The gross mortality rate decreases 1.1% in 2009, as compared with the previous year

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1 4 July 2011 Deaths according to Cause of Death Year 2009 The gross mortality rate decreases 1.1% in 2009, as compared with the previous year Deaths due to traffic accidents decrease by approximately one half in five years 384,933 deaths were recorded in Spain in 2009, that is, 1,391 fewer than those registered in ,838 females (0.4% less than the previous year) and 199,095 males (0.3% less) died. The gross mortality rate stood at deaths per 100,000 inhabitants, indicating a 1.1% decrease, as compared with the previous year. By sex, the female rate rose to deaths per 100,000 females, whereas the male rate was deaths per 100,000 males. Causes of death by group of illnesses Analysing causes of death by large group of illnesses, the same pattern of mortality was maintained in 2009 as in the previous year. The three main causes were diseases of the circulatory tract (responsible for 31.2 out of every 100 deaths), tumours (27.3 out of every 100) and diseases of the respiratory tract (11.2 out of 100). As compared with the previous year, deaths caused by tumours continued their rising trend (1.0% more), whereas cases due to the other two groups decreased (2.2% in the case of circulatory diseases and 2.1% in the case of respiratory diseases). Worth noting was the increase in deaths caused by illnesses relating to mental disorders (10.9%) and diseases of the nervous system (7.3%). The number of deaths caused by diseases of the nervous system stood at 18,771 (of which 11,161 were caused by Alzheimer's disease) and 14,455 by mental disorders (of which 13,732 were dementia). By sex, the group of diseases of the circulatory tract remained the number one cause of death in females. In males, the main cause was tumours. Other differences by sex were also observed. Deaths due to external causes (mainly traffic accidents and suicides) were more frequent among males. Conversely, deaths originating from endocrine, nutritional and metabolic diseases (such as diabetes mellitus), those of the nervous system (such as Alzheimer's disease) and mental disorders (such as dementia) were higher in females. 1

2 By age, the main cause of death in persons aged over 74 years old were diseases of the circulatory tract (35.7% of the total number of deaths in this group). In the groups aged between five and 14 years old, and between 45 and 74 years old, the main causes of death were tumours (33.4% and 46.5% of the total, respectively). Finally, among persons aged between one and four years old, and those aged between 15 and 44 years old, external causes (19.7% and 32.8%, respectively) were the main causes. Distribution by chapter of the International Classification of Diseases. Year 2009 Chapters of the ICD No. of deaths % Total deaths 384, Diseases of the circulatory tract 120, Tumours 105, Diseases of the respiratory tract 43, Diseases of the digestive tract 19, Diseases of the nervous system and sensory organs 18, External causes of mortality 14, Mental and behavioural disorders 14, Endocrine, nutritional and metabolic diseases 12, Signs and abnormal clinical and laboratory findings 11, Diseases of the genitourinary system 10, Infectious and parasitic diseases 6, Diseases of the osteomuscular system and of the conjunctive tissue 3, Diseases of blood and haematopoeitic organs, and certain disorders involving the immune mechanism 1, Diseases of the skin and subcutaneous tissue 1, Affections originated in the perinatal period Congenital malformations, deformations and chromosomal abnormalities Pregnancy, childbirth and the puerperium

3 Deaths due to the most common causes of death On a more detailed level of diseases, ischaemic heart diseases (heart attack, angina pectoris, etc.) and cerebrovascular diseases continued to occupy first and second place in the number of deaths (with 35,607 and 31,143 deaths, respectively). Among tumours, the one causing the greatest mortality was bronchial and lung cancer (20,401 deaths), placing it as the third cause of death, and colon cancer (10,846). As compared with the previous year, deaths due to these causes increased 1.0% and 2.3%, respectively. Deaths in traffic accidents decreased once again in 2009, and stood at 2,588 (14.6% less). The number of deaths due to this cause decreased by almost half in five years. The decrease in mortality due to traffic accidents once again placed suicide as the number one external cause of death, with 3,429 persons who died by suicide, a similar figure to that of previous years. By sex, there was a pronounced male excess mortality, as compared with female mortality: eight out of 10 persons who committed suicide were men. In 2009, 1,079 persons died of AIDS/HIV, 11.2% less than in This was the greatest decrease in the last 11 years. Number of deaths by most frequent causes of death 1 Year 2009 Total Male Female Total deaths 384, , ,838 Ischaemic heart diseases 35,607 20,316 15,291 Cerebrovascular diseases 31,143 13,210 17,933 Bronchial and lung cancer 20,401 17,279 3,122 Cardiac failure 17,601 6,117 11,484 Chronic diseases of the lower respiratory tracts 15,940 11,912 4,028 Dementia 13,732 4,441 9,291 Alzheimer's disease 11,161 3,477 7,684 Colon cancer 10,846 6,266 4,580 Diabetes mellitus 10,000 4,181 5,819 Pneumonia 8,603 4,360 4,243 Hypertensive diseases 8,249 2,697 5,552 Renal failure 6,656 3,206 3,450 Breast cancer 6, ,130 Stomach cancer 5,696 3,533 2,163 Prostate cancer 5,522 5,522 - (1) Causes whose relative weight is greater than 1.4% 3

