Back to top
Eurostat logo
National reference metadata Information message

Sweden

Reference metadata describe statistical concepts and methodologies used for the collection and generation of data. They provide information on data quality and, since they are strongly content-oriented, assist users in interpreting the data. Reference metadata, unlike structural metadata, can be decoupled from the data.

For more information, please consult our metadata website section.

Close

Causes of death (hlth_cdeath)

DownloadPrint

National Reference Metadata in Single Integrated Metadata Structure (SIMS)

Compiling agency: [SE1] Statistics Sweden (SCB)

Need help? Contact the Eurostat user support

Data on causes of death (CoD) provide information on mortality patterns and form a major element of public health information.

CoD data refer to the underlying cause which - according to the World Health Organisation (WHO) - is "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury".

CoD data are derived from death certificates. The information provided in the medical certificate of cause of death is mapped to the International Statistical Classification of Diseases and Related Health Problems (ICD).

8 December 2025

Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.

The statistical units are the deceased persons and the stillborns, respectively.

Residents and non-residents who have died in the country and stillbirths.

Sweden or death among Swedish citizens, regardless of where the death occurs

Data refer to the calendar year (i.e. all deaths occurring during the year).

There is no recent assessment of the overall accuracy. Comparisons between hospital discharge records and the cause of death indicates that the overall accuracy of the cause of death register is good, see Unexplained differences between hospital and mortality data indicated mistakes in death certification: an investigation of 1094 deaths in Sweden during 1995.

Medical advances give doctors new and better opportunities to decide the cause of death, which contributes to increased accuracy in diagnosis. New methods and changes in diagnostic policy can also lead to ill-judgments which previously was often undiagnosed now more clearly seen in the statistics or vice versa. For example, new diagnostic methods and criteria to be part of the explanation for the large increase in dementia diagnoses seen in recent decades, although other causes are also possible. Changes in medical terminology is also reflected in the statistics. Examples include heart attack unlikely that diagnostic terminology in the early 1900s. The diagnosis came into general use after the Second World War, and myocardial infarction and other ischemic heart disease is now the leading cause of death.
Changes in administrative conditions can also affect the statistics. Since 1991 the majority of deaths that occurred outside the hospital are no longer forensically examined. New regulations also gave families a greater opportunity to refuse clinical autopsy. This may have contributed to an increase in the proportion of deaths with incompletely specified cause of death.

The unit is number.

The physician fills in the cause of death certificate and send it to the National Board of Health and Welfare where the cause of death is coded according to the WHO regulation by cause of death coders.

Information about the death, cause of death and previous surgeries etc, is collected from death certificates. Other information like region of residence and country of birth is collected from the civil register. Information on stillbirths is collected from the medical birth registry.

Annual.

Year

Number of months between the end of the reference year and the publication at national level

2011

  7

2012

  8

2013

  14

2014

  8

2015

  8

2016

  9

2017

  10

2018

  9

2019

  6

2020

  7

2021

  7

2022

  6

2023

  9

 

 

Since June 2015 region of occurence is collected and included in the Swedish cause of death register. In the data for 2023, approximately 1,8 percent of the deaths lack information about the region of occurence. The region of the event is calculated based on the region of occurence, but where no information is available the the regional residence is used, unless the the death took place outside Sweden. In the latter region of occurence is stated as unknown. The process is nationally coordinated by the National Board of Health and Welfare, inkluding data collection and coding.

Note that due to the fact that 2011 data is the first data collection with a legal basis (and few changes in the requested variables and breakdowns), the data between 1994-2010 and starting from 2011 are not always comparable (In part due to the different groupings of causes of deaths). Moreover time series for data on stillbirths starts in 2011 and no information on previous data is available.

As the reliability of mortality data comparability is affected over time by several factors. The most important are changes in diagnostic methods and medical concepts, changed the routine collection of cause of death data, new revisions of cause of death classification and amended rules for the classification of the underlying cause of death.


Revisions to the cause of death classification

Changes in medical theory and epidemiological interests means that cause of death classifications must be revised at intervals. Comparability over time is hampered not only by the diagnostic groups and diagnostic concepts are changing in connection with audits and other updates cause of death classifications, but also by changes in the rules for the classification of the underlying cause, see Table F.

 

Table F. Cause of death classification in Sweden

Time period Cause of death classification
1911-1930 Swedish division into 99 groups
1931-1950 Swedish division into 188 groups
1951-1957 ICD-6
1958-1968 ICD-7
1969-1986 ICD-8
1987-1996 ICD-9
1997- ICD-10

 

Each new classification is more detailed than before. New medical discoveries and theories can lead to diseases transferred from one division to another. One example is the HIV / AIDS in the ICD-9 were classified in Chapter IV (diseases of the blood and blood-forming organs) and ICD-10 Chapter I (certain infectious and parasitic diseases). Alzheimer's disease is another example of ICD-9 were classified in Chapter V (Mental Disorders) and ICD-10 Chapter VI (diseases of the nervous system).
In order to assess the effects of change classifications - both that diagnoses moved and that the classification rules changed - a selection of about 25,000 certificates for 1996 were coded according to both ICD-9 and ICD-10. For 4% of deaths were moved on the underlying cause of death from one chapter to another. According to the grouping in the abbreviated European Cause of Death List (65 groups) 7% ​​of deaths got a different cause of death in ICD-10 than in ICD-9. Some groups were affected more strongly than others. A description of the causes of death whose frequency is particularly affected by classification changes is at 2001 Cause of Death publication entitled Guidance on individual tables (table 1).


Updates to ICD-10
Unlike previous revisions of the ICD updated ICD-10 continuously. Decisions of updates are made by the directors of the international classification-center which WHO collaborates with. Proposal of updates prepared by the Update Reference Committee, which consists of experts nominated by the different classification-centres. A special group of experts, Mortality Reference Group, in charge of proposals concerning the classification of causes of death.
Updates apply to both specific codes in ICD-10 and the classification rules. Codes can be added or removed or and content of individual code groups can change. Changes in the rules for the classification of causes of death can lead to a death that were recorded in a certain group of ICD after the update are classified elsewhere. A full account of the changes agreed to be found on the WHO website for ICD-10.


Analysis of shifts in statistics

Shifts in the statistics due to new diagnostic methods and concepts are difficult to identify, especially as changes usually comes gradually and are difficult to distinguish from such changes in pattern of causes of death that depends on an amended illness or injury patterns. However, the displacements due to new revisions of the ICD or change of classification practice can usually be recognized in that they occur suddenly. If a specific cause of death suddenly switch level, the explanation is thus probably a change in cause of death classification or classification routines.
The multiple causes of death may give some indication of a change for a particular underlying cause of death due to revised classification rules or have other causes. If the number of occurrences of the cause of death as multiple cause of death is stable but the number of cases in which the cause of death recorded as underlying cause of death changed the explanation is likely that the classification rules changed. If, however, both the number of multiple and underlying causes of death has changed is the explanation of another.