Life expectancy has increased in EU countries over the past decades, but progress has slowed down in recent years in many countries. The COVID‑19 pandemic will result in a further stagnation or possible decline in life expectancy in 2020 in those countries that have been most impacted.

Large inequalities in life expectancy exist not only by gender, but also by socio-economic status, no matter how they are measured – by education level, income or occupational group. This section focuses on inequalities by education level since this is the socio-economic indicator with the most widely available data, although the data coverage still remains limited to only about half of EU countries.

Healthy life expectancy is an important indicator of population health, as it indicates whether any gains in life expectancy are lived in good health or with some health issues and disabilities. A greater number of healthy life years generally means a healthier workforce, fewer early retirements due to health problems, and reduced or postponed long-term care needs.

Over 4.6 million people died in EU countries in 2017 (). The main causes of death in EU countries are circulatory diseases and various types of cancer, followed by respiratory diseases and external causes of death.

Circulatory (or cardiovascular) diseases remain the main cause of mortality in nearly all EU member states, accounting for some 1.7 million deaths and 37% of all deaths across EU countries in 2017. The morbidity and mortality related to circulatory diseases has major economic costs as well as human costs for Europe. The cost of circulatory diseases to the EU economy was estimated at EUR 210 billion in 2015, of which slightly more than half was due to direct health care costs, a quarter to productivity losses and a fifth to the informal care of people with cardiovascular diseases (Wilkins et al., 2017). This estimate does not take into account the welfare losses associated with premature mortality related to these diseases.

In 2020, about 2.7 million people in the 27 EU countriesare expected to be diagnosed with cancer, and nearly 1.3 millionto die from it(Joint Research Centre, 2020). Over 40% of cancer cases are preventable, and mortality can also be reduced through earlier diagnosis and the provision of more timely and effective treatments. The Europe’s Beating Cancer Plan aims to reduce the cancer burden for patients, their families and health systems, andaddress cancer-related inequalities between and within countries, with actions to support, coordinate and complement the efforts of Member States (EC, 2020).

Poor living conditions and other socio-economic factors affect the health of mothers and newborns, but the quality of health care can greatly reduce the number of infant deaths, particularly by addressing life-threatening issues during the neonatal period (i.e. the first month of life). The main causes of death during the first month are congenital anomalies, prematurity and other conditions arising during pregnancy. For deaths beyond the first month (post neonatal mortality), there tends to be a greater range of causes, with the most common being sudden unexpected death in infancy (Euro-Peristat, 2018).

Communicable diseases, such as measles, hepatitis B and many others, pose major threats to the health of European citizens, although vaccination can efficiently prevent these diseases (EC, 2018).

Childhood and adolescence are fundamental phases in human development, when young people develop knowledge and skills to deal with critical aspects of their health, and are also the period during which many mental health problems first emerge. The COVID‑19 crisis has significantly disrupted children and adolescents’ daily lives, and makes attention to young peoples’ health all the more critical (see Chapter 1 on resilience to the COVID‑19 pandemic).

Good mental health is vital for people to be able to lead healthy and productive lives. Living with a mental health problem can have a significant impact on daily life, contributing to worse educational outcomes, higher rates of unemployment, and poorer physical health. As of 2020, the COVID‑19 crisis is also having a negative impact on mental wellbeing, especially amongst young people and people with lower socio-economic status (see Chapter 1).

Life expectancy has increased greatly in EU countries over the past few decades, but many years of life in old age are lived with some chronic diseases and disabilities (see the indicator Healthy life expectancy). The EU approach to addressing the challenge of chronic diseases involves an integrated response focusing on prevention across sectors, combined with efforts to strengthen health systems to improve the management of chronic conditions (EC, 2020).

Diabetes is a chronic condition that occurs when the body is unable to regulate excessive glucose levels. If left undiagnosed or poorly controlled, it can result in serious complications, including blindness, kidney failure and lower limb amputation. Diabetes also increases the risks of cardiovascular diseases, and people with diabetes also have a greater risk of becoming severely ill if infected by the COVID‑19 virus. Many diabetic patients also did not get proper management and control of their condition during the initial phase of the COVID‑19 pandemic, possibly resulting in avoidable complications.