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Related Experiment Videos

[Regional differences in mortality from ischemic heart disease].

J P Mackenbach1, A E Kunst, C W Looman

  • 1Erasmus Universiteit, Instituut Maatschappelijke Gezondheidszorg, Rotterdam.

Nederlands Tijdschrift Voor Geneeskunde
|March 24, 1990
PubMed
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Mortality from ischaemic heart disease in the Netherlands shifted from high-income areas to lower-income areas between 1950 and 1984. This geographical redistribution of heart disease risk factors likely explains the change.

Area of Science:

  • Epidemiology
  • Cardiovascular Disease Research
  • Public Health

Background:

  • Ischaemic heart disease mortality patterns in the Netherlands have undergone significant geographical shifts since the mid-20th century.
  • Initial patterns showed higher mortality in affluent, urban regions, contrasting with later trends.

Purpose of the Study:

  • To analyze the changing geographical distribution of ischaemic heart disease (IHD) mortality in the Netherlands.
  • To investigate the potential drivers behind these observed geographical shifts in IHD mortality.

Main Methods:

  • Analysis of geographical mortality data for ischaemic heart disease across different time periods in the Netherlands.
  • Comparison of mortality trends with socio-economic factors and risk factor distributions.
  • Evaluation of cause-of-death certification consistency.

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Main Results:

  • A dramatic geographical redistribution of IHD mortality occurred, reversing trends observed between 1950-1954 and 1980-1984.
  • The initial higher mortality in high-income, urban areas shifted to the reverse by 1980-1984.
  • Changes in the association between IHD mortality, income, and risk factors suggest a redistribution of these factors.

Conclusions:

  • The observed geographical shift in ischaemic heart disease mortality is not attributable to changes in death certification.
  • A significant part of the explanation for the changing geographical distribution lies in the redistribution of IHD risk factors.
  • These epidemiological shifts in the Netherlands parallel those observed in the United States.