The Belgian Health Transition and the Dialectics of Progress

For a long time the basic assumption has linked the change in life expectancy between the Flemish and French talking regions in Belgium to the uneven economic development between the regions and to the evolution in relative wealth and socio-economic composition of the population. There is no doubt of the importance of socio-economic factors on population health and mortality, but the pure association over time does not explain the particular mechanisms at work. Moreover, when analysing the shift in age specific mortality between the regions, the age pattern tells another story, not exactly in sync with the shift in socio-economic wealth between north and south. Using historical mortality data and recent individual cause specific mortality data, we try to explore more in depth the factors that caused this inversion in life expectancy and that are still contributing to the enduring lower life expectancy in the Walloon region compared to the Flemish region. The insights based on the detailed analysis of this process illustrates the Belgian case and add insight in the complexity of the general process of the health transition.