The use of referendums has gained popularity among both voters and parties. Yet, despite the diffusion of such direct forms of democracy during the last decades in Europe, referendums remain not a very common policy instrument in Benelux countries (Belgium, the Netherlands and Luxembourg). We establish that this trend could be explained by a large consensus among mainstream (especially right) parties and voters against the use of direct democracy. Moreover, we confirmed the well-established demarcation with radical ideologies, which convey overall more support and congruence on the use of referendums than the mainstream. Additionally, and probably reflecting this new line of cleavage, we show that support for referendums among the voters relate to left-wing economic position, but also with culturally right-wing view. Overall, this article questions the relevance of the traditional left-right divide to explain support for direct democracy, as well as the capacity for (some) parties to align with their voters in terms of democratic demands.
The history of women and their experiences of Reformation in the sixteenth-century Low Countries remains largely unexplored territory, especially compared to the rest of Europe and to the seventeenth century. Why this is the case is something of a puzzle, though it may have to do with available source material. Since the 1980s a handful of works have been published on the subject, mostly falling along confessional lines, with Anabaptist women receiving by far the most scholarly attention. Reformed and Catholic women have received comparatively less attention. This article surveys the current historiography on women’s experience of religious change in the Habsburg Low Countries and offers some suggestions for future research.
The importance of the role of women as artists has been recognised and rightly continues to be researched. However, although there are exceptions, the scholarship that has been produced over the past two decades does not sufficiently challenge patriarchal, male-centric art historical research, with its focus on the so-called ‘creative genius’. The result, whether intentional or not, has been a continued emphasis on so-called stars, exceptional women, and trailblazers. Promising scholarship has focused on the role of women as artisan-makers or considered the gender-specific circumstances in which women operated. This scholarship, while of critical importance, unwittingly validates the assumption that the creation and production of (fine) art in the long seventeenth century in the Low Countries was primarily a man’s affair, with women relegated to more peripheral roles. If we are to truly write an inclusive art history, however, we must be willing to re-examine, expand, and even re-define traditional concepts in art history as they relate to the creation and production of art, pursue interdisciplinarity, and adopt the tools at our disposal, notably technical and object-based art history and the digital humanities.
Perceptions of healthcare personnel and institutions substantially impact healthcare behaviors. In the US, minority experiences with racist events like the Tuskegee study, alongside everyday experiences of marginalization and discrimination, drive medical mistrust in populations that are already burdened with health inequalities. However, the concept of medical mistrust is rarely applied outside of industrialized contexts. Histories of colonialism, underfunded healthcare institutions, and the enormous cultural and ethnolinguistic diversity present in low- and middle-income countries (LMICs) make medical mistrust a likely contributor to health behavior in these contexts. In the era of COVID-19 and emergent malaria vaccines, there is an urgent need to mitigate factors leading to medical mistrust, which impedes interest in novel vaccines. Doing so requires substantial investment in research that examines the causes of medical mistrust across diverse communities, develops methodological tools that can effectively measure medical mistrust across diverse cultural and ethno-linguistic contexts, and applies this data to policy and public health messaging. This commentary highlights the role of medical mistrust in vaccination and argues for its utility in addressing vaccine decision-making in LMICs.
This article reviews what we know about plague and other epidemic diseases in the northern Low Countries before 1450 – the evidence, its limitations, and its implications. I make three observations. First, sources suggest that the Black Death was severe in central inland areas, although we lack conclusive evidence for its impact in the county of Holland. Second, the recurring epidemics occurring in the northern Low Countries were often severe – in certain localities reaching death rates of 20-25 percent. In this respect, Holland was as afflicted as other areas in the Low Countries. Third, while the outbreak of 1439 was a notable exception, most epidemics in the northern Low Countries rarely occurred during or just after grain price spikes, suggesting that food crises were not major drivers of epidemic disease in the period 1349-1450. I support further attempts to obtain empirical evidence for the mortality effects of epidemics in the medieval Low Countries. Ultimately, this information can be the foundation behind insights into other important long-term narratives in social, demographic, and economic history in the region.
