The epidemiological transition in an overseas territory: disease mapping in French Polynesia.

During the last 200 years in French Polynesia the people have experienced several dramatic changes in the pathological scene. First the discovery of Tahiti and the surrounding islands at the end of the eighteenth century caused the spread of diseases previously unknown, usually in the form of epidemic outbreaks. In contrast, from the 1860s to soon after the end of the Second World War, health amelioration in French Polynesia was slowly occurring. This constituted a first epidemiological transition in which infectious disease mortality was sharply reduced. The distribution of vaccines, hygiene education and legislation stemmed the long period of some 100 years of demographic disaster and at last the population was able to increase. However for a long time infectious or parasitic diseases remained the main causes of morbidity and mortality. Only from the end of the 1950s has the situation evolved to the present state where morbidity and mortality of the circulatory system and cancer are similar in prevalence to industrialized countries. Diachronistic mapping of some of the most noteworthy diseases is presented to illustrate this last and most important phase of the epidemiological transition.