4 Most frequent causes of death in females and males Cerebrovascular diseases were the number one cause of death for females in 2009 (with 2.4% fewer deaths among females than the previous year), followed by ischaemic heart diseases (1.6% less). In males, cardiac ischaemic attacks were the main cause (with a decrease of 0.4%), followed by bronchial and lung cancer (0.8% more) and cerebrovascular diseases (1.8% less). Among deaths due to malignant tumours, breast cancer continued to be the most significant in females (the number of cases increased 1.3%), followed by colon cancer (which decreased 1.1%). In males, after bronchial and lung cancer were colon cancer (4.9% more deaths) and prostate cancer (1.1% more). Among the most common illnesses, bronchial and lung cancer was noteworthy as the cause of death with the greatest male excess mortality as compared with female mortality (the incidence as a cause of death among males was 5.7 times that of females). It was followed by suicide and traffic accidents, with an incidence ratio 3.6 times higher. In turn, Alzheimer's disease, dementia and hypertensive diseases presented a clear excess mortality in females (their rate among females was at least double that of males). Excess mortality index (male rate / female rate by illness) 0.46 DEMENTIA CARDIAC FAILURE CEREBROVASCULAR DISEASE CARDIAC ISCHAEMIC ATTACKS CHRONIC DISEASES OF THE LOWER RESPIRATORY TRACTS SUICIDE TOTAL ILLNESSES Female excess mortality Male excess mortality 4

5 Gross mortality rates by Autonomous Community The highest death rates per 100,000 inhabitants in 2009 corresponded to the Autonomous Communities of Principado de Asturias (1,206.9) Galicia (1,102.7) and Castilla y León (1,081.3). The fact that these three Communities had a more aged population than others partly explained these high rates. In fact, gross mortality rates were affected by the age structure of each Community, such that a region with a high number of elderly persons would have more deaths than another whose age structure was younger. In turn, the lowest mortality rates were recorded in Canarias (618.2), Comunidad de Madrid (655.0) and in the autonomous city of Melilla (569.2). Mortality rates per 100,000 inhabitants. Year 2009 Total Asturias, Principado de 1,206.9 Galicia 1,102.7 Castilla y León 1,081.3 Aragón 1,006.0 Extremadura Cantabria País Vasco Castilla-La Mancha Rioja, La Navarra, Comunidad Foral de Cataluña Comunitat Valenciana Andalucía Ceuta Balears, Illes Murcia, Región de Madrid, Comunidad de Canarias Melilla

6 Methodological note The Death Statistics according to Cause of Death provides annual information on deaths which have occurred in the country, dealing by basic cause of death, in accordance with the International Classification of Diseases (ICD) of the World Health Organisation (WHO). The 10th revision of this classification has been used since In accordance with the recommendations of the WHO, the classification of causes of death is studied and tabulated, depending of the basic cause of death. This is defined as the illness or injury which started the chain of pathological events which directly led to death. When the cause is a traumatic injury, the basic cause is considered to be the circumstances of the accident or violence which produced the fatal injury. To be exact, this set or chain of illnesses is what the doctor certifying the death must provide in the statistical bulletin. Starting with these causes, named by the WHO as immediate, intermediate, initial or fundamental and other processes, and in accordance with the international regulations established in the ICD for selecting the basic cause, the latter is reached. Data on causes of death is collected in three statistical questionnaire models: Medical Death Certificate/Statistical Death Register (CMD/BED), Judicial Statistical Death Register (BEDJ) and the Statistical Bulletin of Infants who died within 24 hours (BEP). The first one collects data on deaths due to natural causes, without requiring the intervention of a judge, whereas the second is directed at obtaining information on deaths due to causes requiring judicial intervention, since there are signs of a possible accidental or violent cause; both contain data on deaths among those who have lived more than 24 hours. Deaths occurring within 24 hours of birth are collected in the BEP. Although considered deaths for statistical purposes, for legal purposes, they are not counted as deaths, but as miscarriages. The sections in the bulletins containing the causes of death are different in both models. In the CMD/BED, 4 causes are described, which form the chain of illnesses which led to death, in the BEP only two are shown, one relating to the mother and another to the foetus, and in the BEDJ, the external circumstances that caused the death are shown. These statistics provide information on mortality, by dealing with the basic cause of death, its distribution by sex, age, residence and month of death. It also offers indicators which enable the drawing of comparisons on an Autonomous Community level and by large groups of causes of death. For further information see INEbase- All press releases at: Press Office: Telephone numbers: / Fax: gprensa@ine.es Information Area: Telephone number: Fax: