Regional mortality inequalities and causes of death in the Republic of Moldova, 2014-2023

Abstract

This study examines the regional disparities in overall and cause-specific mortality trends in the Republic of Moldova between 2014 and 2023. Depersonalised individual death records and official post-censal population estimates were used to construct life tables and age-standardised death rates for major causes of death across four territorial units: the North, Center, South and the capital city, Chisinau. Changes in life expectancy were decomposed using Andreev's method. From 2014 to 2019, life expectancy in Moldova increased by 1.4 years, driven by reductions in cardiovascular mortality (0.5 years) among older adults and external mortality (0.4 years) among younger adults. Chisinau showed the greatest reduction in cardiovascular mortality; regions improved more in external causes. The COVID-19 pandemic had a severe impact, particularly on the best-performing regions, with life expectancy dropping by 3.8 years in Chisinau and 2.7 years in the North. In contrast, the Center and South, with lower pre-pandemic life expectancies, experienced less dramatic declines. Post-pandemic recovery (2021–2023) was marked by substantial improvements in life expectancy, primarily due to reductions in mortality from infectious and cardiovascular diseases, with Chisinau showing the largest rebound (4.47 years). Despite these recent improvements, regional disparities, especially in mortality from cardiovascular and digestive diseases, persist.