Mortality decline in The Netherlands in the period 1850-1992: A turning point analysis

Author(s): VanPoppel, F. W. A., Tabeau, E., Mackenbach, J. P.

Journal/Book: Soc Sci Med. 1998; 47: The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England. Pergamon-Elsevier Science Ltd. 429-443.

Abstract: The aim of this paper is to give a detailed and fairly objective description of rapid mortality decline in The Netherlands between 1850 and 1992 with respect to the start, end, and phases of the decline. Turning points were estimated for the standardized mortality trend, and for age and sex-specific trends between 1850-1992. The technique used was derived from spline functions. The turning points divided the trends into phases with different paces of decline. Standardized mortality started to decline rapidly in The Netherlands around 1880. Four phases in the period of decline could be distinguished: 1880-1917 (1.2% annually), 1917-1955 (1.6%), 1955-1970 (0.4%), 1970-1992 (1.1%). For nearly all age groups, the most rapid decline occurred in a period comparable to 1917-1955. Causes of death which might have shaped the standardized mortality trend are, among others, respiratory tuberculosis (1917), heart disease (except ischemic) (1955), and ischemic heart disease (1970). Causes of death that shaped the mortality trend are related to trends of determinants of mortality decline. The technique used in this paper can also be applied to other trends e.g. Fertility decline.

Note: Article WolleswinkelVandenBosch JH, Erasmus Univ, Fac Med & Hlth Sci, Dept Publ Hlth, POB 1738, NL-3000 Dr Rotterdam, NETHERLANDS

Keyword(s): mortality decline; turning point analysis; Netherlands; INFANT-MORTALITY; EPIDEMIOLOGIC TRANSITION; CHILD-MORTALITY

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