Belgium – Health Issues

What are the most common health issues and diseases in Belgium?

As in most affluent Western European nations, Belgium’s overall disease burden is driven primarily by non-communicable conditions rather than infectious illnesses. Cardiovascular diseases and cancer collectively account for close to half of all deaths recorded in the country. These two broad categories sit at the centre of both public health policy and national preventive screening efforts.

The six conditions most frequently reported by the Belgian population include three musculoskeletal complaints — low back disorders, neck disorders, and arthrosis — alongside two cardiovascular risk factors (elevated blood pressure and high blood cholesterol) and allergy. These figures are drawn from Belgium’s regular Health Interview Surveys, which chart how population health evolves over time.

In 2020, Belgium recorded an estimated 15,676 cases of acute myocardial infarction (AMI), with 53% occurring in men. In 2021, the number of people diagnosed with an acute stroke was estimated at 18,550, equivalent to 161 cases per 100,000 inhabitants, though the age-adjusted incidence of acute stroke decreased in both men and women between 2016 and 2021.

Between 2001 and 2018, the proportion of people reporting a chronic disease climbed from 25% to 29%. While population ageing explains part of this trend, the rise persists even after adjustment for age, indicating that other factors are also at play. There are marked regional differences as well: the age-adjusted share of self-reported chronic conditions is higher in the Walloon Region (33%) than in the Flemish Region and Brussels (27% and 31% respectively).

Projections to 2040 suggest that mental health conditions, musculoskeletal disorders, and chronic respiratory diseases will continue to impose the heaviest burden on Belgian society. Anxiety disorders in particular are forecast to climb dramatically — from sixth to second place in the overall disease burden ranking by 2040.

Cancer incidence in Belgium is 33% higher in men than in women. Prostate, lung, and colorectal cancer are the most prevalent malignancies among men, while breast cancer heads the list for women. Belgium compares favourably with many countries internationally on five-year cancer survival rates, reflecting the quality and reach of its oncology services.

Is Belgium considered a healthy country? How do health outcomes compare internationally?

In 2024, life expectancy at birth in Belgium stood at 82.4 years — 4.1 years higher for women (84.4 years) than for men (80.3 years). This places Belgium almost a full year above the EU average, firmly situating the country among the healthier nations in Europe by this measure.

At the regional level in 2024, life expectancy was greatest in the Flemish Region at 84.1 years, followed by the Brussels-Capital Region at 82.1 years, and lowest in the Walloon Region at 80.7 years. A clear socioeconomic gradient is also evident, with those in higher socioeconomic groups living noticeably longer than those in lower ones.

In 2022, healthy life expectancy in Belgium was 63.7 years, compared with an EU27 average of approximately 61.3 years. This means Belgians can expect to spend a relatively high number of years in good health, even though a meaningful gap between total and healthy life expectancy still remains.

Belgium’s overall life expectancy sits slightly above the EU average, although the country experienced a notable decline in 2020 as a consequence of the COVID-19 pandemic. By 2023 and 2024, figures had recovered strongly, climbing to their highest point on record and surpassing the pre-pandemic 2019 level.

Preventable and treatable causes of mortality in Belgium are below the EU average — an encouraging indicator of how well the country’s public health and healthcare systems are functioning. The WHO country profile for Belgium and Healthy Belgium (Sciensano’s official health status platform) are updated regularly and are the best sources for the latest figures.

What infectious diseases or environmental health risks should expats be aware of in Belgium?

By global standards, Belgium carries a low burden of infectious disease. Tap water is clean, food safety systems are robust, and sewage and sanitation infrastructure is reliable and well maintained. Most expats relocating from other high-income countries will encounter an infection risk environment that feels broadly familiar.

For the majority of vaccine-preventable diseases, incidence in Belgium has fallen sharply since routine immunisation programmes were introduced. However, outbreaks still occur when vaccination coverage is insufficient in particular communities or geographic areas. A significant measles outbreak took place in 2024, predominantly affecting unvaccinated schoolchildren in Brussels — a vivid reminder of how critical high population-level immunity remains. Expats should confirm that their measles, mumps, and rubella (MMR) vaccination is current before or shortly after arriving.

In 2024, there were 662 newly diagnosed HIV cases in Belgium, with considerable variation between regions. Adjusting for population size, Brussels has a notably higher HIV incidence rate of 16 per 100,000 inhabitants, compared with rates of around 7–8 per 100,000 in the Flemish and Walloon Regions.

