site.btaGovernment Health Report: Bulgaria Improves on Key Health Indicators Despite Remaining Behind EU Averages

The 2024 Annual Report on the State of Citizens’ Health shows that Bulgaria is improving on key health indicators but still remains behind EU averages, said the Council of Ministers press centre after the Government approved the report on Wednesday. 

The data from the report show that in 2024 the birth rate is decreasing, but the crude birth rate (8.3‰) exceeds the EU average (8.2‰). The average age of women at the birth of their first child in 2024 is 27.6 years, and in regional terms it varies from 22.1 in Sliven Region to 30.9 in Sofia (capital) Region.

A positive trend is observed in life expectancy, which is rising again and reaching 75.6 years, linked mainly to the fading impact of the COV1D-19 pandemic. Life expectancy in the European Union is 81.4 years.

The trend of declining mortality continues (15.6 per 1,000 people, compared with 15.7‰ for 2023, 18.4‰ for 2022 and 21.7‰ for 2021), but despite this Bulgaria continues to have the highest crude mortality rate among EU countries (average 10.8‰).

A positive trend is also reported in treatable and preventable mortality, which are also decreasing (194.13%ооо in 2024 compared with 212.97%ооо in 2020 and 276.58%ооо compared with 316.48%ооо in 2020).

The most common cause of death is diseases of the circulatory system (60.7%), followed by cancer (17%).

The level of infant mortality (4.5‰) also continues to decrease, approaching the EU average of 3.3‰. This indicator reflects the quality of medical care, but it is heavily influenced by living standards and the population’s health culture.

A decrease in the incidence of malignant neoplasms is recorded (391.6%ооо for 2024, 406.5%ооо for 2023 and 405.6%ооо for 2022), which remains significantly lower than in 2019 (434.9%ооо). The highest incidence is of cancer of the male reproductive organs (92%ооо), breast cancer in women (89.4%ооо) and cancer of the digestive organs (8.7%ооо).

The number of individuals assessed and re-assessed with permanent reduced work capacity/type and degree of disability is significant, reaching 193,793 people in 2024, compared with 182,789 in 2023. The highest relative share is among people aged over 60 (51.4%), followed by those aged 50–59 (27.3%).

The analysis of key indicators for monitoring the implementation of the National Health Strategy 2030 shows a positive trend regarding overall, infant and premature mortality; life expectancy at birth; healthy life years at birth; life expectancy, and others. As regards indicators for mortality from circulatory diseases, ischemic heart disease, acute myocardial infarction and cerebrovascular disease, a positive downward trend is also observed. The reasons for this may include improvements in lifestyle, environmental factors, the quality of health care, and the introduction of new technologies for early diagnosis and treatment.

The overall findings on the state of public health show that Bulgaria lags behind EU Member States, with chronic non-communicable diseases remaining a serious challenge, as they are a major cause of disability, reduced work capacity and death. In 2024, a large number of measures were implemented to improve the quality of health services and the efficiency of the healthcare system, but it should be taken into account that the real results of measures in the health sector are reflected in the long term.