Premature mortality from leading causes of death in the FBiH: a Years of Life Lost analysis

This study examines the burden of leading causes of death in the Federation of Bosnia and Herzegovina (FBiH) using both death counts and Years of Life Lost (YLL). Because YLL captures premature mortality, it offers a stronger basis for public health priority-setting than death counts alone. The aim was to identify the main contributors to premature mortality and support targeted health interventions. Sub-national mortality data for 2024 were obtained from the Institute for Statistics of FBiH. Causes of death were classified according to ICD-10. YLL and YLL per 100,000 population were calculated using the Global Burden of Disease (GBD 2021) standard life table, stratified by age, sex and cause of death. Cardiovascular diseases (9,361 death) accounted for 45.7% of all deaths, representing the largest share of premature mortality. Acute myocardial infarction (I21) was the leading cause, contributing 43,913 YLL (62% in males) and 2,047 YLL rate, followed by cerebral infarction (I63) with 27,118 YLL (1,264 YLL rate). Lung cancer (C34) ranked third, contributing 22,138 YLL, with a markedly higher burden in males. Across all leading causes, males consistently exhibited higher YLL. While cardiovascular diseases dominate in terms of number of deaths, their relative contribution to total YLL is lower compared to causes such as lung cancer, reflecting that deaths from cardiovascular conditions occur at older ages, whereas cancers contribute disproportionately to premature mortality. Premature mortality in FBiH is dominated by cardiovascular diseases with a disproportionate burden among males. The high YLL attributable to these causes underscores the need for strengthened primary prevention, particularly addressing modifiable risk factors such as smoking and hypertension, alongside improved early detection and disease management. YLL-based prioritization provides a robust basis for focusing public health resources on conditions with the greatest impact on population health.

Key messages

• A small number of largely preventable conditions (cardiovascular diseases and lung cancer) account for the majority of premature mortality in FBiH.

• The substantially higher YLL in males indicates critical gaps in prevention and risk factor control, particularly for smoking and cardiovascular risk.