Following the introduction of polio vaccination in 1956 and its mandatory status from 1967, the disease was effectively eliminated domestically. Since 2002, the European Region has been certified polio-free by the WHO, and the risk of an epidemic in Belgium remains low given sustained high vaccination coverage. Belgium has also received WHO certification for having eliminated rubella through its vaccination programme.

Air quality is an important environmental health consideration, especially in cities. Across Europe, air pollution continues to generate substantial health and economic costs through shortened lives and increased demand on healthcare services. Particulate matter, nitrogen dioxide, and ground-level ozone are the pollutants of greatest concern for human health. Brussels and other industrial centres can record elevated pollution levels; the European Environment Agency’s Belgium air pollution fact sheet is updated annually and provides a reliable reference.

No specific vaccinations are required for entry into Belgium, but expats are advised to be current on all routine immunisations, including influenza, diphtheria, tetanus, polio, and MMR. Always consult the travel health guidance from your home country’s public health authority — as well as the Belgian public health platform and Sciensano — before relocating, since recommendations can be updated at any time.

Is smoking common in Belgium, and what are the laws around it?

By 2024, approximately 21.7% of adults in Belgium smoked cigarettes. This figure places Belgium broadly on a par with many of its Western European neighbours, and the overall trend has been downward over recent decades thanks to sustained public health campaigns and increasingly stringent legislation.

E-cigarettes occupy a distinct legal category in Belgium — they are lawful to sell and to use, but online sales are restricted. Vaping has gained traction, especially among younger adults, though it is subject to the same restrictions on use in public spaces as conventional tobacco products.

Belgium has steadily tightened its tobacco laws over the years. Smoking has been prohibited in all enclosed workplaces and public buildings for well over a decade. Restaurants, bars, and all other hospitality venues have been entirely smoke-free since a ban was extended across the sector by 2011. Smoking is also forbidden in and around schools, hospitals, and public institutions. Tobacco advertising is banned, and plain packaging requirements have been enacted in line with EU directives. By the standards of some Southern and Eastern European countries, where indoor smoking in hospitality settings remains more common, Belgium’s regime is strict and consistently enforced.

Tobacco use, alongside dietary risks and alcohol consumption, is identified as a major driver of avoidable mortality in Belgium. Both the federal government and regional health bodies operate cessation support programmes. If you smoke and are planning to move to Belgium, be aware that while smoking in private residences or personal outdoor spaces remains lawful, indoor venues where smoking is permitted are now extremely rare.

Is obesity or poor diet a significant health concern in Belgium?

Based on direct measurements of height and weight, the adult obesity rate in Belgium rose from 19% in 2014 to 21% in 2018. This upward trajectory mirrors trends observed across much of Western Europe and reflects a combination of dietary patterns, increasingly sedentary lifestyles, and socioeconomic influences. Belgium’s obesity rate is broadly similar to several neighbouring countries, though it remains well below levels recorded in countries such as the United States or the United Kingdom.

Belgian cuisine enjoys an international reputation for richness — frites, waffles, chocolate, and an extraordinary range of beers are among its most celebrated exports — and while this culinary tradition is a genuine source of national pride, it also describes a diet that can be high in saturated fat, refined carbohydrates, and alcohol. Specific dietary risks flagged in public health assessments include insufficient fruit and vegetable consumption and excessive intake of sugar-sweetened beverages, both of which contribute to preventable mortality in Belgium.

Excessive alcohol consumption is recognised as a significant public health concern. Spirits may only be sold to those aged 18 and over, while other alcoholic beverages can be sold to those aged 16 and over. Alcohol misuse is linked to liver disease, cardiovascular complications, and road traffic injuries, and remains a focus of ongoing public health intervention.

Both federal and regional authorities have introduced a range of initiatives to encourage healthier eating and greater physical activity, including nutrition education in schools, subsidies for sports club membership, and investment in cycling infrastructure. Belgium — Flanders in particular — has among the highest rates of commuter cycling in Europe, providing a meaningful counterweight to broader sedentary trends in the population.

What are the mental health attitudes and services like in Belgium?

Mental health ranks among the conditions generating the greatest disease burden in Belgium, and public awareness of the issue has grown considerably in recent years. Attitudes in Belgium broadly reflect those seen across Northern and Western Europe — stigma persists but is diminishing, and there is increasing openness to conversations about psychological wellbeing, particularly among younger cohorts.

