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

Abstract

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