maternal-Child Health and Under Five Mortality 1968-2008. Hacettepe University Institute of Population Studies. Ankara; 2008. (Turkish)
  • 7. Köse MR, Başara BB, Güler C, Yentür GK. Republic of Turkey Ministry of Health. Health Statistics Yearbook 2013. General Directorate of Health Research. Ministry of Health. Ankara; 2014. ISBN 978-975-590-508-2.
  • 8. Turkish Statistical Institute. Causes of Death Statistics, 2010, 2011 and 2012. No:15847. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri. do?id=15847; 2013.
  • 9. Turkish Statistical Institute. Address Based on the Population Registration System (ABPRS) Results. Available from: http://tuikapp.tuik.gov.tr/ adnksdagitapp/adnks.zul?dil=2; 2013.
  • 10. Turkish Statistical Institute. Basic Fertility Indicators, 2001-2013. Available from: www.tuik.gov.tr/PreIstatistikTablo.do?istab_id=1592; 2014.
  • 11. Turkish Statistical Institute. Elderly Statistics 2013. Turkish Statistical Institute, Printing Division, Ankara; 2014.
  • 12. Berkes N. Türkiye’de Çağdaşlaşma [The Development of Secularism in Turkey, 1964]. Yapı Kredi Publications-1713, İstanbul; 2014. (Turkish)
  • 13. Tekeli İ, İlkin S. Türkiye’de Sıtma Mücadelesinin Tarihi [History of Fighting Malaria in Turkey]. Cumhuriyetin Harcı: Köktenci Modernitenin Ekonomik Politikasının Gelişimi [The Basis of Turkish Republic: Development of Economic Policy of Radical Modernity]. İstanbul Bilgi University Publications 70. İstanbul; 2010:107-61.
  • 14. Karabulut U. A general look at the Health services in the first years of The Republic: Dr. Refik Saydam’s Health Ministry and Services (1925-1937). CTTAD 2007;7:151-160. (Turkish)
  • 15. Tekeli İ, Güler Ç, Yerli SV, Algan N, Vaizoğlu SA, Çobanoğlu Z, et al. Türkiye’nin Sağlık Bağlamı İçinde 1593 Sayılı Umumi Hıfzıssıhha Kanunu ve Cumhuriyetin Sağlık Sorununa Yaklaşımı [An Approach of Public Health Law No. 1593 and Republic to Health Problem in The Health Context of Turkey]. Turkish Academy of Sciences Reports (TUBA). No: 21. Yalçın Publications, Ankara; 2010. (Turkish)
  • 16. Ayar M. Osmanlı Devleti’nde Kolera: İstanbul Örneği (1892-1895) [Cholera in the Ottoman Empire: The Case of Istanbul]. Kitabevi Publications, İstanbul; 2007 (Turkish).
  • 17. Panzac D. Osmanlı İmparatorluğu’nda Veba: 1700-1850 [La peste dans l’Empire Ottoman:1700-1850]. Tarih Vakfı Yurt Publications, İstanbul; 2011. (Turkish)
  • 18. Hacettepe University Institute of Population Studies. Fertility, Reproductive Health and Ageing in Turkey. Ankara; 2014. (Turkish)
  • 19. Pamuk Ş. Türkiye’nin 200 Yıllık İktisadi Tarihi, Büyüme, Kurumlar ve Bölüşüm [Turkey's 200-Year of Economic History, Growth, Institutions and Distribution]. Türkiye İş Bankası Kültür Publication, İstanbul; 2014. (Turkish)
  • 20. Çağlayaner H. Osmanlı’dan Cumhuriyet’e Türkiye’de Sağlığın Çağdaşlaşması [Modernization of Health in the Republic of Turkey from Ottoman Empire]. Deomed Publications, İstanbul; 2014. (Turkish)
  • 21. Minsitry of Health and Social Affairs. Sağlık Hizmetlerinde 50. Yıl [Fifty years in Health Care Services]. Publication No: 422. Ankara; 1973. (Turkish)
  • 22. Keleş R. Kentleşme Politikası [Policy of Urbanization]. İmge Publication, Ankara; 2006. (Turkish)
  • 23. Atun R, Aydın S, Charkraborty S, Sümer S, Aran M, Gürol I, et al. Universal health coverage in Turkey: enhancement of equity. Lancet 2013;382:65-99.
  • 24. TC Sağlık Bakanlığı. Türkiye Halk Sağlığı Kurumu. Aile Hekimliği. http:// ailehekimligi.gov.tr/
  • 25. Fişek NH. An Integrated Health/Family Planning Program. Etimesgut District, Turkey. Studies in Family Planning 1974;5:210-20.
