SEARCH · Search PubMed

Results for “NETHERLANDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed1998

Is there a place for laparoscopic antireflux surgery in The Netherlands?

BACKGROUND: Antireflux surgery has not gained wide acceptance in The Netherlands in the past two decades. The introduction of laparoscopic fundoplication seems to have had no impact on the number of antireflux operations performed per year. METHODS: The SIG data were consulted in order to compile an inventory on the number of antireflux operations performed in The Netherlands between 1977 and 1995. The data were compared with those kindly supplied by the Laparoscopic Societies of the Scandinavian countries. RESULTS: The number of antireflux operations per year in The Netherlands, 1.7/100,000 per year, is far less than reported in the four Scandinavian countries, 15/100,000 per year, and also far below the 10/100,000 per year needed for antireflux surgery on a yearly basis. CONCLUSIONS: In The Netherlands, 1.7/100,000 inhabitants per year undergo antireflux surgery. This figure has remained virtually stable in the past two decades, i.e. it has not changed even since the introduction of H2-receptor antagonists, proton-pump inhibitors and laparoscopic antireflux surgery. The success of medical treatment and personal, anecdotal, experience of gastroenterologists with patients they have referred for surgery explain the low number of antireflux operations performed. Currently, a randomized trial is being conducted in The Netherlands comparing the effectivity, costs and quality of life after conventional Nissen fundoplication with the laparoscopic approach. All operations are performed or supervised by a limited number of experienced surgeons who have gone through the learning curve of both the open and conventional technique.

Gastroesophageal Reflux↗

PubMed2003

Rehabilitation care for patients with ALS in The Netherlands.

BACKGROUND: In the Netherlands, rehabilitation medicine plays an important role in the symptomatic and palliative treatment of ALS patients. Detailed information about the actual care of ALS patients in the Netherlands and about the attitude of consultants in rehabilitation medicine towards the management of this disease was lacking. OBJECTIVE: To obtain detailed information about the rehabilitation care for patients with ALS in the Netherlands. METHODS: We have performed a survey among all consultants in rehabilitation medicine in the Netherlands, using a questionnaire about the organisation of care and the care management of ALS patients. RESULTS: Two hundred eighty one questionnaires were gathered with a response rate of 98%. There were 14 specialised ALS centres spread throughout the country, except in the northwest and southwest. Most consultants worked with an ALS multidisciplinary team and most patients were treated in an outpatient rehabilitation clinic. Follow up visits were performed in most cases 5-6 times per year. The majority of the patients were followed up until death. The Dutch protocol for rehabilitative management in ALS was used in 89% of all treated ALS patients. Follow up and care management was not different in the specialised centres compared with the non-specialised centres. CONCLUSION: In conclusion, this study indicated that the actual care for ALS patients was reasonably well organised in the Netherlands, based on the results and reactions of the consultants in rehabilitation medicine.

Amyotrophic Lateral Sclerosis↗

PubMed2004

Discrepancy between opinion and attitude on the practice of ECT by psychiatrists specializing in old age in the Netherlands.

BACKGROUND: Current guidelines consider electroconvulsive therapy (ECT) in the Netherlands a treatment of choice for a depressive disorder with psychotic features, severe suicidal behavior, severe physical exhaustion, or resistance to treatment with antidepressants (consecutively SSRIs, TCAs, lithium, MAO inhibitors). It is advised to use ECT early on in the treatment of depressed elderly patients. In practice, ECT is applied to only a minority of depressed elderly patients in the Netherlands. This situation dates back to the 1970s, in which strong aversive opinions toward ECT grew in the Netherlands, largely as a reaction to the malpractice of ECT in that time and influenced by social-cultural opinions toward psychiatry. Negative attitudes among professionals and lack of knowledge may contribute to the under use in depressed elderly patients. METHODS: A postal questionnaire was sent to 152 psychiatrists who specialize in old age to assess their opinions and attitudes toward ECT. RESULTS: Only a small minority thought ECT was a treatment of choice in a depressive disorder with psychotic features (4%), severe suicidal risk (2%), or physical exhaustion (5%). The majority of the psychiatrists had strongly reserved opinions in considering ECT as a treatment of first, second or third choice in depressed elderly patients, even in treatment-resistant depressive disorders. CONCLUSIONS: Many psychiatrists who specialize in old age in the Netherlands divert from the current guidelines and are reluctant toward using ECT as a treatment of choice in a number of specific, clinical situations. This might be a major contributing factor to the present and past underuse of ECT in depressed elderly patients in the Netherlands.

