Worrying report: Romania ranks first in the EU in deaths from treatable causes / The most common conditions

For every 100,000 Romanians, 215 die, on average, from treatable causes, according to the report “State of Health in the EU. Romania – Country Health Profile 2025”, recently published by the European Commission and the Organization for Economic Cooperation and Development.

• Mortality figures from treatable causes are almost 2.5 times higher than the European Union average, which is 90 deaths per 100,000 inhabitants.
• Romania continues to allocate the least amount of money for health care per capita among EU countries, something felt by patients when they have to make payments directly out of pocket, most frequently for medicines.
• And bribes remain a reality in the medical system: almost one in ten Romanians made an additional payment, offered a valuable gift to the medical staff or donated money to a hospital.

Avoidable deaths

Ischemic heart disease, pneumonia and stroke were the leading causes of treatable deaths in our country.

The report distinguishes between deaths from treatable causes and deaths from preventable causes. Mortality from treatable causes is considered an indicator of the efficiency of the health system, while mortality from preventable causes is considered an indicator of the effectiveness of public health prevention policies. Both categories are considered indicators of avoidable deaths.

In terms of mortality from preventable causes, Romania has the third highest rate in the European Union, with 304 deaths per 100,000 inhabitants – almost double the European Union average of 168 preventable deaths per 100,000 inhabitants.

Ischemic heart disease, alcohol-related conditions and lung cancer were the main causes.

“Romania has one of the highest avoidable mortality rates in the European Union, with preventable and treatable deaths far exceeding the European Union averages. Recent initiatives aim to improve early detection and care for some treatable causes of mortality, but the measures designed to address primary prevention and behavioral risk factors remain limited”, states the report in “State of Health in the EU. Romania – Country Health Profile 2025”.

One in three deaths in Romania, attributed to behavioral factors and pollution

Behavioral and environmental risk factors are considered responsible for more than a third of all deaths in Romania, according to the “State of Health in the EU” report.

About 29% of all deaths recorded in our country in 2021 could be attributed to behavioral risk factors, such as smoking, dietary habits (for example, high levels of sugar and salt consumption, together with low fruit and vegetable consumption), alcohol consumption and low physical activity.

Romania recorded one of the highest levels of alcohol consumption in the EU in 2023 (12.3 liters per adult), an increase of almost 30% in the last decade – contrary to the downward trend in most other EU countries.

Among Romanian adolescents, 17% of 15-year-olds reported drinking alcohol more than once in 2022, with a higher prevalence among boys (19%) than among girls (14%).

Romania has introduced a limited number of measures to combat the harmful consumption of alcohol, such as regulations on alcohol advertising and a ban on the sale of alcohol to persons under 18 years of age.

We consume too few vegetables and fruits

In addition, poor nutrition and physical inactivity are the main factors contributing to overweight and obesity. Romanians have one of the lowest fruit and vegetable consumption in the EU: in 2022, only 38% of adults ate fruit daily (compared to an EU average of around 60%), and a similar proportion (37%) reported eating vegetables daily (also compared to an EU average of 60%).

Only around one in five adults practiced physical activity more than three times a week in 2022 – the fourth lowest figure among EU countries.

Also, air pollution, in the form of ozone and exposure to fine particles (PM2.5), accounted for an additional 6% of overall mortality, a figure higher than in most European Union countries.

The least money allocated to health

Per capita health spending in our country remains the lowest in the EU – 5.8% of GDP, compared to 10% of GDP, the European Union average.

The amount for health allocated by the Romanian state was, on average, 1,800 euros per capita – less than half of the European Union average, which is 3,832 euros.

Despite repeated promises to increase public funding, the share of government spending allocated to health has decreased in recent years in Romania, the report states.

The document recalls that, until this year, 19 categories were exempt from paying the contribution to health insurance in Romania, among them are children, students, pensioners, people with chronic conditions, people with disabilities, the unemployed, but also workers in construction, agriculture and the food industry with monthly gross incomes of up to 2,000 euros.

The exemptions were limited following the package of austerity measures imposed by the Government starting from the summer of 2025. The Health Insurance Company expects that, after the application of the austerity measures, the base of contributors to health insurance will increase by about a third in the coming years.

Romanians bear more than half of the expenses for medicines out of their pockets

77% of health expenditure in our country is financed from public sources, while private funding accounted for the remaining 23% of health expenditure, almost entirely through direct payments. The share of direct payments is increasing, from 19% in 2019 and above the EU average of 16%.

In direct payments, the largest share is spent on pharmaceutical products.

The report shows that public health funding generally covers hospital and outpatient care (polyclinics) but is limited for drug costs and dental care.

In 2023, for example, public funding covered almost all hospital care in Romania and 77% of outpatient care.

Less than half of drug expenditure was publicly funded and public coverage of dental care costs was five times lower than the European Union average.

Almost 60% of direct out-of-pocket expenditure was on medicines (more than double the EU average), 18% on dental care and 9% on outpatient care.

The report shows that high out-of-pocket payments, especially for drugs and dental care, are important barriers for low-income people to accessing health care.

In 2024, 6% of Romanians with medical care needs had unmet needs due to costs, travel distance or waiting times, representing one of the highest rates in the European Union.

Income disparities are stark, according to the report: unmet needs among people at risk of poverty were nearly three times higher than among the general population.

One in ten Romanians give up when they go to the doctor

Informal payments remain a reality in the Romanian health system and also contribute to the increase in out-of-pocket expenses: 9% of Romanians reported that they made an additional payment, gave a valuable gift to medical staff or donated money to a hospital in 2023: three times more than the European Union average.

The report notes that in recent years, Romania has taken measures to reduce informal payments, through awareness campaigns for both medical staff and patients.

The number of doctors has increased, but their migration remains a problem

The number of doctors and nurses in our country has increased in recent years, but the migration of medical personnel to other countries, as well as the uneven geographical distribution in Romania, remain a problem.

In 2023, there were 3.7 doctors per 1,000 inhabitants in Romania, compared to an EU average of 4.3 doctors and 8.2 nurses per 1,000 inhabitants, compared to 8.5 nurses, the European Union average.

Romania has increased the number of doctors and nurses in the last decade, thanks to larger cohorts of medical and nursing graduates.

But their geographical distribution on the territory of the country is uneven, the majority preferring big cities. Also, retaining medical personnel remains a challenge in Romania, given that, in other EU countries, salaries are higher and working conditions are better.

Life expectancy, 5 years below the EU average

Life expectancy in Romania fell sharply during the pandemic, but began to recover in 2022 and reached a new historical record of 76.6 years in 2024.

However, life expectancy in our country remains 5.1 years below the European Union average.

There is also a large difference between the sexes: men live, on average, 72.8 years and women 80.4 years.

The gap is higher than the EU average of 5.2 years. This is particularly attributed to higher exposure to risk factors among men, such as smoking and excessive alcohol consumption.

Cardiovascular disease and cancer continue to be the leading causes of death, accounting for nearly three-quarters of all deaths.