Wednesday, February 17, 2016

Tuberculosis Mortality and Living Conditions in Bern, Switzerland, 1856-1950

Tuberculosis (TB) is a poverty-related disease that is associated with poor living conditions. We studied TB mortality and living conditions in Bern between 1856 and 1950.

We analysed cause-specific mortality based on mortality registers certified by autopsies, and public health reports 1856 to 1950 from the city council of Bern.

TB mortality was higher in the Black Quarter (550 per 100,000) and in the city centre (327 per 100,000), compared to the outskirts (209 per 100,000 in 1911–1915). TB mortality correlated positively with the number of persons per room (r = 0.69, p = 0.026), the percentage of rooms without sunlight (r = 0.72, p = 0.020), and negatively with the number of windows per apartment (r = -0.79, p = 0.007). TB mortality decreased 10-fold from 330 per 100,000 in 1856 to 33 per 100,000 in 1950, as housing conditions improved, indoor crowding decreased, and open-air schools, sanatoria, systematic tuberculin skin testing of school children and chest radiography screening were introduced.

Improved living conditions and public health measures may have contributed to the massive decline of the TB epidemic in the city of Bern even before effective antibiotic treatment became finally available in the 1950s.

Below:  Changes in the mortality due to injuries (including homicide), communicable (infectious diseases and infant death) and non-communicable diseases (including cancer) in the capital city of Bern, Switzerland, between 1856 and 1950

Below:  Trends in TB mortality in the city of Bern, Switzerland, between1856 to 1950, in relation to important events for TB control

Full article at:

Kathrin Zürcher, Marie Ballif, Marcel Zwahlen, Matthias Egger, Lukas Fenner
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

Marie Ballif, Lukas Fenner
Swiss Tropical and Public Health Institute, Basel, Switzerland

Marie Ballif, Lukas Fenner
University of Basel, Basel, Switzerland

Hans L. Rieder
Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland

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