Causes of death statistics

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Data from September 2011, most recent data: Further Eurostat information, Main tables and Database.

This article gives an overview of recent statistics on causes of death in the European Union (EU). By relating all deaths in the population to an underlying cause of death, the risks associated with death from a range of specific diseases and other causes can be assessed; these figures can be further broken down by age, gender, nationality and region (NUTS level 2), using standardised death rates.

Statistics on causes of death are important to evaluate the state of health and healthcare in the EU. They suggest which preventive and medical-curative measures and which investments in research might increase the life expectancy of the population. These statistics, which are among the oldest medical statistics available, provide information on developments over time and differences in causes of death between Member States.

Figure 1: Causes of death - standardised death rate per 100 000 inhabitants, males, EU-27, 2000-2009 (1)
(2000=100) - Source: Eurostat (hlth_cd_asdr)
Table 1: Causes of death - standardised death rate, 2009 (1) (per 100 000 inhabitants) - Source: Eurostat (hlth_cd_asdr)
Figure 2: Causes of death - standardised death rate per 100 000 inhabitants, females, EU-27, 2000-2009 (1)
(2000=100) - Source: Eurostat (hlth_cd_asdr)
Figure 3: Causes of death - standardised death rate, EU-27, 2009 (1)
(per 100 000 inhabitants) - Source: Eurostat (hlth_cd_asdr)
Figure 4: Deaths from ischaemic heart diseases - standardised death rate, 2009 (1)
(per 100 000 inhabitants) - Source: Eurostat (tps00119)
Figure 5: Deaths from suicide - standardised death rate, 2009 (1)
(per 100 000 inhabitants) - Source: Eurostat (tps00122)
Table 2: Causes of death - standardised death rate, 2009 (1)
(per 100 000 inhabitants aged less than 65) - Source: Eurostat (hlth_cd_asdr)
Figure 6: Causes of death - standardised death rate per 100 000 inhabitants aged less than 65, EU-27, 2000-2009 (1)
(2000=100) - Source: Eurostat (hlth_cd_asdr)

Contents

Main statistical findings

The latest information available for 2009[1] shows that diseases of the circulatory system and cancer were, by far, the leading causes of death in Europe. Between 2000 and 2009 there was a marked reduction in EU-27 death rates resulting from ischaemic heart disease and from transport accidents (with combined rates for men and women falling by more than 30 %), while there was a reduction of almost 10 % in the EU-27 death rate for cancer during the same period.

Diseases of the circulatory system

Diseases of the circulatory system include those related to high blood pressure, cholesterol, diabetes, and smoking; although, the most common causes of death were ischaemic heart diseases and cerebrovascular diseases. The Member States with the highest death rates from ischaemic heart disease – for men and women combined – were the Baltic Member States, Hungary and Slovakia (all above 200 deaths per 100 000 inhabitants in 2009), while France, Portugal, the Netherlands, Luxembourg and Spain had the lowest rates (below 50 deaths per 100 000 inhabitants).

Cancer

Cancer was a major cause of death in each of the EU Member States (averaging 169 deaths per 100 000 inhabitants across the EU-27 in 2009). Hungary, Poland, Slovenia, the Czech Republic, Slovakia, Latvia and Lithuania were most affected by this group of diseases. The most common forms of cancer in the EU-27 in 2009 included malignant neoplasms of the larynx, trachea, bronchus and lung, colon, breast, and those that the International classification of diseases (ICD) classifies as ‘stated or presumed to be primary, of lymphoid, hematopoietic and related tissue’.

Analysing the figures by gender, men outnumbered women in relation to the number of deaths from cancer. Data for cancer of the larynx, trachea, bronchus and lung showed some marked differences between Member States in 2009: for men Hungary reported the highest death rate from these cancers among the EU Member States, followed by Poland, the Baltic Member States, Belgium (2005 data) and Romania; Hungary also reported a high rate for women, just behind the rate reported for Denmark. Mortality figures for this type of cancer are generally rising for women while decreasing for men.

Breast cancer as a cause of death of women was lowest (17.6 deaths per 100 000 inhabitants) in Spain in 2009, around half the rate recorded in Malta (34.4 deaths per 100 000 inhabitants). There were also relatively high death rates from breast cancer among women from Belgium, Denmark, Ireland and Hungary – see Table 1.

Respiratory diseases

The highest death rates from respiratory diseases in 2009 were recorded in Ireland, the United Kingdom, Belgium (2005 data), Denmark and Portugal. After cancer and circulatory diseases, this was the third most common cause of death in the EU-27 (with an average of 43.6 deaths per 100 000 inhabitants). Within this group of diseases, chronic lower respiratory diseases were the most common cause of mortality followed by pneumonia. Respiratory diseases are age-related with the vast majority of deaths from these diseases recorded among those aged 65 or more.