Rates of anxiety and depressive disorders rose sharply during the pandemic years before declining in mid-2024 to 17% and 15% respectively. Throughout the post-pandemic period, anxiety disorders have consistently figured among the most commonly reported mental health conditions in the country.

A public mental health system exists, but timely access to care is a well-documented challenge. Waiting times for both psychologists and psychiatrists within the public sector can be considerable. Reimbursement for mental health services is more restricted than for acute medical care, though accessibility has improved following a reform that extended partial state coverage to outpatient psychological consultations with accredited psychologists for the first time — making private therapy meaningfully more affordable for many residents.

Compared with countries such as the Netherlands, which has embedded primary-level psychological care directly within general practice, Belgium’s mental health provision is more fragmented and uneven. That said, private psychological and psychiatric services are available across most cities, and many practitioners in Brussels and other major expat centres see patients in multiple languages. Expats dealing with adjustment difficulties, social isolation, or occupational stress are encouraged to seek help proactively rather than waiting for a referral through public channels.

Sciensano incorporates surveillance of suicidal thoughts and behaviours into Belgium’s national mental health monitoring, tracking these data across different age groups. Dedicated crisis helplines provide immediate support, and the federal health authorities continue to fund and develop suicide prevention programmes.

Are there any health risks specific to expats living in Belgium?

Belgium does not pose exotic or tropical disease risks for the vast majority of incoming expats, but there are several practical health considerations worth understanding before and after relocation. The country has a temperate maritime climate — mild, frequently overcast, and notably wet — which can come as a genuine shock to those accustomed to sunnier or drier environments. Seasonal affective disorder (SAD) and vitamin D deficiency are widespread during the prolonged grey winter months, and expats from regions with more sunlight may notice the absence of it affecting their mood, energy, and overall wellbeing.

Respiratory conditions such as asthma and chronic bronchitis can worsen in Belgium’s climate and urban air quality context. Particulate matter, nitrogen dioxide, and ground-level ozone — the pollutants of greatest concern for human health — can reach elevated concentrations in and around Brussels, Antwerp, Ghent, and Liège. Expats with pre-existing respiratory conditions are advised to monitor local air quality data regularly and discuss management plans with a doctor.

Social isolation is a significant but frequently underestimated risk factor for expats. Belgian social culture can feel reserved, particularly in Flanders, and establishing a genuine local network takes time. Loneliness and the stress of adjustment are known to affect physical as well as mental health, making early engagement with expat communities, local clubs, or language classes a sound investment.

Here are practical steps to protect your health on arrival:

1. Register with a mutuality (sickness fund): Compulsory social health insurance covers most Belgian residents (99%), who are affiliated to a sickness fund of their choice or to the public auxiliary fund. Register as soon as you have your residency documents to access subsidised healthcare.
2. Find a general practitioner (huisarts/médecin généraliste): Register with a local GP early. Unlike some systems, Belgium does not operate strict gatekeeping, so you have direct access and free choice of physician and healthcare facility, but having a regular GP is important for coordinated, ongoing care.
3. Check and update your vaccinations: Ensure your routine vaccinations are current, particularly MMR, tetanus, and influenza, before or shortly after arrival.
4. Arrange health insurance if not immediately eligible for social insurance: Some categories of expat (such as those on short-term contracts or not yet registered) may need supplementary private health insurance to cover the gap period.
5. Get a vitamin D check: Ask your GP about vitamin D levels, especially if arriving from a climate with more sunlight. Deficiency is common in Belgium, particularly in winter.
6. Seek mental health support if needed: If you experience adjustment difficulties, do not wait for a public referral — private psychologists in major cities often see patients relatively quickly and many work in multiple languages.

Where can expats find reliable health information and services in Belgium?

Belgium’s public health landscape is served by a well-established network of official institutions, most of which publish material in several languages. The key sources for accurate, current health information are set out below.

