This chapter presents an overview of overall (all ages), premature (below 75 years old), and infant (below one year old) mortality in Belgium. All-cause and cause-specific mortality are analyzed for overall and premature mortality.
The number of deaths in Belgium slightly increased between 2000 and 2019. Around 109,000 deaths occurred in 2019. In 2020, the number of deaths in Belgium peaked at more than 127,000 deaths due to the COVID-19 epidemic.
The age-adjusted mortality rate slowly decreased from 2000 to 2019, reaching 916.2 per 100,000 inhabitants in 2019. In 2020, the age-adjusted mortality rate increased to 1051.2 per 100,000 inhabitants.
The age-adjusted mortality rate is higher in men than in women, and higher in Wallonia and Brussels than Flanders.
Tumours and cardiovascular diseases are the main causes of death in Belgium, accounting together for more than half of all deaths in both sexes.
Their relative importance has changed over time: mortality due to tumours has progressively exceeded the mortality of cardiovascular diseases in men because of a rapid decrease in mortality due to ischemic heart disease.
When considering specific causes of death, cerebrovascular and ischemic heart disease remain in the top 3, together with dementia (including Alzheimer's disease) for women and lung cancer for men.
The age-adjusted premature mortality (defined here as mortality before age 75) decreased by 31% between 2000 and 2019. However, in 2020, the age-adjusted premature mortality increased by 10% for men and by 5% for women compared to 2019.
The age-adjusted premature mortality is much higher in men than in women (the sex ratio was 1.7 in 2019).
In 2019, the age-adjusted premature mortality rate was higher in Wallonia (+40%) and Brussels (+21%) than in Flanders. Those regional disparities increased in 2020, the age-adjusted premature mortality rate was 51% higher in Wallonia and 33% higher in Brussels compared to Flanders.
The conditions with the highest burden in term of years of life lost before 75 years are:
- Suicide, lung cancer, and ischemic heart diseases in men
- Breast cancer, lung cancer, and cerebrovascular diseases in women
For most conditions, the premature mortality rates decreased between the years 2000 and 2017. It is particularly the case for ischemic heart diseases and transport accidents who decreased by more than 50% in both genders. Exceptions to this general tendency are lung cancer and Chronic Obstructive Pulmonary Disease (COPD) among women which steadily increased then stabilized.
Regional differences in premature mortality by cause are observed with higher premature mortality in Wallonia and Brussels than in Flanders. The causes contributing most to the difference between Wallonia and Flanders are Ischemic Heart Diseases (IHD), lung cancer and COPD in men, and lung cancer, IHD, and COPD in women. The causes contributing most to the difference between Brussels and Flanders are IHD, cerebrovascular diseases and chronic liver diseases for men and COPD, lung cancer, and chronic liver diseases in women.
The evolution of premature mortality over time is quite similar for the three regions.
In 2018, the infant mortality rate was 3.7 per thousand live births; this is equal to the average EU-15 rate. Infant mortality has sharply declined over the last decennia in Belgium. Current rates and trends are similar in the three regions.