Aged↗

PubMed2005

Predictions of skin cancer incidence in the Netherlands up to 2015.

BACKGROUND: Skin cancer is an important, growing public health problem among white caucasians, causing a heavy burden on dermatologists and general practitioners. OBJECTIVES: To predict the future incidence of skin cancer in the Netherlands up to 2015. METHODS: Expected numbers of skin cancer cases in the Netherlands up to 2015 were calculated by trend modelling of observed rates for melanoma and squamous cell carcinoma (SCC) between 1989 and 2000 obtained from the Netherlands Cancer Registry and for basal cell carcinoma (BCC) obtained from the Eindhoven Cancer Registry; these rates were then multiplied by the predicted age distributions. Incidence rates were fitted to four different models, and predictions were based on the best fitting model. RESULTS: An increase of 80% in the total number of skin cancer patients is expected in the Netherlands: from 20 654 in 2000 to 37 342 in 2015. The total number of melanoma cases is expected to increase by 99%, with the largest increase for males (males aged 35-64, 111%; males aged > or = 65, 139%). Numbers of patients with SCC will increase overall by 80%, mainly among older males and females (increase of 79%) and females aged 35-64 (increase of 93%). The number of cases of BCC will increase by 78%, with the largest increase for the combined groups, those aged 15-64 (males, 66% increase; females, 94% increase), especially for sites other than the head and neck. The contribution of demographic changes (ageing effect) was largest for males with BCC and SCC (35-44%). CONCLUSIONS: If incidence rates for skin cancers in the Netherlands continue to increase and population growth and ageing remain unabated, a rise in annual demand for care of more than 5% could occur, putting a heavy burden on general practitioners and dermatologists. In the absence of marked changes in current ultraviolet radiation exposure, these increases will probably continue after 2015.

Adolescent↗

PubMed2000

Epidemiology of meningitis and bacteraemia due to Streptococcus pneumoniae in The Netherlands.

In The Netherlands, accurate data on the epidemiology of pneumococcal meningitis are available through a clinical microbiology laboratory-based national surveillance of cerebrospinal fluid isolates. The Netherlands Reference Laboratory for Bacterial Meningitis receives isolates of about 80% of all meningitis cases and about 40% of bacteraemic cases. The incidence of pneumococcal meningitis has increased slowly from 1.0/100,000 in 1990 to 1.5/100,000 since 1996. The highest age-specific incidence of meningitis was observed in children < 5 y of age (8.2/100,000 in 1999). Of all isolates, 35% were from children < 5 y of age. The number of isolates from non-meningitis patients with bacteraemia increased considerably since the early 1990s, especially among the elderly. The highest incidence was found in 1996, probably owing to a relatively severe winter. During 1995-1999, pneumococcal meningitis in The Netherlands was caused mainly by serotypes 3, 6B, 7F, 9V, 14, 18C, 19F, and 23F. Of the cases in children < 15 y, almost half were caused by serotypes 6B, 14, 18C, and 19F. The serotypes present in the 23-valent polysaccharide and 7-valent conjugate vaccines accounted for 87% and 47% of all meningitis cases, respectively. Pneumococcal resistance to penicillin in The Netherlands is still low, at about 1%. Genotypically, resistant strains belong to many clones. Horizontal transfer of capsular genes occurs among these isolates. In The Netherlands, 45% of cases of pneumococcal meningitis have severe predisposing factors. The case-fatality rate was significantly higher among patients with impaired immunity than among those with a break in the integrity of the dura.

Adolescent↗

PubMed1997

Twenty years of childhood coeliac disease in The Netherlands: a rapidly increasing incidence?

