Overall mortality by cause

1. Key messages

Tumours and cardiovascular diseases are the main causes of death observed 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: tumours mortality has indeed progressively exceeded the mortality of cardiovascular diseases in men because of a rapid decrease in ischemic heart diseases mortality.
Still, cerebrovascular and ischemic heart diseases are in the top 3 of the specific causes of deaths, completed by dementia (including Alzheimer disease) for women and lung cancer for men.

2. Background

The framework used to analyze the causes of death is the World Health Organization (WHO) International Classification of Diseases 10th Revision (ICD-10). In this report, mortality is analyzed according to 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. This is based on the ICD-10 using the first character. In a second step, the 10 most important specific causes of death are ranked and presented for Belgium as for the regions in function of their mortality rates.

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

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 2016, accounting together for more than half of the mortality share.

  • Men
  • Women

Distribution of the causes of death (ICD-10 chapters) among men, by age-adjusted mortality rates, Belgium, 2016
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, 2016
Source: Own calculation based on data provided by Statbel

Trends

In men, the cardiovascular diseases and the respiratory diseases mortality have significantly decreased between the years 2000 and 2016 (respectively by 45% and 42%). As a consequence, the tumour mortality, decreasing at a slower pace (25%), is nowadays higher than the mortality from cardiovascular diseases.

In women, the mortality rate of the diseases of the cardiovascular and respiratory systems decreased overtime as well. The mortality rates related to most of the other diseases have remained stable. That is the reason why tumour mortality is now almost as high as the one due to cardiovascular diseases.

It is worth mentioning the specific evolution regarding the mental and neurological diseases: the corresponding mortality rates have increased both among women (by 23%) as among men (24%) since the year 2000.

All the trends mentioned are statistically significant.

  • Men
  • Women

Age-adjusted* mortality rates of the 5 main causes of death (ICD10 chapter) among men, Belgium, 2000-2016
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 (ICD10 chapter) among women, Belgium, 2000-2016
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 the cerebrovascular diseases (grouped with HTA), dementia (including the Alzheimer disease) and ischemic heart diseases.

Rankings are rather similar when comparing the regions. However, heart failure in Flanders is the fourth 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.

  • Men
  • Women

Ranking by age-adjusted* mortality rates of the main causes of death (all ages) among men, Belgium and regions, 2016
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, 2016
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.