In 2013, Maarten Prak and Jan Luiten Van Zanden published an all-encompassing synthesis on the economic history of the Netherlands following the “Polder-model-theory”, in itself a variant of the “Rhineland model”. In their opinion, relatively low levels of inequality, a consensus model, and a strong civil society were cornerstones that accounted for a different pathway to capitalism. This review engages hesitantly with this comparative perspective, especially in regard of the history of present-day Belgium.
Importance Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD. Objective To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries. Design, Setting, and Participants Cross-sectional analysis using pooled, individual participant data from nationally representative health surveys conducted between 2013 and 2020 in 51 low-, middle-, and high-income countries. Included surveys contained data on self-reported history of CVD and aspirin use. The sample of participants included nonpregnant adults aged 40 to 69 years. Exposures Countries' per capita income levels and world region; individuals' socioeconomic demographics. Main Outcomes and Measures Self-reported use of aspirin for secondary prevention of CVD. Results The overall pooled sample included 124 505 individuals. The median age was 52 (IQR, 45-59) years, and 50.5% (95% CI, 49.9%-51.1%) were women. A total of 10 589 individuals had a self-reported history of CVD (8.1% [95% CI, 7.6%-8.6%]). Among individuals with a history of CVD, aspirin use for secondary prevention in the overall pooled sample was 40.3% (95% CI, 37.6%-43.0%). By income group, estimates were 16.6% (95% CI, 12.4%-21.9%) in low-income countries, 24.5% (95% CI, 20.8%-28.6%) in lower-middle-income countries, 51.1% (95% CI, 48.2%-54.0%) in upper-middle-income countries, and 65.0% (95% CI, 59.1%-70.4%) in high-income countries. Conclusion and Relevance Worldwide, aspirin is underused in secondary prevention, particularly in low-income countries. National health policies and health systems must develop, implement, and evaluate strategies to promote aspirin therapy.
The history of the smaller European countries is rather neglected in the teaching of European history at university level. We are therefore pleased to announce the publication of the first comprehensive history of the Low Countries -- in English -- from Roman Times to the present. Remaining politically and culturally fragmented, with its inhabitants speaking Dutch, French, Frisian, and German, the Low Countries offer a fascinating picture of European history en miniature. Nevertheless, its parts demonstrate many common traits and similar developments that differentiated them from surrounding countries and lent them a distinct character. Internationally, the region often served both as a mediator for and a buffer to the surrounding great powers, France, Britain, and Germany; an important role still played today as Belgium and the Netherlands become increasingly involved in the broader process of European integration, in which they often share the same interest and follow parallel policies. This highly illustrated volume serves as an ideal introduction to the rich history of the Low Countries for students and the generally interested reader alike.
Background Policy makers intent on improving population mental health are required to make fundamental decisions on where to invest resources to achieve optimal outcomes. While research on the effectiveness and efficiency of interventions is critical to such choices, including clinical outcomes and return on investment, in the “real world” of policy making other concerns invariably also play a role. Politics, history, community awareness and demands for care, understanding of etiology, severity of condition and local circumstances are all critical. Policy makers should not merely rely on previous allocations, but need to take active decisions regarding the proportion of resources that should be allocated to particular interventions to achieve optimum outcomes. Given that scientific evidence is only one of the reasons informing such decisions, it is necessary to have clear and informed reasons for allocations and for making cases for new mental health investments. Main body Investment allocations are unlikely to ever be an exact science. Alternatives therefore need to be rationally weighed up and reasoned decisions made based on this. Using prevalence data and the distribution of mental health resources in South Africa as a backdrop and proxy, investment proposals are made for LMICs with due consideration given to inter alia the social determinants of mental health, the needs and potential benefits of investments in people with severe verses common mental disorder, mental health promotion and disease prevention and to other areas that may impact on population mental health, such as management. Conclusion Based on a range of arguments, it is proposed that mental health investments should follow the following approach. A mental health-in-all-policies method must be adopted. There should be no more than a 20% gap in the humane and human rights oriented care, treatment and rehabilitation of people with severe mental disorder. A minimum additional amount of 10% of the amount spent on severe mental disorder should be allocated to treating people with common mental disorder. Screening for mental disabilities should take place within all chronic care services. A minimum of 3% of the budget spent on severe mental disorder should be spent on promotion and prevention programmes. An additional 1% of the allocation for severe mental disorder should be provided for managing/driving the mental health programme.
