The excess mortality in Slovakia declined to almost zero after three years, the number of deaths fell to the long-term average

In 2023, compared to the average of years not affected by a pandemic, a more significant increase in the number of deaths was kept only in the group of younger seniors aged 65 to 74. The number of COVID-19 deaths decreased year-on-year by more than 80%. The COVID-19 has thus moved among the causes of death, which in the long term only slightly affect the mortality rate in the SR. However, almost 22.3 thousand people are victims of the pandemic.

54.1 thousand people died in Slovakia last year, which was by 9.1% less than in 2022. The number of deaths was only by 1.1% higher than the five-year average of 2015-2019 before the outbreak of the pandemic¹⁾. After three years, the excess mortality in Slovakia dropped to a minimum, and the number of deaths thus considerably reached a value that came close to the pre-covid figures.

The Statistical Office of the SR has been currently publishing definitive data on the number of deaths by cause of death in the SR for the year 2023.

"In addition to the recession of the pandemic, the lower mortality rate in the year-on-year comparison and also the lower excess mortality rate compared to the previous 3 years were also influenced by the lower number of deaths from the most common cause of death in the long term - diseases of the circulatory system," said Zuzana Podmanická, Director of Population Statistics at the Statistical Office of the SR.

The favourable situation was also reflected in decreasing of the gross mortality rate. The number of deaths per 100,000 inhabitants²⁾ decreased below the threshold of one thousand deaths for the first time in three years - to the current 998. At the beginning of the pandemic, in 2020, it represented 1,082 deaths, and in 2021 it even increased to 1,350 deaths, which was the second highest gross mortality rate in the post-war history of Slovakia.

From approximately the 1970s until the outbreak of the pandemic, the gross mortality rate ranged from 900 to 1,000 deaths per 100,000 inhabitants. The highest gross mortality rate was recorded in 1921, when the number of deaths per 100,000 inhabitants exceeded 2.1 thousands of people.

4 regions recorded a lower gross mortality rate than the average for Slovakia

The gross mortality rate facilitates an objective comparison the mortality rate in regions that differ in terms of size and number of inhabitants. Last year, among the eight regions of Slovakia, Prešovský (856), Bratislavský (868), Žilinský (957) and Košický kraj (978) recorded a lower value of the gross mortality rate than the Slovak average. The highest value was in the Banskobystricky kraj, where the mortality rate was 1,155 deaths per 100,000 inhabitants in 2023. The mortality rate in the Nitriansky, Trenčiansky and Trnavský kraj was also above the value of the Slovak average.

The number of deaths last year decreased compared to 2022 in all regions of Slovakia. At the same time, lower number of persons died in Nitriansky, Žilinský and Prešovský kraj, even compared to the 5-year pre-pandemic average¹⁾. The number of deaths exceeded pre-pandemic figures the most in Bratislavský kraj, where the excess mortality was at the level of 4.4% and in Košický kraj it was 3.4%.

Seniors aged 65 to 74 were the most affected group

From the point of view of age structures, 78% of all deaths were among persons of senior age, i.e. in the age group (65+). Their share in the structure of the dead increased during the pandemic. In absolute numbers, up to 42.1 thousand of persons who died were senior age.

The number of seniors who died decreased year-on-year by 9.2%, but was still almost 6% higher than the five-year pre-pandemic average. While the number of older seniors over 75 who died rose only by 1.4% compared with pre-pandemic period, in the group of younger seniors (from 65 to 74 years) a relatively high excess mortality was still recorded compared to the pre-pandemic average¹⁾, i.e. 16.5%. This is an increase of almost 2,000 persons.

"In the category of younger seniors, the mortality rate was 20 percent or more in the previous three years. The number of younger seniors who died in 2021, when the pandemic hit the SR the most, exceeded the pre-pandemic average by more than 60%," Zuzana Podmanická added.

Last year, a positive trend was the fact that significantly lower number of persons of productive age (15 to 64) and children under 14 died compared with the last five years before the pandemic.

Mortality was influenced by the recession of the pandemic and lower number of deaths from diseases of the circulatory system

Traditional causes of death prevailed in the structure of deaths in Slovakia. In 2023, the long-term most common cause of death in the SR – diseases of the circulatory system – contributed significantly to a decrease of total mortality. More than 24,500 persons succumbed to them, and they accounted for 45% of the total number of deaths. The number of deaths from this cause decreased year-on-year by more than 8% and was lower by 4% compared to the pre-pandemic average of five years before the pandemic. The most significant decrease was the number of deaths from diseases of the circulatory system of persons of productive age (from 15 to 64 years). While their number was by 9% lower in the year-on-year comparison, there were up to 15.5% lower number of deaths compared to the average of years not affected by a pandemic.

The second most common cause of death was tumours, which accounted for 25% of all deaths. Year-on-year, the number of deaths from this cause rose by 3.5%, but compared to the pre-pandemic average, it was lower than one percent lower. In total, more than 13.5 thousand persons died of tumours last year. Almost three quarters of them were seniors in the age group of 65 and over.

The third most common cause of death was diseases of the respiratory system, accounting for over 8% of all deaths. This cause of death also contributed to the year-on-year decrease in mortality, which was almost by 19% less than last year. 4.5 thousand persons died from diseases of the respiratory system in 2023. However, compared to the pre-pandemic average, their number increased by 14% and thus prevented an even more significant decrease in the total mortality rate.

The COVID-19 was the eleventh of the 22 most common causes of death

Last year, 526 persons died from the COVID-19. In a year-on-year comparison, their number decreased by more than 80%. It was the least in the last four years. The infection represented only 1% of the total number of deaths and was thus included among the causes of death that only slightly affect the mortality in Slovakia in the long term.

In the ranking of the number of deaths according to the causes of death, which are classified according to the 22 disease groups of the International Classification of Diseases (ICD)³⁾, the COVID-19 fell to 11th place. In 2022, it was the fifth most common cause of death in Slovakia, and in 2021, it was the second, right behind diseases of the circulatory system. In total, since the outbreak of the pandemic, almost 22.3 thousand persons have died from the COVID-19.

The majority of those who died from the COVID-19  were people in the age group of older seniors (75 and over), they accounted for almost 74% of covid deaths (387). At the same time, the COVID-19 caused only 10 deaths per 100,000 inhabitants (in total, for all causes of death, SR recorded 998 deaths per 100,000 inhabitants).

From a regional point of view, the worst situation was the same as the two previous years in Trenčiansky kraj, where 15 persons died from COVID-19 per 100,000 inhabitants. On the contrary, the disease had the least impact on mortality in Prešovský kraj, where there were only 5 deaths per 100,000 inhabitants.