Premature mortality

1. Key messages

The premature (below 75 years of age) mortality rate was 350 per 100,000 in 2016 in Belgium.
This rate decreased by 27% between 2000 and 2016 but despite that, Belgium is ranking poor among EU-15 countries, with an excess in potential years of life lost (PYLL) reaching 8% in men and 13% in women as compared to the EU-15 means. Premature mortality is 1.8 times higher in men than in women.
Lower mortality rates are observed in the Flemish region when compared with the two other regions with respective excesses of 40% and 20% in Wallonia and Brussels as compared to Flanders. Mortality is declining in all three regions, but the regional disparities persist.

2. Background

Premature mortality refers to deaths occurring too early i.e. at any age lower than the life expectancy. Different thresholds can be used in the operational definition of this indicator. In this report, the premature mortality occurring below 75 years of age is considered. Reducing premature mortality is a key public health objective and actually much of the premature mortality is avoidable by public health actions.

The crude mortality rate – i.e. the number of deaths in a given year divided by the population under study - is not well suited for health monitoring. Mortality is indeed strongly related to age; as a consequence aging populations face rising crude mortality rates, even if the health conditions are improving. Therefore, to compare mortality rates (over time or between populations) the age structure of the compared population groups will be aligned on a common reference. This technique is called “age-adjustment”. In this report, age-adjusted mortality rates are presented using the European standard population 2010 as reference.

The premature mortality can also be described using an indicator called Potential Years of Life Lost (PYLL): each death is weighted in function of the age at death. By doing so, more weight is put on deaths occurring at a younger age, since they represent a higher burden in term of life lost. So, if death is occurring at age 65, the corresponding life lost is 10. In this report, PYLLs are used for the international comparison with also the age of 75 years as reference. Here also the PYLL rates will be age-adjusted.

3. Belgium

The crude premature mortality (0–75 years) rate was 331/100,000 and the age-adjusted rate was 350/100,000 in Belgium in 2016. The age-adjusted rate was 1.8 times higher in men (452) than in women (254). Those rates are decreasing over time; actually the decrease is more pronounced among men (-31% between the years 2000 and 2016) than among women (-22%).

4. Regions

There are substantial disparities between the three regions in terms of premature mortality. As compared to Flanders, relative mortality excesses are observed :

  • 44% among men and 36% among women in Wallonia
  • 27% among men and 14% among women in Brussels.

The premature mortality rates are decreasing in all three regions at the same pace and as consequence the disparities between Flanders and the two other regions persist. All those differences are statistically significant.

  • Men
  • Women

Age-adjusted* premature (before 75) mortality rate (per 100,000) among men, by year and region, Belgium, 2000–2016
Source: Own calculations based on Statbel data
(*) with the European standard population 2010 as reference

Age-adjusted* premature (before 75) mortality rate (per 100,000) among women, by year and region, Belgium, 2000–2016
Source: Own calculations based on Statbel data
(*) with the European standard population 2010 as reference

5. Districts

Looking at a lower geographical (district) level, it is quite obvious that most Flemish districts experience, for both sexes (although less pronounced in women), a lower premature mortality rate than the Belgian average. The reverse is observed in Brussels and all Walloon districts (except for Nivelles for both sexes). The highest rates of premature mortality for men are observed in three districts of the province of Hainaut.

  • Men
  • Women

Age-adjusted (°) premature (before 75) mortality rate (per 100,000) among men, by district, 2010–2016
Source: Own calculations based on Statbel data
(°) with the European standard population 2010 as reference; (*) significantly different from the mean at p<0.05; (***) significantly different from the mean at p<0.05 after Bonferroni correction
Premature mortality in men BE 2010 2016

Age-adjusted (°) premature (before 75) mortality rate (per 100,000) among women, by district, 2010–2016
Source: Own calculations based on Statbel data
(°) with the European standard population 2010 as reference; (*) significantly different from the mean at p<0.05; (***) significantly different from the mean at p<0.05 after Bonferroni correction
Preamture mortality women BE 2010 2016

6. International comparison

The Potential Years of Life Lost (PYLL) indicator is used here to perform international comparisons. Belgium ranks poor in this domain in both males and in females. The excess of PYLL in Belgium as compared to the EU-15 mean was respectively 8% for men and 13% for women in 2015 (or nearest year).

  • Men
  • Women

Potential years of life lost (before 75) among men, by country, Europe, 2015 or nearest year
Source: Own estimations based on World Health Organization mortality database

Potential years of life lost (before 75) among women, by country, Europe, 2015 or nearest year
Source: Own estimations based on World Health Organization mortality database

7. Read more

View the metadata for this indicator

Statbel: General mortality

Sciensano: Standardized Procedures for Mortality Analysis (SPMA)

WHO: Mortality database

Definitions

Crude Mortality rate
The mortality rate is the number of deaths registered in the country divided by the corresponding population.
Age-standardized mortality rates
The age-standardization is a weighted average of age-specific mortality rates to remove variations arising from differences in age structure between population groups.
Premature mortality rate
The premature mortality rate is defined here as the number of deaths occurring before the age of 75 registered in the country divided by the corresponding population.
Potential Years of Life Lost
The potential years of life lost (PYLL) measure the number of years of life that have been lost due to a premature death. PYLL weights the deaths occurring at younger age groups more heavily than the ones occurring in older people. The calculation of PYLL involves summing up deaths occurring at each age and multiplying this with the number of remaining years to live up to a selected age limit (here, 75 years).