ABSTRACT It is well known that after the fall of Constantinople, Greek refugees fled to Western Europe. This migration is usually associated with Italy, where it stimulated the further development of the Renaissance. It is sometimes overlooked that the Burgundian Low Countries also exerted a great attraction for the Greeks. The location of the region, its prosperity and the crusading ambitions of the Burgundian dukes may explain this. Unlike other parts of Europe, most refugees did not settle permanently. Despite an interest among a small circle of humanists in their language and culture, the wider population had mixed feelings about the Greeks. Initially they were well received, but after a while their credibility was questioned. Anti-Greek prejudices persisted, which resulted in imprisonment or even execution of some refugees. Using previously unexploited sources, this article provides new insights into the history of the refugees, their motivation and their reception.
The connection between warfare and an increased wolf presence or even wolf attacks is a recurrent theme in European narrative sources. Many historical studies have also commented on the widespread belief in this connection and suggested that armed conflicts instigated a breakdown of the standard wolf-human relationship. In peacetime, wolves generally avoided humans and remained outside human communities. This article argues that the close link between wolves and warfare in the history of the Low Countries is far more the result of a complex interplay between human perceptions of nature and the ecological impact of combat. Wolves could only profit from human conflict in very specific circumstances, yet these exceptions became part of a widespread narrative since the High Middle Ages, because they confirmed peoples’ association of wolves with wilderness. This narrative also explains why wolf hunting exhibited strong similarities to fighting human enemies. Het verband tussen oorlog en een toenemende aanwezigheid van wolven, of zelfs aanvallen van wolven, is een terugkerend thema in Europese literaire bronnen. Het is niet verwonderlijk dat ook veel geschiedwetenschappelijke studies wijzen op deze connectie en opperen dat gewapende conflicten de gebruikelijke relatie tussen wolf en mens verstoorden. In vredestijd vermeden wolven mensen over het algemeen en bleven ze ver van menselijke bewoning. Dit artikel beargumenteert echter dat de nauwe associatie tussen wolven en oorlogsvoering in de geschiedenis van de Lage Landen veeleer het resultaat is van een complexe wisselwerking tussen menselijke percepties van natuur en de ecologische impact van oorlog. Wolven konden slechts in bijzondere omstandigheden van oorlogsvoering profiteren, maar deze uitzonderingen werden niettemin onderdeel van een wijdverspreid literair topos vanaf de Hoge Middeleeuwen omdat ze de menselijke associatie van wolven met wildernis bevestigden. Dit topos verklaart ook waarom wolvenjacht grote gelijkenissen vertoonde met de strijd tegen menselijke vijanden.Actualiteitsparagraaf Angst voor de wolfWolven en gewapende conflicten in de Lage Landen, 1000-1800Na meer dan een eeuw afwezigheid heeft de wolf Nederland en België opnieuw veroverd. Dat gaat gepaard met heftige discussies tussen voor- en tegenstanders van de wolf, angst bij burgers die vrezen voor het lot van hun kinderen en bij boeren die bang zijn dat hun vee ten prooi valt aan de wolf. Dat is niets nieuws, in het verleden werden wolven ook gevreesd. Toen legden bewoners van wat we nu de Benelux noemen, sterk het verband tussen de komst van de wolf en oorlog. Sander Govaerts onderzoekt in zijn artikel dit verband tussen gewapende conflicten en een heropleving van wolf populaties. Hoewel wolven een groot aanpassingsvermogen hebben, zo blijkt uit het artikel, leidden oorlogen niet per definitie tot grote groei van het aantal wolven, zoals tijdgenoten wel vreesden. Het waren juist de uitzonderlijke keren dat dit wel het geval was die het algemeen aanvaarde stereotype van de bloeddorstige wolf bevestigden en versterkten. De nauwe associatie tussen wolven en oorlog wettigde echter wel het nemen van doorgedreven maatregelen om de soort uit te roeien.
