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A mathematical model structure is described that can be used to simulate the changes of the Dutch public health state over time. The model is based on the concept of demographic and epidemiologic processes (events) and is mathematically based on the lifetable method. The population is divided over several states, risk factor classes and disease stadia. State transitions over time are possible due to birth, aging, migration, mortality, transitions between risk factor classes, disease incidence, progression and remission. The main model parameters are initial population numbers, initial risk factor class and disease stadium prevalence rates, one-year transition rates between the risk factor classes and disease stadia, and risk factor-cause-specific relative risks. The model is used to describe the public health effects of possible intervention programs. These effects can be defined in terms of classic epidemiologic morbidity and mortality figures, but also in terms of life and health expectancy. Several examples of model applications are described: comparing trend extrapolations and model predictions on cause-specific mortality, and comparing the effects of different intervention programs on population smoking and physical activity levels. |
