Résumé :
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[BDSP. Notice produite par INIST-CNRS 5zR0xg08. Diffusion soumise à autorisation]. The objective of this study was to determine the relative importance of cultural and economic factors in mortality decline in the Netherlands in the periods 1875/1879 1895/1899 and 1895/1899 1920/1924, Mortality data by region, age, sex and cause of death as well as population data were derived from Statistics Netherlands for the years 1875/1879,1885/1889,1895/1899,1910/1914,1920/1924. Regional mortality declines were estimated on the basis of Poisson regression models. In a multivariate analysis the estimated declines were associated with economic (wealth tax) and cultural variables (% Roman Catholics and secularisation) corrected for confounders (soiltype, urbanisation). In the period from 1875/1879-1895/1899,% Roman Catholics was significantly associated with all-cause mortality decline and with mortality decline from diseases other than infectious diseases. Mortality declined less rapidly in areas with a high percentage of Roman Catholics. Secularisation was significantly associated with infectious-disease mortality decline. In areas with a high percentage population without a religious affiliation, mortality declined more rapidly. In the period from 1895/1899 to 1920/1924, wealth tax was significantly associated with all-cause and infectious-disease mortality decline. Mortality declined more rapidly in wealthy areas, Intermediary factors in the relationship between cultural factors and mortality decline were fertility decline, but more importantly, the number of medical doctors per 100,000 inhabitants. No intermediary factors were found for the association between the economic variable and mortality decline. Cultural and economic factors both played an important role in mortality decline in The Netherlands, albeit in different periods of time. (...)
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