Indicators of avoidable mortality provide a general “starting point” to assess the effectiveness of public health and health care systems in reducing premature deaths from various diseases and injuries, but further analysis is required to assess more precisely different causes of potentially avoidable deaths and possible interventions to reduce them.

Diseases such as measles, diphtheria, pertussis and influenza are highly infectious and spread through human contact, while the hepatitis B virus is transmitted by contact with blood or body fluids of an infected person, by sex or from mother to child. Effective vaccination is available to prevent all these infectious diseases. All EU countries have established childhood vaccination programmes, contributing to reducing many deaths related to these diseases, although the number and type of vaccines vary to some extent across countries.

Across EU countries, delivering health care that is patient-centred is becoming a priority in health care policy. Given the importance of utilising people’s voice for developing health systems and improving quality of care, national efforts to develop and monitor patient-reported measures have been intensified in recent years. In many countries, responsible organisations have been established or existing institutions have been identified for measuring and reporting patient experiences. These organisations develop survey instruments for regular collection of patient experience data and standardise procedures for analysis and reporting. An increasing number of countries collect not only Patient-Reported Experience Measures (PREMs) but also Patient-Reported Outcome Measures (PROMs) which collect patients’ perception on their specific medical conditions and general health, including mobility, pain/discomfort and anxiety/depression, before and after a specific medical intervention (OECD, 2018).

Mortality due to coronary heart diseases has declined substantially over the past few decades (see indicator “Mortality from circulatory diseases” in ). Important advances in both public health policies, including reductions in smoking and improved treatment for heart diseases, have contributed to these declines (OECD, 2015). Clinical practice guidelines such as those developed by the European Society of Cardiology have helped optimise treatment. Despite these advances, acute myocardial infarction (AMI or heart attack) remains the leading cause of cardiovascular deaths across European countries, making further improvements a priority.

Across EU countries, some 610 000 stroke events occurred in 2015 and the number is expected to rise by one-third by 2035 due to population ageing and increases in some risk factors (King’s College London, 2017). Stroke is the second leading cause of death after heart disease (see the indicator “Mortality from circulatory diseases” in ), and is also the second leading cause of disability after depression.

The main risk factors for hip fractures are associated with ageing, including an increased risk of falling and loss of skeletal strength from osteoporosis. With increasing life expectancy, it is anticipated that hip fractures will become an even greater public health issue in the coming years.

More than 100 000 women in EU countries are diagnosed each year with cervical cancer (see indicator on “Cancer incidence” in ). Cervical cancer is highly preventable if precancerous cells are detected and treated before progression occurs. The human papilloma virus (HPV) is found in over 90% of cervical cancers (European Commission, 2018), and vaccination against the main types of HPV responsible for cervical cancer is expected to reduce incidence.

Breast cancer is the most frequent cancer among women across EU countries, with more than 400 000 cases diagnosed each year across EU countries (see indicator “Cancer incidence” in ). The main risk factors for breast cancer are age, genetic predisposition, oestrogen replacement therapy, and lifestyle factors including obesity, physical inactivity, nutrition habits and alcohol consumption.

Colorectal cancer is the second most common cause of cancer deaths after lung cancer among men, and the third most common cause of cancer deaths after breast and lung cancers among women across EU countries (see indicator “Mortality from cancer” in ). The main risk factors for colorectal cancer include age, ulcerative colitis, a personal or family history of colorectal cancer or polyps, and lifestyle factors such as a diet high in fat and low in fibre, physical inactivity, obesity, tobacco and alcohol consumption. The incidence of colorectal cancer is significantly higher among men. Generally, rectal cancer is more difficult to treat than colon cancer due to a higher probability of spreading to other tissue, recurrence and postoperative complications.

The prevention and management of infectious diseases such as the Human Immunodeficiency Virus (HIV) and tuberculosis remain a high priority in many European countries. The EU is committed to play an important role in achieving target 3.3 of the United Nations’ Sustainable Development Goals, which is to end the epidemics of Acquired Immunodeficiency Syndrome (AIDS), tuberculosis and other communicable diseases by 2030 (European Commission, 2018).

The European Centre for Disease Control estimates that 3.7 million people acquire a healthcare-associated infection each year in acute care hospitals in EU countries and Norway and Iceland (Suetens et al., 2018), and an estimated 90 000 people in the EU die each year due to the six most common infections in health care settings (Cassini, 2016). At least 20% of healthcare-associated infections are considered to be avoidable through better infection prevention and control (Harbath, 2003).