The common occurrence of chronic diseases – such as ischemic heart diseases (IHD, stroke, and stomach cancer in most populations and the attendant mortality, loss of independence, impaired quality of life, and social and economic costs are compelling reasons for public health concern. Although mortality from IHD , stroke , and stomach cancer have fallen substantially in western Europe over recent decades, IHD and stroke remain among the leading causes of death in Europe. Furthermore, elderly people constitute a growing part of the population and therefore, the absolute number of deaths might continue to increase due to ageing of European population. Together, IHD, stroke and stomach cancer, have figured prominently in the large shifts among causes of death, especially in industrial societies, during the 20th century. During this period, the mortality and morbidity rates of these diseases has changed rapidly in many countries, as a result of both increasing proportions of these populations attaining older ages and concurrent social changes. The epidemiology and prevention of these diseases involve the understanding of their causes, identification of means of prevention, and monitoring of populations to assess the changing burden of these diseases and measurable impact of interventions to control them. This thesis monitors seven European populations – i.e., Denmark, England and Wales, Finland, France, the Netherlands, Norway and Sweden. It assesses the changing impact of the above mentioned diseases over time by extrapolation of observed trends in the past. It projects the future profile of these diseases in seven European countries.

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G.J. Bonsel (Gouke)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam