Causes of death statistics

From Statistics Explained

Data from May 2014. Most recent data: Further Eurostat information, Main tables and Database. Planned article update: March 2015.
Table 1: Causes of death — standardised death rate, 2010
(per 100 000 inhabitants) - Source: Eurostat (hlth_cd_asdr)
Figure 1: Causes of death — standardised death rate per 100 000 inhabitants, males, EU-28, 2004–10 (1)
(2004 = 100) - Source: Eurostat (hlth_cd_asdr)
Figure 2: Causes of death — standardised death rate per 100 000 inhabitants, females, EU-28, 2004–10 (1)
(2004 = 100) - Source: Eurostat (hlth_cd_asdr)
Figure 3: Causes of death — standardised death rate, EU-28, 2010 (1)
(per 100 000 inhabitants) - Source: Eurostat (hlth_cd_asdr)
Figure 4: Deaths from ischaemic heart diseases — standardised death rate, 2010 (1)
(per 100 000 inhabitants) - Source: Eurostat (tps00119)
Figure 5: Deaths from suicide — standardised death rate, 2010 (1)
(per 100 000 inhabitants) - Source: Eurostat (tps00122)
Table 2: Causes of death — standardised death rate, 2010
(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-28, 2004–10 (1)
(2004 = 100) - Source: Eurostat (hlth_cd_asdr)

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 analysed by age, sex, nationality and region (NUTS level 2), using standardised death rates.

Main statistical findings

The latest provisional information for the EU-28 relating to causes of death is available for the 2010 reference period. Table 1 shows that diseases of the circulatory system and cancer (malignant neoplasms) were, by far, the leading causes of death.

Between 2004 and 2010 there was an 8.4 % reduction in EU-28 death rates relating to cancer for men and a 4.8 % reduction for women; much larger reductions were recorded in relation to deaths from ischaemic heart disease or from transport accidents (where rates fell by more than 20 %) — see Figures 1 and 2. It should be noted that the time series for malignant neoplasms of trachea, bronchus and lung that are presented in Figures 1 and 2 (as well as in Figure 6 later in this article) do not include data for Germany, Italy or the Netherlands as the time series for these Member States are not complete.

Diseases of the circulatory system

Diseases of the circulatory system include those related to high blood pressure, cholesterol, diabetes and smoking; the most common causes of death from diseases of the circulatory system are ischaemic heart diseases and cerebrovascular diseases. Ischaemic heart diseases accounted for 147.2 deaths per 100 000 inhabitants across the EU-28 in 2010. The EU Member States with the highest death rates from ischaemic heart disease were the Baltic Member States, Slovakia and Hungary — all close to or above 400 deaths per 100 000 inhabitants in 2010. At the other end of the range, France, Portugal, the Netherlands, Spain, Luxembourg and Belgium had the lowest death rates from ischaemic heart disease — below 100.0 deaths per 100 000 inhabitants in 2010.

Cancer

Cancer was a major cause of death — averaging 270.4 deaths per 100 000 inhabitants across the EU-28 in 2010. The most common forms of cancer in the EU-28 in 2010 included malignant neoplasms of the trachea, bronchus and lung, colon, breast, pancreas, stomach and liver.

Hungary, Croatia, Slovenia, Denmark (2009), the Czech Republic, Slovakia, Latvia, Poland and the Netherlands were most affected by cancer — with upwards of 300.0 deaths per 100 000 inhabitants in 2010. Hungary recorded, by far, the highest death rates from lung cancer among EU Member States in 2010 (98.8 deaths per 100 000 inhabitants), followed by Denmark (2009), Poland, the Netherlands, Croatia and Belgium.

Respiratory diseases

After circulatory diseases and cancer, respiratory diseases were the third most common cause of death in the EU-28, with an average of 81.2 deaths per 100 000 inhabitants in 2010. 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.

The highest death rates from respiratory diseases among the EU Member States were recorded in the United Kingdom (138.8), Denmark (134.2, 2009), Ireland (128.4) and Portugal (122.1).

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 EU Member States may suffer from under-reporting, it is often considered as an important indicator that needs to be addressed or considered by society. On average, there were 11.8 deaths per 100 000 inhabitants resulting from suicide in the EU-28 in 2010.

The lowest suicide rates in 2010 were recorded in Greece (3.3 deaths per 100 000 inhabitants) and Cyprus (4.7), and relatively low rates — of less than 10.0 deaths per 100 000 inhabitants — were also recorded in Italy, Spain, the United Kingdom, Malta and the Netherlands, as well as in the former Yugoslav Republic of Macedonia. The death rate from suicide in Lithuania (32.9) was 2.8 times the EU-28 average, while the rate in Hungary (25.6) was more than double the average; the rate in Liechtenstein (28.3 per 100 000 inhabitants) was also relatively high.

Although transport accidents occur on a daily basis, the number of deaths caused by transport accidents in the EU-28 in 2010 (7.0 per 100 000 inhabitants) was lower than the incidence of suicides.

Romania, Greece, Latvia, Lithuania, Poland, Croatia and Cyprus had the highest death rates (10.0 or more deaths per 100 000 inhabitants) resulting from transport accidents in 2010, while Sweden, the United Kingdom and Malta each reported fewer than four deaths from transport accidents per 100 000 inhabitants. Among the non-member countries shown in Table 1, Liechtenstein (16.6) recorded a relatively high death rate from transport accidents while the rates in the other non-member countries were all below the EU-28 average.

Analysis by sex

Except for breast cancer, EU-28 death rates were higher for men than for women for all of the main causes of death in 2010 — see Figure 3. The death rate for alcohol abuse and drug dependence were between four and five times higher for men than for women, and three to four times higher for suicide (intentional self-harm), cancer of the trachea, bronchus and lung and AIDS (HIV).

Deaths from cancer were also generally higher for men than for women. There are, however, a number of cancers which are prevalent among only one of the sexes, such as breast cancer in women, while some other cancers are exclusive to one of the sexes, such as cancer of the uterus for women, or prostate cancer for men.

Mortality figures for cancer of the trachea, bronchus and lung in the EU-28 rose more strongly for women during the period 2004 to 2010 than for men. The incidence of deaths among women increased by 62.1 % (see Figure 2) in contrast to an increase of 25.4 % for men (see Figure 1). However, while the gap between the sexes was closing, death rates for men remained considerably higher than those for women.

Breast cancer accounted for 33.9 deaths per 100 000 female inhabitants across the EU-28 in 2010. The highest rates were recorded for Denmark (45.1, 2009) and Croatia (42.2). At the other end of the range, there were less than 30.0 deaths per 100 000 female inhabitants from breast cancer in 2010 in Spain, Bulgaria, Sweden, Poland, Portugal and Estonia, as well as in Norway.

The incidence of death from suicide was systematically higher for men in each of the EU Member States. The highest death rates from suicide were recorded in Lithuania, Hungary and Latvia — see Figure 5 — peaking at 59.7 deaths per 100 000 male inhabitants in Lithuania. By contrast, death rates from suicide remained relatively low among women, with the highest incidence registered in Lithuania, Belgium and Hungary, all over 10.0 deaths per 100 000 female inhabitants; in Liechtenstein the female death rate from suicide was 21.5 per 100 000 female inhabitants.

Analysis by 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 most prominent cause of death within this age group — averaging 84.5 deaths per 100 000 inhabitants in the EU-28 in 2010 — followed by diseases of the circulatory system. Contrary to the data for the whole of the population, diseases of the respiratory system did not figure among the most prevalent causes of mortality for those aged less than 65: for example, the standardised rate for diseases of the respiratory system was lower than that for suicide.

EU-28 death rates for persons aged less than 65 fell between 2004 and 2010 for each of the main causes of death shown in Figure 6, with the notable exception of cancer of the trachea, bronchus and lung. This was particularly the case for transport accidents and ischaemic heart diseases, where the incidence of death fell by 36.0 % and 22.7 % respectively.

Data sources and availability

Eurostat began collecting and disseminating mortality data in 1994. Currently data are analysed by:

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 sex, 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.

In April 2011, European Commission Regulation 328/2011 on statistics on causes of death was adopted specifying in detail the variables, analysis (breakdowns) and metadata that EU Member States must deliver.

Revised European standard population

For statistics concerning causes of death one of the key methods to control for different age distributions among populations and over time is age standardisation: a standard population is used to compare mortality rates as well as other population-based rates such as the ones on disease incidence. The European standard population used for the standardisation of crude rates dated back to 1976 and so it was necessary to adapt it to the changes in the age-structure of the population that had occurred in the EU Member States since the mid-1970s. A revised European standard population (ESP) was agreed with the Member States and includes the EU-27 Member States and the EFTA countries on the basis of population projections that were made in 2010 for the period 2011–30. It has been in use since the summer of 2013.

Data sources

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 ascertaining the cause of death; and the coding of causes of death following the WHO-ICD system. 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 validity and reliability of statistics on the causes of death rely, to some degree, on the quality of the data provided by certifying physicians. Inaccuracies may result for several reasons, including:

  • errors when issuing the death certificate;
  • problems associated with 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: 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 EU Member States in their efforts to develop a joint automated coding system called IRIS for the improvement and better comparability of causes of death data in Europe.

Context

Statistics on causes of death, which are among the oldest medical statistics available, provide information on developments over time and differences in causes of death between EU Member States. Statistics on causes of death play a key role in the general information system relating to the state of health in the EU. They may be used to determine which preventive and medical-curative measures or which investments in research might increase the life expectancy of the population.

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.

The EU promotes a comprehensive approach to tackling major and chronic diseases, through integrated action on risk factors across sectors, combined with efforts to strengthen health systems towards improved prevention and control, through:

  • making national statistics as reliable and comparable as possible, so they can serve as a good guide to policy effectiveness;
  • supporting campaigns related to raising public-awareness and disease-prevention that actively target high-risk groups and individuals;
  • systematically integrating policy and action to reduce inequalities in health;
  • providing partnerships in relation to specific diseases, for example, cancer.

See also

Further Eurostat information

Publications

Main tables

Database

Dedicated section

Methodology / Metadata

Source data for tables and figures (MS Excel)

External links


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