Causes of death

1. Key messages

Tumours and cardiovascular diseases are the main groups of causes of death in Belgium, accounting together for more than half of all deaths in both sexes.
The relative importance of those two broad categories 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 are in the top 3, together with lung cancer for men and dementia (including Alzheimer's disease) for women.

2. Background

The causes of death are classified according to the International Classification of Diseases 10th Revision (ICD-10) [1]. In this report, mortality is analyzed with the underlying cause of death as indicated on the death certificate. The underlying cause of death is by rule preferred to the immediate and the contributing causes of death for mortality statistics because, from a public health perspective, the objective is to break the chain of events leading to death and to prevent the precipitating cause [1].

In a first step, the causes of death are presented here according to the ICD-10 main chapters. Those are based on the first digit of the ICD-10 code. In a second step, the 10 most important specific causes of death are ranked by mortality rates for Belgium and by regions. 

To take into account the variations in the age structure of the Belgian population overtime and allow comparisons between periods, the rates are age-standardized (using the European standard population 2010 as reference).

The COVID-19 mortality is analyzed on another page. 

3. Causes of death grouped by ICD-10 chapter

Distribution

Tumours and circulatory system diseases (or cardiovascular diseases) were the main causes of death in 2018, accounting together for more than half of the mortality share (53% for men and 49% for women).

  • Men
  • Women

Distribution of the causes of death (ICD-10 chapters) among men, by age-adjusted mortality rates, Belgium, 2018
Source: Own calculation based on data provided by Statbel

Distribution of the causes of death (ICD-10 chapters) among women, by age-adjusted mortality rates, Belgium, 2018
Source: Own calculation based on data provided by Statbel

Trends

In men, the age-adjusted mortality rate of cardiovascular diseases has significantly decreased between the years 2000 and 2018 (by -50%). As a consequence, tumour mortality, decreasing at a slower pace (-30%), is nowadays higher than the mortality from cardiovascular diseases.

In women, the age-adjusted mortality rate of cardiovascular diseases decreased a lot as well (by 49%). As a result, tumour mortality (which barely decreased) ranks now almost as high as cardiovascular diseases mortality.

In both genders, the mortality of respiratory system diseases has decreased since 2000 (by 39% in men, 15% in women). However, the decrease has slowed down and stopped in the last decade.

It is worth mentioning the evolution of mental and neurological diseases mortality: the corresponding mortality rates have increased among both men (by 33%) and women (by 31%) since the year 2000.

  • Men
  • Women

Age-adjusted* mortality rates of the 5 main causes of death (ICD-10 chapter) among men, Belgium, 2000-2018
Source: Own calculation based on data provided by Statbel
(*) reference population: European standard population 2010

Age-adjusted* mortality rates of the 5 main causes of death (ICD-10 chapter) among women, Belgium, 2000-2018
Source: Own calculation based on data provided by Statbel
(*) reference population: European standard population 2010

4. Specific causes of deaths

The ten main causes of death have been ranked in function of their age-adjusted mortality rates, separately for men and women. The three main causes of death are:

  • among men, ischemic heart diseases, lung cancer, and cerebrovascular diseases (grouped with arterial hypertension (HTA))
  • among women, dementia (including Alzheimer's disease), cerebrovascular diseases (grouped with HTA), and ischemic heart diseases

Rankings are rather similar between regions. However, heart failure in Flanders is the fifth cause of death in men and the third in women, which is much higher than in the other regions. A part of these disparities could be due to differences in the coding of causes of deaths among regions.

For more information concerning the morbidity of some specific conditions, please consult the related page: Overview non-communicable diseases, Cancer, Ischemic heart disease, Diabetes, and Suicidal behaviour.

  • Men
  • Women

Ranking of the main causes of death (all ages) by age-adjusted* mortality rates among men, Belgium and regions, 2018
Source: Own calculation based on data provided by Statbel
(*) reference population: European standard population 2010




Ranking by age-adjusted* mortality rates of the main causes of death (all ages) among women, Belgium and regions, 2018
Source: Own calculation based on data provided by Statbel
(*) reference population: European standard population 2010




5. Read more

View the metadata for this indicator

Statbel: Causes of death

Sciensano: Standardized Procedure for Mortality Analysis (SPMA)

WHO: ICD-10

Definitions

International Classification of Diseases (ICD-10)
The International Classification of Diseases is an international codification for diseases and for a very wide variety of signs, symptoms, traumatic injuries, poisonings, social circumstances and external causes of injury or illness.
Underlying cause of death
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.
Immediate cause of death
The final disease, injury, or complication directly causing death.
Contributing cause of death
All other significant diseases, conditions, or injuries that contributed to death but which did not result in the underlying cause of death.
Tumours
Also known as neoplasms in ICD-10. The neoplasms group includes actually 95% of malignant neoplasms (or cancers), the other 5% being tumors of benign or borderline behavior.
Age-standardized mortality rate
The age-standardization is a weighted average of age-specific mortality rates to remove variations arising from differences in age structure between population groups.

References

  1. WHO. ICD-10: International statistical classification of diseases and related health problems: Instruction manual. Geneva: World Health Organization; 2011.