Taken from the official translation of the German Sustainable Development Strategy
The data sources are the cause of death statistics and the population statistics of the Federal Statistical Office. For the cause of death statistics, all official death certificates are recorded and evaluated. The population statistics shows the current population data based on the results of the most recent census. The data relate to the old European standard population. A standard population is a modelled population that makes it possible to compare change rates over time. The cohort under one year of age, and hence infant mortality, is disregarded. The indicator is also part of the health reporting conducted by the Federal Government.
Premature mortality decreased steadily between 1991 and 2018 for both women (-36%) and men (-43%). The larger decline among men has also reduced the gender-specific difference in premature mortality. In 2018, for example, 151 women and 279 men per 100,000 inhabitants died before the age of 70. If the trend of past years remains unchanged, however, the gender-specific targets for 2030 will be missed.
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 60-year-old men another 14.3.
In the period from 2016 to 2018, the average life expectancy for newborn girls was 83.3 years and for boys 78.5 years, which was 4.3 years more for girls and 6.0 years more for boys girls than in the years 1991 to 1993. Differences in life expectancy between the old Länder and the new Länder (each excluding Berlin) are to be seen only among newborn boys. This difference amounts to 1.4 years.
The main cause of premature mortality in 2018 was malignant tumours, accounting for 37.0% of premature deaths, followed by cardiovascular diseases at 20.1%. At 8.9%, fatalities due to external causes, such as accidents, poisoning and suicide, were also a significant factor. Diseases of the digestive and respiratory systems contributed with figures of 7.0% and 5.9% respectively. Since 1991, the share of malignant tumours and diseases of the respiratory system among all causes of death have increased by 11.2% and 47.1% respectively. In contrast, there have been decreases in the shares of cardiovascular diseases (-35.4%), external causes (-19.0%) and diseases of the digestive system (-8.3%).
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 a important influence on mortality rates. Health expenditure rose to EUR 391 billion in 2018. This was EUR 15 billion or 4.0% higher than in 2017. This expenditure corresponds to 11.7% of Germany’s gross domestic product. It is equivalent to an annual amount of EUR 4,712 per head of population, compared with EUR 4,545 in 2017.