The focus of this theme is on health systems with an emphasis on the performance of these systems and an analysis of risk factors and interventions on health and healthcare costs. As financial transactions are a major component of the functioning of health systems, it is important to analyse financial flows. NIDI has charted global resource flows for population activities since 1997 in the context of reviewing progress towards the achievement of goals set at the International Conference on Population and Development (ICPD, Cairo 1994) and its follow-up. The resource flows relate to spending on four areas of population activities in developing countries and countries in transition: family planning, reproductive health, sexually transmitted diseases (including HIV/AIDS), and population policy and the collection and analysis of demographic data.
Both the ageing of the population and changes in the health status of the elderly will determine future changes in the need of care. To forecast long-term care needs of the elderly the ANCIEN project develops a multi-state modes describing the severity of care dependence, depending on risk factors, such as smoking and obesity. Another project analyses the influence of life course factors on health and mortality by making use of historical cohorts. Historical datasets covering a long time period have advantages compared with prospective birth cohort studies and retrospective studies. An international comparative research project funded by the US National Institute of Health aims to link the common historical approach to flourishing research in epidemiology. This has been done by using historical data for cohorts born between 1850 and 1922 to study the effect of circumstances in early childhood and adolescence on survival in adulthood and old age and by linking micro-level survival data to macro-level social and economic conditions. The research draws on both NIDI data and data provided by the Historical Sample of the Dutch Population (HSN).