Overall mortality

1. Key messages

The number of deaths in Belgium slightly increased during the last decade. There were almost 109,000 deaths in 2019. In 2020, however, the number of deaths in Belgium peaked at more than 127,000 deaths.
The crude mortality rate remained quite stable from 2000 to 2019. After standardization for age, the overall mortality rate declined by 25% from 2000 to 2019. This is reflecting the fact that the age distribution of the population is shifting towards older ages over time, and that the age at death is increasing.
However in 2020 both the crude and the age-adjusted mortality rates shown an important increase linked to the COVID-19 epidemic.
The age-standardized all-cause mortality is 1.5 times higher in men than in women, but this gap is decreasing.
Geographical disparities are observed, with lower age-standardized mortality rates in the Flemish region. Mortality is declining over time in all three regions, but the regional disparities persist.

2. Background

Mortality is a traditional health indicator, actually better understood as a measure of “non-health”. Although quantifying irreversible events, the mortality analysis provides unique information for public health guidance, like the importance of severe health problems, their evolution over time and some insights on their determinants (i.e. the road security and the smoking behavior). It is also a health indicator that has a long tradition and is measured with more validity than any other. Indeed, death is an unambiguous event, that used to be systematically registered in vital registration systems of most countries for more than one century.

The crude mortality rate is the number of deaths in a given year divided by the population under study. This indicator is not well suited for health monitoring; mortality is indeed strongly related to age. As a consequence, aging populations are facing rising crude mortality rates even if the health state is improving.

Therefore, comparisons of mortality indicators between population groups or years should always use estimators that are adjusted for differences in age composition between the groups. In this report, the age-adjusted mortality rates are used, with the European Standard Population 2010 (ESP 2010) [1] as a reference.

Two databases are used here. First, mortality statistics from 2000 to 2017 have been computed based on the 2017 national causes of death database owned by Statbel. Then, rates for 2018 to 2020 have been computed based on the open data of Statbel [2].

In this section, we describe the all-cause mortality. The specific causes of death are described in the section on overall mortality by cause. 

3. Number of deaths per day

In 2020, mortality peaks were observed from March to April, and from the end of October to the end of the year. These peaks can be explained by the COVID-19 epidemic. An additional peak was observed during summer in Augustus, caused by higher temperatures. A heatwave mortality peak was also observed in 2019.

Daily number of deaths, Belgium, 2015-2020
Source: Own calculations based on data provided by Statbel

4. Mortality rates

Belgium

The crude mortality rate in 2019 was 949 per 100 000 inhabitants, and quite similar in both genders: 942 in men and 955 in women. However, after adjustment for age, a 42% higher mortality rate is observed in men (1099 per 100.000) as compared to women (773 per 100,000) in 2019.

In 2020, the crude mortality rate jumped to 1090 due to the COVID-19 epidemic and was close for both genders, 1084 in men and 1096 in men. After age-adjustment, a 44% higher mortality rate is observed in men (1271 per 100.000) as compared to women (880 per 100,000) in 2020.

Over the last two decades, the age-adjusted mortality rate declined until 2019; a 31% decrease in men and a 22% decrease in women are observed between 2000 and 2019. In 2020, it has raised due to the COVID-19 epidemic and reached 1051 per 100,000 (a 16% increase in men and 14% in women compared to 2019), the highest mortality rate since 2008.

  • Crude
  • Age-adjusted

Crude mortality rates (per 100,000) among men and women, Belgium, 2000–2020
Source: Own calculations based on data provided by Statbel

Age-adjusted* mortality rates (per 100,000) among men and women, Belgium, 2000–2020
Source: Own calculations based on data provided by Statbel
(*) with the European standard population 2010 as reference

Regional specificities

Among men in 2019, the age-adjusted mortality rate was 25% and 15% higher respectively in Wallonia and in Brussels as compared to Flanders; among women, it was 20% and 8% higher respectively in Wallonia and in Brussels as compared to Flanders.

During the year 2020, the regional differentials in mortality increased. Among men, the age-adjusted mortality rate was 33% in Wallonia and 28% higher in Brussels than in Flanders, and among women the mortality rate was 31% and 22% higher in Wallonia and in Brussels than in Flanders. The COVID-19 mortality rates observed in the epidemiological surveillance have shown the COVID-19 specific mortality rates to be higher in Wallonia and in Brussels, which can explain the increase of the regional differentials in all-cause mortality.

  • Men
  • Women

Age-adjusted* mortality rates (per 100,000) among men, Belgium and regions, 2000–2020
Source: Own calculations based on data provided by Statbel
(*) with the European standard population 2010 as reference

Age-adjusted* mortality rates (per 100,000) among women, Belgium and regions, 2000–2020
Source: Own calculations based on data provided by Statbel
(*) with the European standard population 2010 as reference

5. Read more

View the metadata for this indicator

Statbel: General mortality

Statbel: Open data

Sciensano: Standardized Procedure for Mortality Analysis (SPMA)

Definitions

Crude mortality rate
The crude mortality rate is the number of deaths registered in the country divided by the corresponding population.
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. Pace M, Giampaolo L, Glickman M, Zupanic T. Revision of the European Standard Population Report of Eurostat's Task Force. Luxembourg; 2013.
  2. Statbel. Number of deaths per day, sex, age, region, province, district. https://statbel.fgov.be/en/open-data/number-deaths-day-sex-district-age