BACKGROUND: The incidence of coeliac disease varies internationally. AIMS: To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. SUBJECTS: Identified cases of childhood coeliac disease in The Netherlands in 1993-4 by means of the Dutch Paediatric Surveillance Unit. METHODS: Inclusion criteria were born in The Netherlands, diagnosed with at least one biopsy of the small bowel in 1993-4 and age at diagnosis 0-14 years. The data were cross checked by the Dutch Network and National Database of Pathology and compared with data from a previous study on childhood coeliac disease, 1975-90. RESULTS: A total of 193 coeliac patients were identified by means of the Surveillance Unit, another 20 through the National Database of Pathology. The mean crude incidence rate of diagnosed childhood coeliac disease was 0.54/1000 live births, which is in the range of rates found in other western European countries and significantly higher than the mean crude incidence rate of 0.18/1000 live births found in The Netherlands in 1975-90. The clinical presentation was classic: chronic diarrhoea, abdominal distension, and growth failure. Associated disorders were present in 11.7% of the cases. CONCLUSIONS: The incidence of diagnosed childhood coeliac disease in The Netherlands seems to have increased significantly during the past few years. In a period of 20 years no significant changes could be found in the clinical picture at preentation of coeliac disease in Dutch children.

Adolescent↗

PubMed1991

Cultural and economic determinants of geographical mortality patterns in The Netherlands.

STUDY OBJECTIVE: The geographical pattern of mortality in The Netherlands is dominated by an area of relatively high mortality in the southern part of the country. The aim was to analyse the background of this geographical mortality pattern in the early 1980s, and its evolution over time since the early 1950s. DESIGN: Mortality data by district (n = 39), cause of death (13 large causes, "symptoms and ill defined conditions", all other causes), and time period (1950-54, 1960-64, 1970-74, 1980-84) were available from the Netherlands Central Bureau of Statistics. Standardised mortality ratios were calculated, and the logarithms of these were related to three sociodemographic characteristics using multiple, ordinary least squares regression analysis. SETTING: This study used data for the whole Dutch population. MAIN RESULTS: Although the geographical mortality pattern has been rather stable over the last decades, a clear tendency towards convergence is also apparent. Approximately 90% of the current excess mortality in the southern part of the country is due to cardiovascular diseases. The results of regression analysis show that the excess mortality is primarily related to the high percentage of Roman Catholics in this part of the country, and additionally to a slightly lower average income. In The Netherlands, a higher percentage of Roman Catholics in the population is linked with higher all cause mortality rates, as well as with higher mortality rates for lung cancer, ischaemic heart disease, cerebrovascular disease, arterial disease, and chronic non-specific lung disease. Survey data show that these associations are partly due to a higher prevalence of smoking among Roman Catholics. As in many other countries, a lower average income is linked with high all cause mortality rates in The Netherlands. Cause specific data show negative associations for stomach cancer, ischaemic heart disease, cerebrovascular disease, chronic non-specific lung disease, and traffic accidents. Since the early 1950s the association between geographical mortality patterns and the percentage of Roman Catholics in the population has gradually become less strongly positive. This suggests that the convergence of the mortality rates in the South towards the national average may be related to a gradual lessening of differences in lifestyle between population groups. CONCLUSIONS: Both cultural and economic factors are important in the explanation of geographical mortality patterns in The Netherlands.

Adolescent↗

PubMed1993

Air pollution, lagged effects of temperature, and mortality: The Netherlands 1979-87.