• Healthy Belgium (healthybelgium.be): Sciensano’s official health status reporting platform. It publishes detailed, regularly updated data on diseases, life expectancy, risk factors, and health system performance across Belgium and its regions. This is the most comprehensive official source for population health data.
• FPS Health, Food Chain Safety and Environment (health.belgium.be): The Federal Public Service for Health is the national ministry responsible for health policy. It publishes legislation, public health guidance, and information relevant to expats and residents.
• Sciensano (sciensano.be): Belgium’s national public health institute, responsible for epidemiological surveillance, infectious disease monitoring, and health surveys. A key source for outbreak alerts and vaccination guidance.
• RIZIV/INAMI (riziv.fgov.be): The National Institute for Health and Disability Insurance administers Belgium’s compulsory health insurance system. Essential reading for understanding what healthcare costs are reimbursed and how.
• WHO Belgium Country Profile (data.who.int): The World Health Organization maintains country-level health data for Belgium, including mortality statistics and health system indicators.
• Your home country’s travel health authority: Before relocating, check the official travel health advice from your home country’s public health agency (such as the CDC, NHS travel health, or equivalent), as they may have specific vaccination recommendations or health advisories for Belgium.

Health regulations, vaccination schedules, reimbursement rules, and outbreak information are all subject to change. Always verify current details with official Belgian sources before and after your move. The figures cited throughout this article should be read as a guide — consult Sciensano and the FPS Health website for the most up-to-date data available.

Frequently Asked Questions About Health Issues in Belgium

Is the tap water safe to drink in Belgium?

Yes. Tap water across Belgium complies with EU drinking water standards and is safe to consume throughout the country. The water treatment and distribution network is well maintained, and purchasing bottled water is purely a matter of personal preference rather than a health necessity.

Do I need any vaccinations before moving to Belgium?

Belgium imposes no mandatory vaccination requirements for entry or residency. Nevertheless, you are strongly encouraged to confirm that your routine immunisations are up to date — particularly MMR (measles, mumps, rubella), tetanus, diphtheria, and polio. A notable measles outbreak struck in 2024, primarily hitting unvaccinated schoolchildren in Brussels, and serves as a clear illustration of why maintaining current vaccinations matters. Consult your home country’s health authority and Sciensano for the latest guidance.

Is Belgium a good country for people with chronic illnesses?

Compulsory social health insurance covers 99% of Belgian residents, which means access to specialist care, medications, and hospital treatment is generally well subsidised. Belgium has strong oncology, cardiology, and chronic disease management services. Out-of-pocket costs do exist — particularly for dental and some specialist care — so supplementary insurance is worth considering.

What is the biggest public health concern in Belgium?

Cardiovascular disease and cancer together account for close to half of all deaths in Belgium. Lifestyle-related risk factors — in particular tobacco use, dietary patterns, physical inactivity, and excessive alcohol consumption — are the principal drivers of preventable mortality. Mental health is increasingly prominent as a concern, with anxiety disorders projected to rise substantially in the coming decades.

Are mental health services available in English or other languages in Belgium?

Yes, especially in Brussels and other large cities with substantial expat communities. Many psychologists and psychiatrists in urban settings offer consultations in English, French, Dutch, and additional languages. Brussels’ international character makes multilingual mental health support considerably more accessible there than in smaller towns. Your GP can provide a referral, or you can search directly through professional bodies such as the Belgian Federation of Psychologists.

How does Belgium’s healthcare system compare to other European countries?

Belgium’s healthcare system is built on the principles of independent medical practice, freedom of choice regarding both physician and healthcare facility, and direct access without mandatory gatekeeping. In contrast to systems like those in the Netherlands or the UK — where a GP referral is typically required before seeing a specialist — Belgian patients can consult a specialist directly. This flexibility is a considerable advantage, though it also means that individuals carry greater personal responsibility for navigating and coordinating their own care.

Is air pollution a health concern in Belgium?

Air pollution remains a meaningful health concern across Europe, particularly in cities. Particulate matter, nitrogen dioxide, and ground-level ozone are the pollutants with the greatest impact on human health. Brussels, Antwerp, and other industrial urban centres can record elevated concentrations of these pollutants. The European Environment Agency publishes annual country-specific air quality reports for Belgium. Individuals living with asthma or other respiratory conditions are especially advised to keep an eye on local air quality data.

What is the regional health divide in Belgium?

In 2024, life expectancy was highest in the Flemish Region at 84.1 years, followed by the Brussels-Capital Region at 82.1 years, and lowest in the Walloon Region at 80.7 years. The age-adjusted proportion of self-reported chronic diseases is also greatest in the Walloon Region (33%) compared with the Flemish and Brussels Regions. These disparities primarily reflect underlying socioeconomic inequalities rather than differences in healthcare quality alone, and addressing them remains an ongoing focus of Belgian public health policy.