Mean life expectancy at birth (1967-1992) increased for both sexes com
bined with 5.6 years in Belgium and 3.6 years in The Netherlands. Age
adjusted mortality from all causes and cardiovascular diseases has bee
n followed up from 1968 onwards to 1989 in Belgium and The Netherlands
and in Flanders and Wallonia from 1971 to 1989 for each sex and two a
ge classes, 45-74 y and 75-85+ y. Flanders and Wallonia were selected
because of differences in mortality and life-style. Total mortality de
creased faster in Belgium especially in the period 1980-89, for almost
all comparisons in each sex and age class and for most cardiovascular
diseases. A comparison of mortality trends in the period 1980-89 amon
g 35 countries worldwide showed a better performance in Belgium than i
n The Netherlands for 10 different causes of death. The mortality gap
between both countries is closing, especially between The Netherlands
and Flanders. The decreasing slope in mortality from all causes is exp
lained mostly by the change in cardiovascular mortality. Medical treat
ment and care, which are nor better in Belgium, do not explain the dif
ferences in mortality trends Observed changes in life-style, including
saturated and polyunsaturated fat intake, smoking habits and salt int
ake are consistent with the observed mortality changes.