Text from the Indicator Report 2022
The data sources of the indicators are the death statistics and the intercensal population updates produced by the Federal Statistical Office. As part of the causes of death statistics, all official cause of death certificates are recorded and evaluated. The population statistics specify the current population based on the results of the most recent census. The data refer to the “old” standardised European population. A standard population is a modelled population that makes it possible to compare change rates over time.
The indicators 3.1.a and 3.1.b are also part of the Federal Health Monitoring information system (www.gbe-bund.de). Those under 1 year of age and consequently the infant mortality rate are excluded from the assessment.
Premature mortality steadily decreased between 1991 and 2020, both for women (‒ 38 %) and for men (‒ 44 %). As a result of this decrease, the gender difference in premature mortality declined, too. In 2020, for example, 145 women and 276 men per 100,000 inhabitants died before they reached the age of 70. If this trend continues unchanged as seen in recent years, the gender-specific targets for 2030 will not be achieved.
The COVID-19-pandemic caused significantly more deaths in 2020, however, considering the indicators over time, the changes of the values are minor. The mortality in the age group of above 80 years old (not considered for the indicators) considerably increased in 2020, while in the age group below 70 years 1.7 % women and 2.3 % men died due to COVID-19. Therefore, the indicators are less affected by the COVID-19-pandemic. It is assumed, that a substantial undercoverage of COVID-deaths is not prevalent.
Life expectancy is an indicator based on death statistics and the intercensal population updates and excludes the effects of population ageing on the development of mortality. In 2020 and 2021, the pandemic caused a short-run decline in life expectancy. In the long-run, reflecting the steady decrease in premature mortality, life expectancy in Germany has continued to follow an upward curve. Todays 70-year-old women can, statistically, expect to live another 17.0 years and 70-year-old men another 14.3. Between 2019 and 2021, the average life expectancy was 83.4 years for new-born girls and 78.5 years for boys, which was 4.4 years higher for girls and 6.1 years for boys than the average for the years 1991 to 1993. Differences in life expectancy between the western Länder and the eastern Länder (each excluding Berlin) are for new born girls 0.2 years and for new-born boys 1.8 years and, thus, significantly decreased. However, the differences between east-west Germany are increasing in size due to the pandemic.
The largest share of all causes of premature mortality in 2020 was malignant neoplasms (35.9 %), followed by cardiovascular diseases (19.5 %). Deaths due to external causes (such as accidents, poisoning, suicide) accounted for as much as 8.6 %. Diseases of the digestive and respiratory tracts contributed 7.3 % and 5.2 %, respectively, to the causes of death. Since 1991, the shares of malignant neoplasms and diseases of the respiratory tract among all causes of death have increased (by + 2.7 and + 1.2 percentage points, respectively). In contrast, causes such as cardiovascular diseases (‒ 11.6 percentage points), external causes (‒ 2.4 percentage points) and diseases of the digestive tract (‒ 0.3 percentage points) have declined.
Besides factors such as health related behaviour (see, for instance, indicators 3.1.c and 3.1.d on adolescent and adult smoking rates or 3.1.e and 3.1.f on child/adolescent and adult obesity rates), medical care also has an important influence on mortality rates. Health expenditure rose to 440.6 billion euros in 2020 due to the pandemic and reached a peak. It is equivalent to an annual amount of 5,298 euros per capita of population, compared with 4,980 euros in 2019. Since the beginning of calculations in 1992, health care expenditures per capita reached a value above 5,000 euros for the first time. Health care expenditures amounted to 26.8 billion euros in 2020, and, thus, were 6.5 % higher than pre-pandemic level in 2019. This level of spending represented 13.1 % of the gross domestic product and has increased by 1.2 % from the value in 2019.