External causes of death

This category includes deaths resulting from intentional self-harm (suicide) and transport accidents. Although suicide is not a major cause of death and the data for some Member States may suffer from underreporting, it is often considered as an important indicator to be addressed by society. The lowest suicide rates in 2009 were recorded in Greece and Cyprus, and relatively low rates were also recorded in Italy (2008), Spain, the United Kingdom, Portugal and Malta. In 2009, the death rate from suicide in Lithuania was approximately three times the EU-27 average (10.3 deaths per 100 000 inhabitants), and relatively high rates (around double the EU-27 average) were recorded in Hungary and Latvia. Among women, relatively high suicide rates were recorded in Finland, Belgium (2005 data), Hungary and Lithuania – see Figure 5.

Although transport accidents occur on a daily basis, the number of deaths caused by transport accidents are fewer than, for example, the number of suicides. Romania, Greece, Lithuania and Poland had the highest death rates (in excess of 12 deaths per 100 000 inhabitants) resulting from transport accidents in 2009, while Sweden, the Netherlands and the United Kingdom reported the lowest rates (no more than four deaths from transport accidents per 100 000 inhabitants).

Gender

EU-27 death rates were higher for men than for women for all of the main causes of death in 2009 (except for breast cancer) - see Figure 3. Death rates for ischaemic heart diseases were about twice as high for men (110 deaths per 100 000 inhabitants in 2009) as for women (56 deaths per 100 000 inhabitants). Death rates for men were four to five times higher than those recorded for women for drug dependence and alcohol abuse, and three to four time higher for AIDS (HIV) and suicide (intentional self-harm).

There was a higher incidence of death from heart disease than from cancer for both genders in the Baltic Member States, Slovakia and Romania, while in Finland there were more deaths from heart disease than from cancer among the male population.

Age

For people below 65 years of age the leading causes of mortality were somewhat different in terms of their relative importance (see Table 2). Cancer was the leading cause of death within this age group, followed by diseases of the circulatory system, external causes of mortality and morbidity, and diseases of the digestive system. However, unlike for those aged 65 years or more, diseases of the respiratory system did not figure among the four most prevalent causes of mortality.

Data sources and availability

Eurostat began collecting and disseminating mortality data in 1994, broken down by:

  • a shortlist of 65 causes of death based on the International classification of diseases (ICD), developed and maintained by the World Health Organization (WHO);
  • gender;
  • age;
  • geographical region (NUTS level 2).

Annual data are provided in absolute numbers, as crude death rates and as standardised death rates. Since most causes of death vary significantly by age and according to gender, the use of standardised death rates improves comparability over time and between countries as death rates can be measured independently of the population’s age structure.

Statistics on the causes of death are based on two pillars: medical information contained on death certificates, which may be used as a basis for the ascertaining the cause of death; and the coding of causes of death following the WHO-ICD system.

The validity and reliability of statistics on the causes of death rely on the quality of the data provided by certifying physicians. Inaccuracies may result for several reasons, including:

  • errors can occur with the issue of the death certificate;
  • the medical diagnosis;
  • the selection of the main cause of death;
  • the coding of the cause of death.

Sometimes there is ambiguity in the cause of death of a person. Besides the illness leading directly to death, the medical data on the death certificate should also contain a causal chain linked to the suffering of the deceased. Other substantial health conditions may be indicated, which did not have a link to the illness leading directly to death, but may have unfavourably affected the course of a disease and thus contributed to the fatal outcome. Indeed, there is sometimes criticism that the coding of only one illness as a cause of death appears more and more unrealistic in view of the increasing life expectancy and associated changes in morbidity. For the majority of the deceased of 65 years and older the selection of just one out of a number of possible causes of death may be somewhat misleading. For this reason, some of the EU Member States have started to consider multiple-cause coding. Eurostat has supported Member States in their efforts of developing a joint automated coding system called IRIS for the improvement and better comparability of the causes of death data in Europe.

Context

Statistics on causes of death play a key role in the general information system relating to the state of health in the EU. All deaths in the population are identified by the underlying cause of death, in other words ‘the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury’ (a definition adopted by the World Health Assembly). The data presented in this article provide information on the risks associated with death from a range of specific diseases and other causes; a breakdown by age, gender, nationality and region (NUTS level 2) of the deceased is also available.

Statistics on causes of death provide indications as to which preventive and medical-curative measures as well as investments in research have the potential to increase the life expectancy of the population. Standardised death rates may be used as a starting point for targeted epidemiological research. As there is a general lack of comprehensive European morbidity statistics, data on causes of death are often used as a tool for evaluating health systems in the EU and may also be employed for evidence-based health policy.

Further Eurostat information

Publications

Main tables

Public health (t_hlth)
Causes of death (t_hlth_cdeath)

Database

Public health (hlth)
Causes of death (hlth_cdeath)

Dedicated section

Public health

Methodology / Metadata

Source data for tables and figures (MS Excel)

External links

See also

Notes

  1. ↑ France and Italy, 2008; Switzerland, 2007; Belgium, 2005.
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