Data from famines from the nineteenth century onward suggest that women hold a mortality advantage during times of acute malnutrition, while modern laboratory research suggests that women are more resilient to most pathogens causing epidemic diseases. There is, however, a paucity of sex‐disaggregated mortality data for the period prior to the Industrial Revolution to test this view across a broader span of history. We offer a newly compiled database of adult burial information for 293 rural localities and small towns in the seventeenth‐century Low Countries, explicitly comparing mortality crises against ‘normal’ years. In contrast to expected results, we find no clear female mortality advantage during mortality spikes and, more to the point, women tended to die more frequently than men when only taking into account those years with very severe raised mortality. Gender‐related differences in levels of protection, but also exposure to vectors and points of contagion, meant that some of these female advantages were ‘lost’ during food crises or epidemic disease outbreaks. Responses to mortality crises such as epidemics may shine new light on gender‐based inequalities perhaps hidden from view in ‘normal times’ – with relevance for recent work asserting ‘female agency’ in the early modern Low Countries context.
Abstract This article provides a comparative analysis of four large towns in the Southern Low Countries between c. 1350 and c. 1550. Combining the data on Ghent, Bruges and Antwerp – each of which is discussed in greater detail in the articles in this special section – with recent research on Bruges, the authors argue against the historiographical trend in which the political history of late medieval towns is supposedly dominated by a trend towards oligarchy. Rather than a closure of the ruling class, the four towns show a high turnover in the social composition of the political elite, and a consistent trend towards aristocracy, in which an increasingly large number of aldermen enjoyed noble status. The intensity of these trends differed from town to town, and was tied to different institutional configurations as well as different economic and political developments in each of the four towns.
The Ecclesiastical Province of Cambrai may sound unfamiliar to modern readers. The bishopric of Cambrai dates to the sixth century but only became an archdiocese and, consequently, the centre of a church province in the sixteenth century. The elevation of the see resulted from the heavily contested reorganization of the diocesan map of the Low Countries by King Philip II in 1559. The new province included the medieval sees of Arras, Cambrai and Tournai, as well as the newly created bishoprics of Saint-Omer and Namur. Its borders were established to encompass the French-speaking Walloon provinces in the south of the Low Countries, territories that are now divided between France and Belgium.1 In the early modern period, this area was already a border and transit zone between France, the Low Countries, the Holy Roman Empire and the British Isles. The province’s history in the sixteenth and seventeenth centuries was deeply marked by recurrent and devastating warfare between the kings of Spain and France, eventually resulting in the transfer of significant territory to France.2 However, the Province of Cambrai was also the scene of frequent cross-border mobility, and a safe haven for Catholic exiles originating from the British Isles, France and other parts of the Low Countries.
What is there new to say on the Low Countries and transatlantic relations during the Cold War? How do recent trends in Cold War research open up uncharted areas to explore these relations from new angles and perspectives? With attention shifting to cultural, global, transnational and multi-centric approaches to the international history of the twentieth century, it would seem that the transatlantic is long passé as a primary frame of reference. As the first special issue in this series claimed (The Low Countries and Eastern Europe during the Cold War), existing scholarship on the Benelux nations has tended to emphasise the ‘loyal ally’ thesis, the uniqueness of small states among larger powers and the importance of traditional diplomacy. With this special issue, a set of articles has been brought together that open up new ways to consider the changing relations both within and between the Benelux nations and their Western allies during the Cold War. As a starting point, it takes the dual approach of the Benelux nations as both actors in the Cold War and as sites where Cold War dynamics were played out and influenced local political and social outcomes. By applying such a structure-agency approach, new perspectives on the importance of the Cold War for Benelux history, and the relevance of the Benelux for Cold War history, can be mapped out.