OBJECTIVE: To explore whether the apparent low threshold for the mortality effects of air pollution could be the result of confounding. DESIGN: The associations between mortality and sulphur dioxide (SO2) were analysed taking into account potential confounding factors. SETTING: The Netherlands, 1979-87. MEASUREMENTS AND MAIN RESULTS: The number of deaths listed by the day on which the death occurred and by the cause of death were obtained from the Netherlands Central Bureau of Statistics. Mortality from all causes and mortality from four large groups of causes (neoplasms, cardiovascular diseases, respiratory diseases, and external causes) were related to the daily levels of SO2 air pollution and potential confounders (available from various sources) using log-linear regression analysis. Variables considered as potential confounders were: average temperature; difference between maximum and minimum temperatures; amount of precipitation; air humidity; wind speed; influenza incidence; and calendar year, month, and weekday. Both lagged and unlagged effects of the meteorological and influenza variables were considered. Average temperature was represented by two variables--'cold', temperatures below 16.5 degrees C, and 'warm', those above 16.5 degrees C--to allow for the V shaped relation between temperature and mortality. The positive regression coefficient for the univariate effect of SO2 density on mortality from all causes dwindles to close to zero when all potential confounding variables are taken into account. The most important of these represents the lagged (one to five days) effect of low temperatures. Low temperatures have strong lagged effects on mortality, and often precede relatively high SO2 densities in the Netherlands. Results were similar for separate causes of death. While univariate associations suggest an effect of air pollution on mortality in all four cause of death groups, multivariate analyses show these effects, including that on mortality from respiratory diseases, are a result of confounding. CONCLUSIONS: The SO2 density (or that of compounds closely associated with SO2) does not seem to have any short term effect on mortality in the Netherlands. SO2 levels higher than those currently reached in the Netherlands (above 200 micrograms/m3) may have a measurable effect on mortality and this should be investigated. Furthermore, analyses of the public health impact of outdoor air pollution should properly control for the lagged effects of temperature.

Air Pollution↗

PubMed2002

Trends in socioeconomic health inequalities in the Netherlands, 1981-1999.

STUDY OBJECTIVE: To determine changes in socioeconomic inequalities in self reported health in both the 1980s and the 1990s in the Netherlands. DESIGN: Analysis of trends in socioeconomic health inequalities during the last decades of the 20th century were made using data from the Health Interview Survey (Nethhis) and the subsequent Permanent Survey on Living Conditions (POLS) from Statistics Netherlands. Socioeconomic inequalities in self assessed health, short-term disabilities during the past 14 days, long term health problems and chronic diseases were studied in relation to both educational level and household income. Trends from 1981 to 1999 were studied using summary indices for both the relative and absolute size of socioeconomic inequalities in health. SETTING: The Netherlands. PARTICIPANTS: For the period 1981-1999 per year a random sample of about 7000 respondents of 18 years and older from the non-institutionalised population. MAIN RESULTS: Socioeconomic inequalities in self assessed health showed a fairly consistent increase over time. Socioeconomic inequalities in the other health indicators were more or less stable over time. In no case did socioeconomic inequalities in health seemed to have decreased over time. Socioeconomic inequalities in self assessed health increased both in the 1980s and the 1990s. This increase was more pronounced for income (as compared with education) and for women (as compared with men). CONCLUSION: There are several possible explanations for the fact that, in addition to stable health inequalities in general, income related inequalities in some health indicators increased in the Netherlands, especially in the early 1990s. Most influential were perhaps selection effects, related to changing labour market policies in the Netherlands. The fact that the health inequalities did not decrease over recent years underscores the necessity of policies that explicitly aim to tackle these inequalities.

Adolescent↗

PubMed2004

Euthanasia and physician-assisted suicide policy in The Netherlands and Oregon: a comparative analysis.

This article presents a comparative analysis of euthanasia and physician-assisted suicide policy in The Netherlands and the state of Oregon in the United States. The topics of euthanasia and physician-assisted suicide are discussed in the context of the historical setting of The Netherlands and the United States with special emphasis placed on public opinion, role of the courts and the legislative bodies, and opinions of physicians. Major similarities and differences in the laws of The Netherlands and Oregon are discussed. The article examines whether the passage of the law has led to a slide down the slippery slope in The Netherlands and Oregon as had been suggested by the opponents of the law. The article concludes that the empirical evidence does not support the contention of the opponents. However, the author argues that the potential for this happening is much greater in The Netherlands than in Oregon.

Empirical Research↗

PubMed1999

[Increase of reported HIV-1 infections in children in Netherlands, 1982-1997: more vertical transmission and a greater proportion of other than Dutch children].