  • 26. Republique Turque Presidence du Conseil Office Central de Statistique. Statistiques Concernant Le Mouvement De La Population. Mariages, Divorces et Deces, 1938-1951. Publication No: 345, Ankara; 1953. (Turkish and French)
  • 27. Republic of Turkey Prime Ministry, The Official Gazette. The Population Planning Law (Law number: 2827). Date:27.05.1983, Number: 18059;1983. (Turkish)
  • 28. Başara BB, Güler C, Eryılmaz Z, Yentür GK, Pulgat E. The Ministry of Health of Turkey Health Statistics Yearbook 2011. General Directorate of Health Research. Ministry of Health. Ankara; 2012.
  • 29. International Classification of Diseases, Revision 6 (ICD-6) List B: Abbreviated list of 50 causes for tabulation of mortality. Available from: http://www.wolfbane.com/icd/icd6b.htm; 1948.
  • 30. International Classification of Diseases, Revision 8 (ICD-8) List B: List of 50 Causes for tabulation of mortality. Available from: http://www. wolfbane.com/icd/icd8b.htm; 1955.
  • 31. International Classification of Diseases, Revision 10 (ICD-10). Available from: http://www.wolfbane.com/icd/icd10.htm; 1990.
  • 32. Republic of Turkey Prime Ministry State Institute of Statistics. Deaths Statistics in Provinces and Districts Centers 2008. Publication No.3355. Turkish Statistical Institute, Printing Division. Ankara; 2009.
  • 33. Turkish Statistical Institute. Death Statistics, 2012. Metada. No:15848. 16.04.2013. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri. do?id=15848; 2013.
  • 34. Ministry of Health, Refik Saydam Hygiene Centre Presidency School of Public Health, Baskent University. National Burden of Disease and Cost Effectiveness Project (BoD-CE Project) Burden of Disease Final Report. Ankara; 2004.
  • 35. Republic of Turkey Prime Ministry State Institute of Statistics. Deaths Statistics From Provincial And District Centers 2000. Publication No.2673. Turkish Statistical Institute, Printing Division, Ankara; 2003.
  • 36. World Health Organization. Turkey: WHO statistical profile.2013. Available from: http://www.who.int/gho/countries/tur.pdf?ua=1; 2013
  • 37. TC Başbakanlık. Devlet Planlama Teşkilatı Müsteşarlığı. İkinci Beş Yıllık Kalkınma Planı 1968-1972 [The second development plan, 1968-1972]. Ankara. Available from: http://www.kalkinma.gov.tr/Lists/Kalknma%20 Planlar/Attachments/8/plan2.pdf; 1972. (Turkish)
  • 38. Hamzaoğlu O, Özcan U. Turkey Health Statistics 2006. Turkish Medical Association. Ankara; 2006. (Turkish)
  • 39. Türkay O. Türkiye’de Nüfus Artışı ve İktisadi Gelişme [Population Growth and Economic Development in Turkey]. (Doktora Tezi-PhD Thesis). Doğuş Ltd. Şirketi Matbaası, Ankara; 1962. (Turkish)
  • 40. Turkish Statistical Institute. Statistical Indicators 1923-2012. Turkish Statistical Institute, Printing Division, Ankara; 2013.
  • 41. Turkish Statistical Institute. News Release. Causes of Death Statistic 2013. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri. do?id=16162; 2013
  • 42. Hamzaoğlu O, Kılıç B. Turkey Health Statistics 2000. Turkish Medical Association. Ankara; 2000. (Turkish)
  • 43. Hoşgör Ş, Tasel A. 2050'ye Doğru Nüfusbilim ve Yönetim: Eğitim, İşgücü, Sağlık ve Sosyal Güvenlik Sistemlerine Yansımalar [Demography and Management to 2050: Reflections on The Education, Workforce, Health and Social Security Systems]. Publication No: TUSİAD-T/2010/11/505, 2010. İstanbul; 2010. (Turkish)
  • 44. Hacettepe University Institute of Population Studies. Turkey demographic and Health Survey 2013. Ankara; 2014.
  • 45. Turkish Statistical Institute. Deaths Statistics, 2013. No:16050. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri.do?id=16050; 2014.
  • 46. Salomon JA, Wang H, Freeman MK, Vas T, Flaxman AD, Lopez AD, et al. Healthy life expectancy for 187 countries, 1990-2010: Asystematic analiysis for the Global Burden Disease Study 2010. Lancet 2010;380:2144-62.
  • 47. World Health Organization. World Health Statistics 2014. Available from: http://apps.who.int/iris/bitstream/10665/112738/1/9789240692671_eng. pdf?ua=1; 2014.
  • 48. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-spesific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117-71.
  • 49. Mollahaliloğlu S, Başara BB, Eryılmaz Z. The Ministry of Health of Turkey Health Statistics Yearbook 2010. School of Public Health, Refik Saydam Hygiene Center Presidency, Ministry of Health of Turkey, Ankara; 2011.