Premature mortality

1. Key messages

2. Premature mortality rates

Age-adjusted premature mortality rates decrease below the 2019 level in 2023

In Belgium, the crude premature mortality (0–74 years) rate was 314 per 100,000 inhabitants under 75 years old and the age-adjusted premature mortality rate was 315 per 100,000 inhabitants in 2023. The age-adjusted premature mortality rate was 1.6 times higher in men (392 per 100,000) than in women (240 per 100,000). The age-adjusted premature mortality rates were generally decreasing over time. Between the years 2010 and 2022, the decrease was more pronounced among men (-22%) than among women (-14%).

In 2020, the age-adjusted premature mortality rates increased by 10% for men and by 5% for women compared to 2019. That increase can be explained by the COVID-19 epidemic. In 2023, the age-adjusted premature mortality rates decreased further and were below the 2019 level.

Premature mortality rates are lower in the Flemish Region

There are substantial disparities between the three regions in terms of age-adjusted premature mortality rate. As compared to the Flemish Region, the following relative mortality excesses were observed in the other regions in 2023 :

• Walloon Region: +44% among men and +37% among women
• Brussels Capital Region: +20% among men and +8% among women

After the widening of regional disparities in 2020 and 2021, disparities have reduced in 2022 and 2023.

Disparities by districts are large

Looking at a smaller geographical level, it becomes clear 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 premature mortality rates for men are observed in three districts of the province of Hainaut (Charleroi, Mons, Tournai). In women, the districts with the highest rates were found in the provinces of Hainaut, Namur, and Liège.

Belgian premature deaths are among the highest in Europe

The Potential Years of Life Lost (PYLL) indicator is used 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 5% for men and 13% for women in 2018 (or the nearest year). These data are the most recent data (2018) currently available from the World Health Organization mortality database.

Insights into these differences can be found in the causes of premature death section. 

3. Read more

View the metadata for this indicator

Statbel: General mortality

Statbel: Open data

Sciensano: Standardized Procedures for Mortality Analysis (SPMA)

WHO: Mortality database

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, premature mortality occurring below 75 years of age is considered. Reducing premature mortality is a key public health objective and 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 their 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. The PYLL rates will also be age-adjusted.

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).

References

1. Statbel. Number of deaths per day, sex, age, region, province, district. https://statbel.fgov.be/en/open-data/number-deaths-day-sex-district-age
2. WHO. Global health estimates: Leading causes of deaths. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death

Please cite this page as: Sciensano. Mortality and Causes of Death: Premature mortality, Health Status Report, 29 Aug 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/mortality-and-causes-of-death/premature-mortality