OBJECTIVE: To document the trend of the yearly number of newly diagnosed paediatric HIV-1 infections in the Netherlands. DESIGN: Retrospective registration regarding the period January 1st 1982-December 31st 1994 and prospective registration regarding January 1st 1995-December 31st 1997. METHOD: Based on reports to the Dutch Paediatric Surveillance Unit (Nederlands Signaleringscentrum Kindergeneeskunde) numbers of paediatric HIV-1 diagnoses (0-18 years) in the Netherlands were determined prospectively. Retrospective figures were determined by asking the paediatricians also to report the HIV-1 infected children diagnosed before the first of January 1995. A comparison was made with data from the Inspectorate for Health Care (Inspectie voor de Gezondheidszorg). All reports were followed up with standard questionnaires. RESULTS: In both periods an increase in the number of newly diagnosed paediatric HIV-1 infections per year in the Netherlands was seen (1982-1994: 74 children; 1995-1997: 43 children). The majority of the parents of the HIV-1 infected children originated from outside the Netherlands (1982-1994: 57%; 1995-1997: 91%), often from HIV-endemic countries (1982-1994: 41%; 1995-1997: 77%). The main mode of infection was vertical transmission (1982-1994: 62%; 1995-1997: 84%); diagnosis in allochtonous children was made relatively late. CONCLUSION: The current rise in the absolute number of newly detected paediatric HIV-1 infections in the Netherlands is predominantly due to the growing group of children born to parents who originate from HIV-endemic countries.

Africa↗

PubMed2000

[Incidence of herpes neonatorum in Netherlands].

OBJECTIVE: Investigation of the incidence of neonatal herpes in the Netherlands between 1992 and 1998. DESIGN: Inventory questionnaire survey. METHODS: All virological laboratories in the Netherlands were sent a questionnaire on the number of culture proven cases of neonatal herpes recorded between 1992 and 1998 and on the type of herpes simplex virus (HSV-1 or HSV-2). The gynaecological and paediatric departments of all university hospitals and of half of the general hospitals were sent questionnaires as well. Gynaecologists were asked how often caesarean section was performed in order to prevent neonatal herpes and how frequently pregnant women were seen with genital herpes. Paediatricians were asked how often they observed neonatal herpes, the type of HSV and the possible transmission route. Based on these data the figures for the whole of the Netherlands were estimated. RESULTS: The incidence of neonatal herpes in the Netherlands in the period 1992 to 1998 was 2.4 per 100,000 neonates. HSV-1 was the cause of neonatal herpes in 73%, HSV-2 in 9%, and in 18% of the cases the type of infection was not recorded. The number of pregnant women with genital herpes had increased, but, in agreement with a consensus statement, the gynaecologists hardly performed caesarean sections any more to prevent neonatal herpes (2 per year). CONCLUSIONS: The incidence of neonatal herpes in the Netherlands had not increased. There was no predominant role of HSV type 2 causing neonatal herpes.

Adult↗

PubMed1993

[Turkish and Moroccan migrants in the Netherlands. Some background information].

During the years 1960-1970 a large number of foreign workers from mainly Turkey and Morocco came to the Netherlands. Most of the men came from rural areas and were poorly educated. In the seventies wives and children came to join their husbands and fathers. A lot of ths 'first generation' of men and women are now unemployed. Bad health makes it impossible for them to work. Their children and grandchildren are growing up in the Netherlands and quite a number of them are not benefitting fully from education and as a consequence do not have good opportunities in the job market. The legal circumstances for foreigners are very complicated. The many changes in their legal status create a feeling of continuous insecurity about their residence here. Most of the migrants have a low social-economic status and as such are at risk with their health. The older migrants mainly wish to return to their own country, but feel that they are obliged to stay with their children in the Netherlands. Most of the migrants came to the Netherlands in order to work, earn what is to them a substantial income, return home with their savings and start a business or settle in their own country. Their current situation in the Netherlands makes it very difficult for them to attain this ideal.

