When a death certificate contains more than one death cause (around 80 percent of the forms), one of these is listed as the underlying cause of death. ICD-10 defines an underlying cause of death as: (a) the disease or disorder that initiates the causal chain of diseases or disorders leading directly to death (natural death); (b) the circumstances of the accident or violence causing the injury that initiated the causal chain of morbid events leading directly to death (non-natural death). If for example the death certificate lists dementia as cause of pneumonia, then dementia is identified as underlying cause of death and included in the statistics. In another example, when a fall is indicated as cause of a hip fracture, then the fall is identified as underlying cause of death and included in the statistics. Statistics on death causes are a form of tabulation for underlying causes of death. For an overview of developments in causes of deaths the ICD-10 blocks such as cancer or cardiovascular diseases offer general reference (in Statistics Netherlands quarterly figures). In addition, publications on specific causes of death such as lung cancer, heart infarcts or dementia (CBS StatLine: BELDO or extensive list) offer a detailed account of mortality in the Netherlands to serve as reference for relevant research and policymaking.
Conversion of figures from one year into another (standard) year based on age or gender. In the first graph of this news release, mortality rates for the acute heart infarct from 1970-2013 were converted year by year, giving each year in the series the (virtual) figure as though that year would have had the same age composition as in 2014. By applying standardisation, differences in age composition of the population over time are accounted for, and figures can be compared more easily, also making real in- or decrease noticeable. For this article the age composition of the population in 2014 is used as the standard.