[The epidemiological transition in The Netherlands].
OBJECTIVE
To assess the differences in the pattern of mortality by sex, age and cause of death between 1875-1879 and 1970 for the Netherlands, and the contribution of different causes of death to the decrease of total mortality between these periods.


METHODS
Mortality data for 1875-1879 were extracted from one of the first publications after the start of the national cause-of-death register, and were reclassified according to the cause-of-death classification in use in 1970. The mortality data for 1875-79 and 1970 were directly standardised using the age structure of the Dutch population in 1930.


RESULTS
The mortality rates in 1970 were only a third (for men) to a quarter (for women) of those in 1875-79. Mortality patterns by age changed drastically, due to stronger mortality reductions among younger people. The share in total mortality decreased enormously for infectious diseases (from 38-39% to 4-5%) and for mental disorders/diseases of the nervous system (9-11% to 2-3%), but the shares of cancer (2-3% to 25-26%), cardiovascular diseases (7-8% to 42%) and external causes (1-3% to 7-9%) increased correspondingly. Almost 50% of the decrease of total mortality was due to a number of infectious diseases, of which respiratory diseases were the most important subgroup.


CONCLUSIONS
The Dutch population experienced an 'epidemiological transition' very much like that described for some other countries.
Mackenbach
J P
JP
Erasmus Universiteit, Instituut Maatschappelijke Gezondheidszorg, Rotterdam.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D012737:Sex Factors