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The European Journal of Public Health 2003 13(3):226-229; doi:10.1093/eurpub/13.3.226
© 2003 by European Journal of Public Health
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Health Patterns and Determinants

High coronary heart disease rates among Dutch women of the baby boom, born 1945–1959

Age-cohort analysis and projection

L. Bonneux1,* and C.W.N. Looman1

1 Department of Public Health, Erasmus University Rotterdam, the Netherlands

Background: After a steep decline in older generations, coronary heart disease mortality is stagnating in female cohorts born after the Second World War. We analysed past trends and predicted future health care needs for coronary heart disease in the Dutch population. Methods: A loglinear age-cohort model relates numbers of deaths and hospital admissions for coronary heart disease to sex, age, birth cohort and population size, and projects age-cohort changes over the future population. Population size, population forecasts and coronary heart disease mortality (period 1970–1999) are from vital statistics. Numbers of hospitalised acute coronary events are from the nationwide hospital register (period 1980–1999). Results: Among men, the rate ratios of deaths and hospital admissions were, respectively, 0.21 (death) and 0.78 (survivors at discharge) in the cohorts born in the period 1948–1962 compared to the period 1918–1922. Among women, the same rate ratios were 0.41 and 1.89. The projection model predicts 22% less deaths from coronary heart disease and 22% more survivors of an infarction in 2015, among men. Among women, there will be 5% less deaths and 70% more survivors of an infarction, most of these being middle age members of the baby boom cohorts. Conclusions: Stagnating all-cause mortality is correlated with an upward trend in coronary heart disease risk in the female baby boomers. Heart health care needs among middle-aged women will increase sharply. These changes are correlated to high lung cancer mortality and high smoking rates in these cohorts.

Keywords: baby boom cohorts, coronary heart disease, lung cancer, smoking, women


Received 13 December 2001. Accepted 22 May 2002.

* Correspondence: Luc Bonneux, Department of Public Health, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands, tel. +31 10 408 7714, fax +31 10 408 9449, e-mail: l.bonneux{at}jc.azu.nl


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