AbstractBackground Mortality burden declined markedly in the late 19th and early 20th century. We investigated patterns in disease burden of measles, pertussis, and diarrheal diseases in Amsterdam. Methods We utilized the Amsterdam Cause-of-death Database, including 481,990 individual death records from 1856 to 1920, and estimated mortality burden for measles, pertussis, and diarrheal disease in years-of-life-lost up to 20 years. We analyzed mortality trends and associations with socio-economic and demographic factors, including population size, school enrollment, and rye prices, using fractional multinomial logistic regressions. Results All-cause mortality burden declined from almost 8 life years lost per birth in 1856 to slightly over 2 in 1920. The mortality burden for measles and pertussis was relatively stable but mean age at death declined over time. The burden for diarrheal disease declined rapidly after 1885. The most promising factors to explain the changing epidemiology were the water crisis of 1887-1900, increasing diarrheal mortality burden by 3% (95% CI: 1.5—4.4%), and rye prices, increasing measles mortality burden by 0.7% (95% CI: 0.04 – 1.4%). Conclusions These findings highlight the complexity of the epidemiological transition, and the importance of socio-economic and demographic changes in understanding the historical patterns of infectious diseases.
Buzási et al. (Sun,) studied this question.