Disease in changing populations: Growth and disequilibrium

This paper examines simple age-structured models of childhood disease epidemiology, focusing on nonstationary populations which characterize LDCs. An age-structured model of childhood disease epidemiology for nonstationary populations is formulated which incorporates explicit scaling assumptions with respect both to time and to population density. The static equilibrium properties and the dynamic local stability of the model are analyzed, as are the effects of random variability due to fluctuations in demographic structure. We determine the consequences of population growth rate for: the critical level of immunization needed to eradicate an endemic disease, the transient epidemic period, the return time which measures the stability of departures from epidemiological equilibrium, and the power spectrum of epidemiological fluctuations and combined demographic-epidemiological fluctuations. Growing populations are found to be significantly different from stationary ones in each of these characteristics. The policy implications of these findings are discussed.