[Reduction of the drowning risk for young children, but increased risk for children of recently immigrated non-Westerners]

OBJECTIVE

To describe differences in the risk of drowning of young children (under 10 years) in the Netherlands according to ethnicity and relevant trends since 996.

DESIGN

Retrospective.

METHOD

We analysed the causes of death data for all 266 children aged 0 to 10 years who died of drowning between 1996 and 2005. Information for the cause of death was obtained from the cause of death data of Statistics Netherlands. Data about the size and composition of the population at risk (age, sex and ethnicity) were obtained from the municipal population registers.

RESULTS

Young children's risk of drowning has decreased by about one-third since 1996. This decrease took place among native Dutch children and children of the major ethnic groups, notably Turkish, Moroccan and Surinamese. However for children of recently immigrated parents of non-Western ethnicity, mainly asylum seekers, the risk of drowning was 4 to 8 times higher than that of native children aged 3 to 10 years.

CONCLUSION

Timely health education directed at newly arrived families with children could be an important measure to help them cope with the hazards of living in a water-rich environment such as the Netherlands. The education should point out the necessity of increased supervision of the youngest children and improved swimming skills for the slightly older ones.

[Suicide among Surinamese migrants in the Netherlands by ethnicity]

BACKGROUND

Research into attempted suicide among Surinamese migrants in the Netherlands has revealed a high incidence of suicidal behaviour among young Hindustani women. Due to a lack of data on the ethnicity of Surinamese migrants residing in the Netherlands, there has not yet been any quantitative study of the relationship between ethnicity and suicide.

AIM

To measure the differences between the rates of suicide mortality in the group of Surinamese migrants in the Netherlands and the corresponding rates in the native Dutch population, taking into account ethnicity, age and gender.

METHOD

The study is based on all the cases of suicide among the Surinamese migrants resident in the Netherlands between 1996 and 2005. Ethnicity was inferred from residents' surnames. To determine the size of the groups at risk, a sample of Surinamese migrants resident in the Netherlands was taken.

RESULTS

Suicide rates within the group of Surinamese migrants are particularly high among Hindustani men and young Creole men and are considerably higher than among native Dutch men. Suicide rates for Surinamese women are considerably lower than for Surinamese men and in most cases do not differ significantly from the suicide rates for native Dutch women.

CONCLUSION

The incidence of suicide is particularly high among Surinamese men in the Netherlands. The high incidence is not restricted to Hindustani men.

[Suicide among migrant populations and native Dutch in The Netherlands]

OBJECTIVE

To determine the differences in suicide mortality between native Dutch and migrant groups in the Netherlands from different countries and regions of origin, taking the differences in age structure into account.

DESIGN

Retrospective.

METHODS

Data from the statistics on causes of death from the Dutch Central Bureau of Statistics, Statistics Netherlands (CBS), based on the causes of death given in the certificates from the doctor or forensic pathologist, were coupled to the reports of death from the Municipal Population Registration (GBA). In this way, the country of origin of the deceased could be determined. The confidentiality of these data is regulated by law. For the period 1996-2004, all 13,737 persons were selected who had committed suicide (International classification of diseases (ICD)-10-codes X60-X84). The country of origin was determined on the basis of data on the country of birth of the deceased and his or her parents. Someone is a 'migrant' ('foreign') according to the definition of the CBS if at least one of the parents was born outside the Netherlands.

RESULTS

There were substantial differences in suicide mortality between migrant groups in the Netherlands. These differences reflected, to some extent, suicide mortality patterns in the countries and regions of origin. On the whole, migrants originating from western countries showed suicide mortality rates that were well above the average rate for native Dutch. High suicide rates were seen in male migrants from southern and eastern Europe. On the other hand, suicide mortality was significantly lower among Turks and Moroccans than among native Dutch. Only young adult males of non-western origin, with the exception of Moroccans, were much more likely to commit suicide than native Dutch.

CONCLUSION

Although much attention has recently been paid to the elevated rates of attempted suicide among young women from Surinam, their suicide mortality was increased less than that of men from Surinam up to middle age. These increased suicide rates may reflect high levels of mental illness, identity problems, disappointments related to the process of migration, high expectations with respect to education, work and income, and the responsibilities for a family.

[Background on recent trends in mortality in the Netherlands]

In the Netherlands, a considerable reduction in the annual number of deaths occurred in 2004. This reduction was largely caused by a decrease in the number of deaths from cardiovascular disease. - The risk of dying from cardiovascular disease has decreased in an almost linear manner during the past few decades. This reduction, which was well above average in the case of ischaemic heart disease, was registered for both sexes and across all age groups. The risk reduction in men aged 30-59 years was particularly large. - The contribution of neoplasms to total mortality continues to increase. However, the risk of dying from certain forms of cancer (lung for men, colon for women, stomach, gall-bladder, breast, prostate, uterus and ovaries) has been decreasing since the 1990s. - The risk of dying from breast cancer has decreased since the end of the 1990s. If present trends continue, Dutch women will be more likely to die from lung cancer than breast cancer from 2007 onwards. - The remarkably low mortality in 2004 may be attributed to the equable climatic conditions and the absence of an influenza epidemic. The drop in mortality was short-lived: in the first quarter of 2005, influenza caused a very strong increase in mortality among those aged over 80 years. - Even a further substantial reduction in mortality risks will not be able to prevent the predicted increase in the annual number of deaths in the Netherlands. This increase is estimated to end by the middle of this century.

[Epidemiology of 25 years of crib death (sudden infant death syndrome) in the Netherlands; incidence of crib death and prevalence of risk factors in 1980-2004]

OBJECTIVE

To describe the prevalence of risk factors and the incidence of cot death (sudden infant death syndrome; SIDS) in the Netherlands during the last 25 years.

DESIGN

Descriptive.

METHOD

The incidence of cot death/SIDS in infants aged 7-365 days in 1980-2004 was derived from Statistics Netherlands, the Dutch Central Bureau of Statistics. The prevalence of risk factors for cot death/SIDS in the general population was derived from national surveys of baby clinics (0-9 months; 1985-2004) and studies of cot death/SIDS victims (0-23 months; 1984-1991 and 1996/'04).

RESULTS

The prevalence of the following risk factors for cot death/SIDS has decreased: primary prone sleeping position (from 60% to 8%), the use of a duvet (from 85% to 18%), maternal smoking (from 34% to 20%), paternal smoking (from 48% to 32%). The prevalence of routine bed-sharing with a parent increased from nearly 0% to 5%. The registered incidence of cot death/SIDS per 100,000 live births decreased from 103 in 1986 to < 15 in 2003 and 2004. The incidence of cot deaths/SIDS that occurred during habitual bed-sharing with a parent, in a playpen, in child-care settings, or in a secondary prone sleeping position increased.

CONCLUSION

The incidence of cot death/SIDS and the prevalence of known risk factors for cot death/SIDS has decreased. New risk factors have emerged in recent years. Considering the evolving conditions of infant care, an ongoing study on the special features of child care and the factors involved in cases of cot death/SIDS is warranted. This knowledge is essential for periodic adaptation of the national prevention programme.

Sleeping position for infants and cot death in The Netherlands 1985-91

Until the early 1970s the traditional sleeping position for Dutch infants was not prone. After a much publicised lecture in October 1987 on the possible relation between sleeping prone and cot death, the fairly new habit of placing infants prone is being replaced by more traditional positions. The decrease in the prevalence of the prone sleeping position has been documented in six studies. Since 1987 the incidence of registered cot deaths has decreased from 1.04/1000 live births in 1986 to 0.44 in 1991; the real decrease of sudden unexpected death in infancy, however, is greater.