Causes of excess mortality in the Republic of Moldova as compared to the European model

Background: Disregarding the recent rise in life expectancy in Moldova, the gap with Western countries is very high. The aim of the study is to identify the causes of death and the age groups responsible for excess mortality in Moldova in relation to the European average model in 2001-2019. Mortality beyond the European model set as a threshold was considered excessive. Material and methods: Data were retrieved from the Human Cause-of-Death Database and the WHO mortality database. Multiple decrement life tables by cause were computed for Moldova and the model (Germany, England and Wales, Czech Republic, Poland). Results: 27% of all deaths in males and 13% of all deaths in females under the age of 70 are excessive compared with the model. 80% of excess deaths were attributable to cardiovascular and digestive diseases (both males and females) and external causes (males). Excess deaths were mainly concentrated between the ages of 40 and 70 in men and 50 and 80 in women. Over the study period, cardiovascular diseases contributed the most to the decline in excess mortality in females, but not males. For the latter, excess mortality increased because of the cardiovascular component, completely compensating for moderate progress in external causes of death. Conclusions: Narrowing the life expectancy gap between Moldova and Western countries should be possible through better control of the key risk factors behind the identified causes of death.