What Romanians die of

What moved

Two counts, the same dead

A picture of causes of death says who dies most often. It does not say how much is lost. Those are two different questions and, in Romania, they produce two different pictures.

The first count is simple: every person recorded dead in 2023 is worth one. That is how you arrive at the 241,928 deaths and at the red block that fills half the screen. It is the count that produces headlines about the “number one killer”.

The second asks how many years are missing. The international convention is to count the years up to 75 and stop there: a death at 41 is worth 34 years lost, a death at 88 is worth zero. Added up that way, the 241,928 deaths become 1,438,372 years of life lost in a single year, and 110,883 deaths carry all of them.

Moving from one unit to the other shifts the weight from the diseases that close long lives to the ones that cut lives short. The red block stays the largest, but it is no longer a majority. Around it rise four things the first canvas had all but hidden.

The biggest jump belongs to those who have only just been born. Newborn conditions, congenital malformations and deaths linked to pregnancy came to 658 deaths in 2023, three dots out of a thousand. Because each of them takes almost 75 years at once, in the second count they occupy 33. One such death weighs as much as twelve ordinary ones.

Accidents and suicides make the same journey with larger numbers: 8,491 deaths across the whole year, but 163,397 years lost. And cirrhosis together with the other chronic liver diseases, 7,850 deaths, reach 100,855 years — more than all cerebrovascular disease combined, which kills four times as many people.

Cancers are the only large family whose place barely changes: 192 dots by deaths, 247 by years. They strike early enough to lose nothing in the recount and often enough to stay second everywhere.

Cause by cause

Fifteen rows, two orders

The families above gather very different diseases. Opened up into individual causes, the two counts produce two rankings that agree only at the top.

The bar shows the size relative to the first row. “The rest of circulatory disease” is a residual category of the classification, not a disease; see the limits below.

The same unit, another continent

Where the distance from Europe sits

Measured as years lost per hundred thousand inhabitants, with the age structures brought to a common standard, Romania loses 7,938 and the European Union 4,767. A factor of 1.67. The distance, though, is not spread evenly.

European Union Romania years lost before 75, per 100,000 inhabitants, age-standardised

Most is lost where European medicine has had cheap answers for decades. In lung disease, where pneumonia alone accounts for six in ten deaths, Romania loses more than three times as many years as the Union average. In infectious disease, where tuberculosis still kills 705 people a year, almost two and a half times. In liver disease, almost three times. In heart disease, two and a half.

For cancers the gap narrows to 1.3. It is the only large family where Romania sits close to Europe, and not because the treatment is good: for many cancers, people die before reaching the age at which cancers appear. The inverse reading is more useful: if heart, lung and liver disease came down to the European average, what would remain is a picture of death in which oncology becomes the main problem. That is where the countries of western Europe have arrived.

The same distance shows up in something far simpler to check: 21.5% of deaths in Romania come before the age of 65, against 14.9% in the Union. One in five, against one in seven.