Secular Trends in Tuberculosis during the Second Epidemiological Transition: A Swiss Perspective

摘要

The second epidemiologic transition is defined as “the age of receding pandemics”, wherein mortality declines, life expectancy increases, and population growth occurs. The major causes of death also shifted from predominantly acute infectious diseases to degenerative and “man-made” diseases (Omran, 1983). The aim of this study was to determine the timing of the transition in Zürich (Switzerland) and to investigate patterns of tuberculosis mortality during this period. This is one of the first studies to specifically investigate the timing of the second transition in Zürich, Switzerland. The data sources for this study were Swiss records of mortality from the Staatsarchiv (Canton Archives), Stadtarchiv (City Archives) and a published volume of State Statistics (Historische Statistik der Schweiz). The changes in mortality through time were addressed for all causes of death in the city ofZürichfor the years 1893 to 1933 that is, the time including the second epidemiological transition. After 1933 the structure of the mortality data collection changed as the responsibility was transferred away from the canton archives. Mortality from tuberculosis was then examined in greater detail and compared with changes in living standards as well as population density occurring at the time.