Causes of Death and Years of Life Lost in Romania, 1980–2023: An Analysis of GBD 2023 Mortality Estimates

Background/Objectives: We examined cause-specific mortality and years of life lost in Romania during 1980–2023 against estimates for the Global Burden of Disease (GBD) regions of central, eastern and western Europe. Methods: This national ecological study used GBD 2023 estimates and published aggregated civil-registration tables. We analysed deaths, years of life lost, age-standardised and age-specific rates, grouped mean age at death and the probability of death before age 70. An exact endpoint decomposition separated population-size, age-structure and age-specific-rate contributions. Counterfactual counts applied comparator rates to Romania’s population. Results: Between 1980 and 2023, the all-cause age-standardised death rate fell 38.7% in Romania, 42.5% in central Europe, 28.8% in eastern Europe and 48.4% in western Europe, whereas Romanian deaths increased 7.8%. Between 1980 and 2023, the male probability of death before age 70 fell from 44.2% to 38.1% in Romania and from 37.8% to 19.4% in western Europe. The age-standardised neoplasm death rate increased from 125.2 (95% uncertainty interval 121.9–128.8) per 100,000 in 1980 to 139.9 (133.6–144.5) in 2023. In 2023, western European rates applied to Romania’s population yielded 95,237 fewer deaths, 87,165 of them from cardiovascular diseases. Conclusions: Romania’s remaining mortality gap with western Europe was concentrated in cardiovascular diseases. For several cancers, the derived contributions to the probability of death before age 70 had higher point estimates in 2023 than in 1980, and the grouped mean age at death was below the value produced by western European rates; these measures have no propagated uncertainty intervals.