Reclassifying causes of death to study the epidemiological transition in The Netherlands, 1875–1992

This article describes a method for reclassifying causes of death in the Netherlands for the period 1875–1992. Two criteria should be met to obtain a useful classification to study the epidemiological transition. First, the categories should be nosologically continuous over the period under study and second, there should be enough detail in causes which are important in the context of the epidemiological transition viz. communicable diseases, non-communicable diseases and external causes of death. A method developed by Vallin and Meslé (1988), which involves ‘dual correspondence tables’ and ‘fundamental associations’, was used to create nosologically continuous categories. These categories were tested for statistical continuity during the transition years of one ICD-revision to the next, using ordinary least squares regression analysis. The reclassification procedure resulted in a nested classification consisting of three levels of refinement of causes of death: 27 causes, 1875–1992; 65 causes, 1901–1992; and 92 causes, 1931–1992. On the basis of this classification, 43% of all deaths in 1875–79 and 98% of all deaths in 1992 could be allocated to either communicable diseases, non-communicable diseases or external causes.