What are people dying of in Europe? The differences between Italy and other countries and the role of lifestyle

Among the over-90s, the increase reaches 21% in January and 18% in February. Young people, on the other hand, die more often in summer, especially in road accidents or in public places. And more often at weekends.

"In general, fewer people die on Saturdays (-1%), Sundays (-2.7%) and public holidays than on other days of the week. Tuesday is the day with the highest mortality rate (+1.2%). This difference can be explained by the visits that families make to sick or elderly relatives at the weekend, which help to prevent some deaths. 15 August, a summer holiday, is the least deadly day (12% fewer deaths than the rest of the year). 3 January is the deadliest day, with about 1,900 deaths per year, a 19% increase. It is a 'winter day' that 'follows the end-of-year festivities', explains INSEE, during which some dying people manage to hang on thanks to their loved ones, only to die shortly afterwards', writes Libération.

There is also a higher risk of mortality on one's birthday: this risk increases by an average of 6% in the French population compared to the rest of the year. It is highest in young adults, particularly men: between the ages of 18 and 39, there is a 24% increase in mortality on birthday.

Poor people and people of colour die more than others in the same age group: due to territorial exclusion, less access to care, fewer resources, less education. However, in France, for a long time it was not possible to process much of this data because of a law prohibiting statistics based on ethnicity.

According to data from the Institute of Hygiene, 37,453 people died in Lithuania in 2024, which is 448 more than in 2023. The mortality rate was 13.0 per 1,000 inhabitants (12.9 in 2023). The four main causes accounted for 84.1 per cent of deaths: diseases of the circulatory system (50.8 per cent), malignant tumours (21.5 per cent), external causes (6.1 per cent) and diseases of the digestive system (5.2 per cent).

Among men, there were 18,331 deaths (44.6% circulatory, 23.9% cancer, 9% external causes, 6.1% digestive system). Among women, 19,122 (56.8% circulatory, 19.2% cancer, 5.3% digestive system, 3.4% external causes).

An interview with cardiologist Sigita Glaveckaitė, president of the Lithuanian Heart Association, highlights how cardiovascular mortality in Lithuania is more than double the EU average. The reasons: widespread risk factors such as smoking and obesity, poor use of prevention programmes (only 48 per cent of those eligible), insufficient funding for cardiology, delays in the reimbursement of innovative drugs, and shortcomings in telemedicine.

The specialist also denounces a medical mentality still linked to the Soviet model, in which professionals are paid for hours of work rather than for performance. According to Glaveckaitė, 80 per cent of cardiovascular diseases can be prevented by modifying risk factors such as smoking, diet, hypertension and cholesterol. A national strategy is needed to improve prevention, diagnosis and access to innovative drugs.

In 2023, 101,006 deaths were recorded, of which approximately 60-61% were caused by diseases of the circulatory system and 13-15% by malignant tumours. Together, these two causes explain more than 70% of mortality.

Infectious diseases account for less than 1% of deaths, a sign of the low incidence of communicable diseases. Despite national programmes to promote healthy lifestyles, Bulgaria has one of the highest rates of preventable mortality in the EU.

According to Eurostat, the country is first in Europe for smoking prevalence (29% of the population against an EU average of 18.4%). Alcohol consumption is also high (31.7 litres per capita per year) and 30% of citizens say they do not engage in any physical activity outside work.

Experts agree: 'the experts' explanation for the high mortality rate is an unhealthy lifestyle', marked by poor diet, sedentary lifestyle, pollution, smoking and alcohol consumption.

According to Gazeta Wyborcza, life expectancy started to increase again after the pandemic: in 2023, women reached 82.1 years, men 74.7, a difference of 7.4 years. As Professor Bogdan Wojtyniak of the Institute of Public Health explains, this disparity does not depend on genes but on behaviour, as men die much more often before the age of 65.

Socio-economic status has a strong influence: for men, there is a 12.8-year difference in life expectancy between those with only secondary school and those with a university degree (8.8 for women).

The main causes of premature death: circulatory diseases and cancers for men (41.5%), cancers for women (38%), followed by circulatory diseases (16.5%). Alcohol and suicide weigh heavily: "As many as 10% of premature deaths among Poles are directly linked to alcohol consumption... Suicide is the leading cause of death among young people."

However, despite medical advances, the number of obese and smokers remains high, and alcohol-related mortality is more than double the EU average (six times higher than in the Netherlands).

In the Czech Republic, the main causes of death remain cardiovascular diseases. Professor Josef Kautzner (IKEM) explains: "When I ask patients (patients under 60 after a heart attack), they almost always smoke, are obese, do not treat hypertension or do not take cholesterol medication." However, long-term data show a gradual decline in mortality from circulatory diseases and malignancies, thanks to an improvement in the quality of healthcare.

Lung cancer is the leading cause of cancer death, linked to the smoking habits of generations born between the 1940s and 1960s. Deaths from female breast cancer, on the other hand, have decreased over the last decade, thanks in part to prevention and screening campaigns.

In 2023, there were 600.8 deaths from cardiovascular diseases per 100,000 inhabitants in Romania, with ischaemic and cerebrovascular diseases causing 43,460 and 42,826 deaths respectively. The standardised rate is 2.5 times higher than the EU average.

According to the National Institute for Public Health, the main modifiable risk factors are smoking, stress, sleep disorders, sedentary lifestyle, alcohol and poor diet. Hypertension is listed as the number one risk factor in the European region.

The report 'Health at a Glance: Europe 2024' ranks Romania first in the EU for deaths from treatable causes and second for preventable deaths.

Cardiologist Ștefan Busnatu points out: "We are in first place for mortality caused by cardiovascular diseases in Romania and the Eastern European region... we don't have sufficient infrastructure to manage ischaemic heart disease." We need more interventional cardiology centres, but also more focus on prevention and health education, already at a young age.

The year 2024 marked a negative record for road fatalities: 665 deaths (provisional figure, set to rise). The association *SOS Road Traffic Crimes* denounces that, in spite of the official goal of halving the number of victims by 2030, fatalities have instead increased compared to 2021.

In 2024, 422 road accidents were recorded in western Greece, resulting in 52 deaths and 559 injuries (compared to 45 deaths and 480 injuries in 2023). In the Peloponnese, 256 accidents caused 52 deaths and 292 injuries.

According to George Kouvidis, founder of the association, the Patras-Pirgos section remains among the most dangerous. Moreover, since the opening of the safer Morea motorway, 'road accidents in the area have increased at a frightening rate, we are talking about an increase of more than 100 per cent', due to the increased speed of vehicles, which then spill over onto more unsafe provincial roads.

*This article is part of the European collaborative journalism project "Pulse".