The rate of preventable mortality is significantly higher in Eastern Europe compared to Western and Northern Europe.
More than 1.1 million deaths in 2022 could have been avoided in the European Union with more effective healthcare systems and public health measures.
These deaths, caused by diseases and conditions, could either have been prevented or treated. They account for more than one in five deaths among EU citizens.
Preventable mortality rates reflect the effectiveness of public health and healthcare systems, including the quality of medical care and access to services, according to the OECD and EU report "Health at a Glance: Europe 2024."
Rates of preventable mortality in Europe vary widely. Experts point to several influencing factors, including healthcare spending levels and the prevalence of preventable risk factors such as smoking and alcohol consumption.
According to Eurostat, preventable death or mortality is divided into two categories:
Preventable deaths: These are causes of death that could have been avoided through public health measures in the broadest sense. This category includes lung cancer, ischemic heart disease, COVID-19, alcohol-related deaths, stroke, accidents, chronic obstructive pulmonary disease (COPD), suicide, and other causes.
Treatable deaths: These include causes of death that could have been avoided with optimal quality medical care. They include ischemic heart disease, colorectal cancer, breast cancer, stroke, pneumonia, hypertension, diabetes, and other causes.
According to Eurostat, in 2022, the number of deaths that could have been avoided among people under 75 years old amounted to 1.11 million across the EU. For country comparisons, an age-standardized mortality rate per 100,000 people under 75 years old is used.
The rate of preventable mortality in the EU ranges from 169 deaths in Sweden to 543 in Latvia per 100,000 residents, with an average of 258 deaths across the EU in 2022.
When including candidate countries for EU membership, EFTA members, and the UK—where data is available—the lowest preventable mortality rate is recorded in Switzerland: 153 per 100,000 people.
Significant differences: Eastern, Western, and Northern Europe
Countries in Eastern and Baltic Europe have the highest recorded rates of preventable mortality. Latvia, Romania, Hungary, Lithuania, and Bulgaria topped the list, exceeding 470 deaths per 100,000 people. They are followed by Serbia, Slovakia, and Estonia with lower rates, yet still exceeding 390 deaths.
In contrast, in Western and Northern European countries, the rate of preventable mortality was lower. Countries such as Switzerland, Sweden, Norway, the Netherlands, and France show significantly lower rates—less than 200 deaths per 100,000 people.
Central and Southern European countries generally show average rates of preventable mortality. Croatia, Poland, Turkey, Greece, the Czech Republic, and Italy fall into this range, with most recording between 200 and 300 deaths per 100,000 people.
Although Germany fell below the EU average, it recorded the highest rate of preventable mortality (249) among the leading EU economies.
Two-thirds of deaths are preventable, one-third treatable
Of the 1.11 million deaths that could be avoided in the EU in 2022, 65 percent (725,624) are considered preventable, while 35 percent (386,709) are treatable. This corresponds to 168 preventable deaths and 98 treatable deaths per 100,000 people in the EU.
There is a very strong positive correlation between the two types of preventable mortality: Countries with higher rates of preventable mortality also tend to have higher rates of treatable mortality. Naturally, this reflects on the overall level of preventable mortality.
For example, Latvia and Romania have some of the highest rates of both preventable and treatable mortality, while Switzerland and Sweden demonstrate very low rates in both categories.
Main causes of preventable mortality
Cardiovascular diseases were the leading treatable cause of death in the EU, accounting for 21% of deaths, according to the report "Health at a Glance: Europe 2024." The percentage of other major causes was as follows: colorectal cancer (14), breast cancer and stroke (10 each), pneumonia (8), hypertension (5), and diabetes (4).
In 2021, COVID-19 was the leading preventable cause of death, accounting for 24% of deaths. However, in 2022, according to Eurostat, its share decreased to 10%. This year, the largest share is attributed to lung cancer—19%, followed by heart diseases—11%. Alcohol-related deaths account for 8% of preventable mortality.
Factors determining country-level differences
The prevalence of these causes varies across different countries in Europe, which accounts for the differences in overall levels of preventable mortality between countries.
"Several factors can influence the level of preventable mortality, such as social and healthcare spending, education, and gas emissions," said Aida Isabel Tavares, an associate professor at the Lisbon School of Economics and Management, to Euronews Health.
According to the report, Central and Eastern European countries have significantly higher rates of lung cancer, cardiovascular diseases, and poisoning associated with alcoholism.
"This can largely be explained by differences in the prevalence of preventable risk factors, such as smoking and alcohol consumption," the report states.
Tavares also noted that countries with higher levels of healthcare spending tend to have lower rates of treatable mortality.
"Overall, high treatable mortality is observed in Eastern European countries, while low rates are found in Northern European countries," she said. She cited Sweden, which spends a significant portion of its GDP on healthcare, compared to Bulgaria, which allocates a much smaller share.
Rock Hrzhich, an associate professor at the Department of International Health at Maastricht University, noted that much of the difference in preventable mortality between Western and Eastern European countries is related to mortality from cardiovascular diseases in middle and older age.
"The persistently higher mortality from cardiovascular diseases in some Eastern European countries is widely seen as a remnant of a delayed cardiovascular revolution, meaning the late adoption of medical technologies and policies that allow for the prevention and treatment of heart diseases," he said in an interview with Euronews Health.
Differences in the registration of causes of death
Dr. Susanna Stölpe, a researcher at Ruhr University Bochum (Germany), noted that differences in the registration of causes of death can affect preventable mortality rates.
"A certifying specialist may choose more than one disease as the cause of death. Depending on the subjective choice of the certifier, the death may be attributed to an inevitable, preventable, or treatable cause," she said in an interview with Euronews Health.
She also noted that the share of deaths with unknown causes also affects the level of preventable mortality, with the Baltic countries, the UK, and Finland having lower rates than most Western European countries.
Experts emphasized that healthcare spending varies significantly across different countries in Europe. This reflects the varying levels of healthcare accessibility and the robustness of healthcare systems.
Measured in euros per capita, in purchasing power parity (PPP) per capita, and as a percentage of GDP, Western and Northern European countries showed the highest current healthcare expenditures, while Eastern European and Balkan countries had the lowest.
In Southern European countries, spending levels were generally moderate. Since Ireland and Luxembourg have very high GDPs, their healthcare expenditures as a percentage of GDP remain comparatively low.
