Main causes of mortality

In 2019 (before the pandemic), the two main broad causes of mortality in the EU were circulatory diseases, which accounted for over 1.6 million deaths or 35% of all deaths, and cancer, which accounted for almost 1.2 million deaths or 26% of all deaths (Figure 3.7). By comparison, COVID-19 accounted for 8% of all deaths in the EU in 2020 (over 400 000 deaths) and 10% of all deaths in 2021 (520 000 deaths). Survivors of severe COVID-19 are more likely to die from other causes.

Ischaemic heart diseases (including acute myocardial infarctions commonly called heart attacks and other diseases) and cerebrovascular diseases (strokes) are the most common causes of mortality from circulatory diseases, accounting for over half of deaths from this group of diseases in the EU (see indicator “Mortality from circulatory diseases”).

Lung cancer was the leading cause of cancer mortality in the EU in 2019, with about 235 000 deaths. The main risk factor for lung cancer is tobacco smoking. However, there are gender differences in cancer mortality. While lung cancer is the main cause of cancer death among men followed by colorectal cancer, breast cancer is the leading cause of cancer death among women followed by lung cancer (see indicator “Mortality from cancer”).

Respiratory diseases are the third cause of death in EU countries, leading to about 364 000 deaths in 2019 or 8% of all deaths. Chronic obstructive pulmonary disease (COPD) is the most common cause of mortality among respiratory diseases, followed by pneumonia. Tobacco smoking is also the most important risk factor for COPD.

External causes of death, including accidents, suicides, homicides and other violent causes of death, were responsible for 5% of all deaths among women and 6% of all deaths among men across EU countries in 2019. The most important causes of violent deaths are accidents (155 000 deaths in 2019, including about 27 000 deaths for transport accidents) and suicides (47 000 deaths). Transport accidents are a particularly important cause of death among young people (aged 18-25), whereas suicide rates generally increase with age.

Looking at other specific causes, Alzheimer’s and other dementias accounted for 5% of all deaths in the EU in 2019, with the number of deaths for these ageing-related diseases increasing by over 50% in the decade up to 2019. Alzheimer’s and other dementias are a cause of death more important among women.

Overall mortality rates ranged from less than 830 deaths per 100 000 population in Spain, Italy and France, (which is about 15% lower than the EU average) to over 1 400 deaths per 100 000 population in Bulgaria, Romania, Hungary and Latvia (over 40% higher than the EU average) in 2019 (Figure 3.8). The main reason for the much higher mortality rates in this latter group of countries is higher mortality rates from circulatory diseases, the most common cause of death. In Hungary, higher cancer mortality rates also explain a large part of the difference with the EU average.

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