Emigration and Immigration↗

PubMed2002

[Epidemiological characteristics of reported HIV-1 infection in children in the Netherlands, 1998-2000: vertical transmission via parents from countries with a generalised epidemic].

OBJECTIVE: To document the course and characteristics of the annual new diagnoses of HIV-1 infection in children in the Netherlands. DESIGN: Prospective registration from January 1, 1998 till December 31, 2000. METHODS: Dutch paediatricians reported HIV-positive children to the Dutch Paediatric Surveillance Unit on a monthly basis. All reports were followed up with standard questionnaires. RESULTS: During the period 1998-2000, 42 children were diagnosed with HIV-1 infection. This number was almost equal to the number of HIV-1 infected children diagnosed during the period 1995-1997 (n = 43). In 86% of the children one or both parents originated from a country with a generalised HIV epidemic. In the case of two children (5%), both parents were of Dutch origin. Most children (81%) were infected by mother-to-child transmission. Of these children, 48% (n = 20) were born in the Netherlands. Forty percent of the children born in the Netherlands and infected through vertical transmission lived in one of the four big cities of the Netherlands (Amsterdam, Rotterdam, The Hague and Utrecht). The remaining 60% were distributed across almost all the Dutch provinces. CONCLUSIONS: The increase in the number of newly-infected children in 1995-1997 appears to have reached a plateau in 1998-2000, possibly as a result of a more active detection and treatment policy amongst pregnant women in at-risk groups. However, the 20 newly infected children born in the Netherlands indicate that this policy aimed at preventing vertical transmission is not yet being fully implemented.

Child↗

PubMedDate not supplied

Health strategy on HCV in The Netherlands.

The current basis for the health care policy on hepatitis C in The Netherlands is an advisory report of the national Health Council, published in 1997. The Council confirmed that: Chronic hepatitis C (HC) is to be considered as a serious disease; the hepatitis C virus (HCV) can be detected easily and accurately; transmission of HCV occurs mainly via blood; the prevalence of HC is low in The Netherlands and comparable to or somewhat lower than other countries in Northern Europe; treatment is possible and worthwhile; patients have the right to be provided spontaneously with relevant information; the general population lacks adequate knowledge about the essentials of HCV infection, preventing them from taking adequate measures for their own health. The Council recommended that: general tracing and testing of all people who received blood products in the past would be inefficient; hospitals should keep precise records of the origin and use of blood products; as practically all active drug users in The Netherlands are involved in medical care in connection with their addiction, they will be tested for HCV and qualify for treatment of HC; information should be provided to the general population; medical doctors are stimulated to participate in training courses on HC; medical and non-medical professionals involved in increased risk of HCV transmission must be informed on hygiene. Epidemiological research of HCV infection in the various population groups of The Netherlands is stimulated. Currently, an active approach to the health care policy on hepatitis C is supported by the Ministry of Health, Welfare and Sport, including awareness programs in risk groups and training courses for professionals. Such programs are typically aiming at supporting and stimulating the own initiatives in the society, based on responsibilities of professional and patient's organisations and individuals at risk. Treatment of HC, given in accordance with the current consensus, including long term combination therapy with interferon and ribavirin, is available and refundable for all Dutch citizens. A special program for HC screening and treatment of drug addicts is being started up, using the special infrastructure for drug user control programs in The Netherlands.

Female↗

PubMed2002

[Financing medical research in the Netherlands: start taking care of the future now].

