10 percent more deaths than expected in 2021

© Hollandse Hoogte / ANP Kippa
In 2021, nearly 171 thousand deaths were recorded. This is 16 thousand (10 percent) more than the expected number for last year. Mortality was elevated in every age group. Excess mortality was lower among people using long-term care (Wlz) relative to the rest of the population. The provinces of Flevoland, Zeeland and Limburg in particular recorded more excess deaths. In 2021, life expectancy was approximately the same as in 2020. Statistics Netherlands (CBS) reports this on the basis of provisional annual figures.

Excess mortality over a one-year period is a recurring phenomenon. It was slightly higher in 2021 than in 2020, the first year of the COVID-19 pandemic, when it stood at over 15 thousand. Although influenza epidemics also cause excess mortality, these are mostly followed by a period of undermortality, resulting in lower excess mortality over the year. Excess mortality occurred in several periods of the years 2020 and 2021. There was no undermortality.

Excess mortality
JaarExcess mortality (x 1,000)
2011-1.154
20124.366
20130.079
2014-4.300
20155.394
20160.954
20171.673
20182.478
2019-1.670
202015.276
2021*15.952
* provisional figures

Excess mortality in all age groups

There were more deaths than expected across all age groups. Since more deaths were recorded among elderly people, the number of excess deaths among elderly was also higher than in the younger age groups. However, relative to expected mortality, the excess mortality was not very different among the various age groups. This relative excess mortality was lowest among the over-90s (7 percent) and highest among people aged 65 to 79 years (14 percent).

Compared to 2020, excess mortality was higher in the age groups 50 to 64 years and 65 to 79 years. In the latter group, 6.5 thousand more deaths occurred than expected, versus 5.5 thousand in 2020. In the group aged 50 to 64, the relative excess mortality was significantly higher at 11 percent than in the previous year. Over 1.6 thousand more people died than expected for this age group in 2021, against nearly 500 more in 2020.

Mortality higher than expected among men in particular

In 2021, male mortality was slightly higher than female mortality. The female mortality rate is normally higher as there are relatively more women among the elderly population. Among men, mortality was over 11 percent higher than expected; among women, 9 percent. Male and female mortality were both approximately equal to 2020.

Lower excess mortality among long-term care users

In 2021, there were approximately 63 thousand deaths among recipients of long-term care (Wlz). This is over 5 thousand (9 percent) higher than expected for this group. Among the rest of the population, there were 108 thousand deaths; this is slightly under 11 thousand (11 percent) more than expected. Long-term care recipients include relatively more elderly and more women than the rest of the population.
The relative excess mortality among long-term care users was lower than in 2020; the reverse was true for the rest of the population.

Relative excess mortality among users of long-term care (Wlz)
 Long-term care users (%)Rest of the population (%)
202014.07.5
2021*9.410.8
* provisional figures

Highest relative excess mortality in Flevoland, Zeeland and Limburg

In 2021, higher than expected mortality was recorded in the provinces of Flevoland (20 percent), Zeeland (16 percent) and Limburg (14 percent) in particular. Relative excess mortality was lowest (6 percent) in the GGD regions of Kennemerland and Amsterdam.

In 2020, Flevoland and Limburg also recorded relatively high excess mortality, while it was very limited in Zeeland. In that year, relatively more deaths than expected occurred in GGD regions located in eastern Noord-Brabant and southern Gelderland as well as in the GGD regions of Zaanstreek/Waterland and Rotterdam-Rijnmond.

Excess mortality by GGD region, 2021*
GGD-regioExcess mortality 2021* (%)
GGD Groningen7.9
GGD Drenthe10.6
GGD IJsselland8.4
GGD Regio Twente11.9
GGD Noord- en Oost-Gelderland10
Veiligheids- en Gezondheidsregio Gelderland-Midden12.1
GGD Gelderland-Zuid13
GGD Flevoland20.3
GGD Regio Utrecht9.2
GGD Hollands-Noorden12.4
GGD Kennemerland6.3
GGD Amsterdam6.1
GGD Gooi en Vechtstreek8.3
GGD Hollands-Midden8.8
GGD Rotterdam-Rijnmond7.7
Dienst Gezondheid & Jeugd ZHZ13.3
GGD Zeeland16.3
GGD West-Brabant9.8
GGD Hart voor Brabant11
GGD Brabant-Zuidoost9.2
GGD Limburg-Noord14.6
GGD Zuid-Limburg14.1
GGD Haaglanden7.4
GGD Frysl�n9.7
GGD Zaanstreek/Waterland12.8
* provisional figures
Excess mortality by GGD region, 2020
GGD-regioExcess mortality 2020 (%)
GGD Groningen0.4
GGD Drenthe5.6
GGD IJsselland10
GGD Regio Twente10.5
GGD Noord- en Oost-Gelderland10.3
Veiligheids- en Gezondheidsregio Gelderland-Midden9.8
GGD Gelderland-Zuid12.4
GGD Flevoland13
GGD Regio Utrecht9.1
GGD Hollands-Noorden7.9
GGD Kennemerland7
GGD Amsterdam5.8
GGD Gooi en Vechtstreek8.2
GGD Hollands-Midden10.2
GGD Rotterdam-Rijnmond13.8
Dienst Gezondheid & Jeugd ZHZ12
GGD Zeeland2.8
GGD West-Brabant10
GGD Hart voor Brabant19.3
GGD Brabant-Zuidoost14.2
GGD Limburg-Noord12.6
GGD Zuid-Limburg13.2
GGD Haaglanden8.3
GGD Frysl�n1.1
GGD Zaanstreek/Waterland14.1

Life expectancy approximately the same in 2021

A summary indication of mortality in a given year is the period life expectancy. This figure represents the number of remaining years a person is expected to live, based on the number of deaths by age for that year. In 2021, the period life expectancy at birth was 79.7 years for men and 83.0 years for women. For men this is the same as the year before, for women one month less. Relative to 2019 - the last pre-pandemic year - life expectancy was 9 months lower for men and 7 months lower for women. On average, life expectancy rises gradually from year to year.

Despite the declines in 2020 and 2021, the coronavirus pandemic will not have an adverse effect on the rising trend in life expectancy which has been taking place for many years. Life expectancy recovered rapidly just after previous periods with elevated mortality such as the ‘Spanish flu’ 1918 influenza pandemic and the Second World War. Therefore, the CBS population forecast is still based on the assumption that, in a number of years, life expectancy will again be more or less be the same as in the forecast made before the COVID-19 pandemic.

COVID-19 mortality known for the period up to August inclusive

The figures on (excess) mortality are based on municipal death records as received by CBS on a daily basis. These reports do not contain any information about the cause of death. CBS receives such information at a later stage via death cause certificates. The cause of death is known for all deceased persons up to and including August 2021. According to these figures, 11,881 people died of COVID-19 in the period January - August 2021 (11 percent in the total number of deaths over that period), as was reported by CBS on 3 January 2022. In 2020, the total number of COVID-19 deaths stood at 20,173 or 12 percent of total annual mortality.