LAUSR

Aims: Since the scientific revolution of the 18th century, human health has gradually improved, but there is no unifying theory that explains this improvement in health. Studies of macrodeterminants have produced conflicting results. Most studies have analysed health at a given point in time as the outcome; however, the rate of improvement in health might be a more appropriate outcome. Methods: Twenty-eight OECD member countries were selected for analysis in the period 1990–2010. The main outcomes studied, in six age groups, were the national rates of decrease in mortality in the period 1990–2010. The effects of seven potential determinants on the rates of decrease in mortality were analysed in linear multiple regression models using least squares, controlling for country-specific history constants, which represent the mortality rate in 1990. Results: The multiple regression analyses started with models that only included mortality rates in 1990 as determinants. These models explained 87% of the intercountry variation in the children aged 1–4 years and 51% in adults aged 55–74 years. When added to the regression equations, the seven determinants did not seem to significantly increase the explanatory power of the equations. Conclusions : The analyses indicated a decrease in mortality in all nations and in all age groups. The development of mortality rates in the different nations demonstrated significant catch-up effects. Therefore an important objective of the national public health sector seems to be to reduce the delay between international research findings and the universal implementation of relevant innovations.