Less money is spent on medical research in the Netherlands than in other industrialised countries, even though Dutch science, and certainly Dutch medical science, scores qualitatively among the best in the world. Part of the explanation is that a relatively large part of scientific research in the Netherlands is financed directly by the government. As a result of several rounds of cutbacks in government spending, that were executed each time by cutting research that performed less well, the remaining research groups are at high qualitative level and highly competitive. In countries that surpass the Netherlands, there is an important second stream of government funding via Medical and Health Research Councils. In the same countries, the pharmaceutical industry also provides more money for medical research. The other side of the coin is that medical research in those countries seems more or less 'for sale'. Too heavy dependence on market oriented research leads to doubts regarding the independence of medical research. International observers judged that the direct financing of research by government in the Netherlands was an enormous bonus since it leads to flexibility to start new topics and at the same time stability of positions. However, a major concern for Dutch science is that there are too few possibilities to attract and hold promising young people. It is especially difficult to keep promising young women; though this is true for all industrialised countries, the Netherlands lags behind its major competitors as far as the position of women in the higher ranks of science is concerned. These problems will have to be solved by stimulation programmes for young researchers and flexibility of the higher echelons. The educational system must not be directed only at the production of more doctors for medical practice, but also at sufficient scientific training for these doctors so that they will be able to comprehend new developments. The ordinary daily practice of medical science is to verify the usefulness of new developments--which is just as important as breakthroughs at the top. This means that there should be new investments, not only for top ranking scientists in fashionable areas, but also to maintain sufficient numbers of medical scientists at all levels. It cannot be foreseen where the next new developments will arise, and even in a small country, active research should be ongoing in many areas to maintain contact with the international research community. New investments should primarily be in direct government financing and in augmentation of streams of money via Medical and Health Research Councils.

Education, Medical↗

PubMed2005

[Mortality among non-western migrants in The Netherlands].

Mortality among 10 groups of non-western migrants to The Netherlands, observed in the period 1995-2000, is compared with mortality among people who were born in and whose parents were born in The Netherlands. The migrant groups concerned consisted of people who were born in, or whose parents were born in Turkey, Morocco, Surinam, The Netherlands Antilles, Ghana, Somalia, Iraq, Iran, Afghanistan and Vietnam. Differences in mortality were adjusted for age, marital status, region, degree of urbanization, and socioeconomic status. Despite the fact that most migrants originate from countries with a substantially higher mortality rate than The Netherlands, most groups had similar or more favourable total mortality rates than native Dutch people. Men from Turkey and Surinam had slightly elevated mortality rates and men and women from Somalia had a notably higher mortality rate than native Dutch people. The generally favourable mortality rates among migrants are the result of two compensating phenomena: higher mortality among young migrants than among young native Dutch people, and lower mortality among elderly migrants than among elderly native Dutch people. An analysis of cause-of-death patterns revealed relatively low mortality from cardiovascular diseases, cancer and respiratory diseases in most migrant groups, and relatively high mortality from infectious diseases and injuries. These findings are unlikely to have been influenced by incomplete registration of mortality. Selective migration may play a role--some migrant groups have a relatively high level of education for example. Also some of the findings may be explained by a difference in timing between the health benefits and the health risks of migration. Migrant health could be benefiting from the favourable socioeconomic, public health and health-care conditions in The Netherlands, but not yet be affected by the higher risks of cancer and cardiovascular disease associated with prosperity.

Adolescent↗

PubMed2006

[Perinatal mortality in the Netherlands: everyone's problem and yet no one's problem].

In 1986, this journal published a paper showing that the rate of decline of perinatal mortality in the Netherlands was lower than in several other European countries. As a result, the Netherlands had lost its position as a country with one of the lowest perinatal mortality rates in the world. Since then, relatively little has happened to redress the situation, despite the fact that several studies have shown that the higher perinatal mortality rates are not due to registration artefacts, and that the quality of perinatal care in the Netherlands is lower than that in countries with lower perinatal mortality rates. In a recent analysis by the Rijksinstituut voor Volksgezondheid en Milieu (State Institute for Public Health and the Environment) it was estimated that between 20 and 25% of the difference between the perinatal mortality rates of the Netherlands and those of Sweden and Finland is due to the higher frequency in the Netherlands of five factors: multiple pregnancies (probably as a result of in-vitro fertilisation), smoking during pregnancy, pregnancies among non-western immigrants, no screening for congenital disorders, and (other) 'substandard' factors in perinatal care. Unfortunately, there are still no signs of a determined policy response. It seems that twenty years of working on the basis of the voluntary participation of many different organisations, and without clear leadership, have not produced the gain in perinatal mortality that would theoretically have been possible.

Emigration and Immigration↗