Romania – Health Issues

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

Cardiovascular diseases and cancer are the foremost causes of mortality in Romania, together responsible for close to three-quarters of all deaths. While this pattern is shared across much of Eastern Europe, Romania carries a disproportionately heavy burden relative to the broader EU average.

In 2021, the leading causes of death per 100,000 people in Romania included ischaemic heart disease, stroke, hypertensive heart disease, lower respiratory infections, tracheal, bronchial and lung cancers, cirrhosis of the liver, colon and rectum cancers, chronic obstructive pulmonary disease, and kidney diseases. This wide spectrum of conditions reflects both entrenched lifestyle habits and the strains placed on the national healthcare infrastructure.

The rate of cardiovascular disease in Romania is markedly elevated compared to the EU average. To tackle these enduring disparities, the Romanian government adopted a 2024–2030 National Strategy to Fight Cardiovascular and Cerebrovascular Diseases, placing emphasis on prevention, early identification of risk factors, and improved treatment pathways.

Deaths attributable to external causes and to infectious and parasitic diseases are more prevalent in Romania — at 4–5% — than in other EU member states. Cirrhosis also represents a major driver of premature death; in 2013, the mortality rate from cirrhosis stood at 40.8 per 100,000 people, with the majority of fatal cases linked to hepatitis C infection and alcohol consumption.

It is estimated that around one in five Romanians lives with a communicable or chronic disease. Geographical inequalities further compound the picture: people in rural areas tend to experience worse health outcomes and have considerably less access to specialist medical care than those in urban hubs such as Bucharest, Cluj-Napoca, and Timișoara.

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

According to preliminary Eurostat figures, Romania recorded the second-lowest life expectancy in the European Union in 2024, at 76.6 years — surpassed only by Bulgaria, which stood at 75.9 years.

Eurostat’s preliminary 2024 data places average life expectancy at birth across the EU at 81.7 years, with the highest figures recorded in Italy and Sweden (both 84.1 years) and Spain (84.0 years). Romania’s 76.6 years therefore falls roughly five years below the EU mean — a substantial difference by any standard.

In 2024, life expectancy was 72.8 years for men and 80.4 years for women in Romania — a gender gap of 7.6 years, which is wider than the EU average of 5.2 years. This disparity is partly explained by greater exposure to risk factors among men, including higher rates of smoking and heavy alcohol use.

Romania did, however, register one of the greatest improvements in life expectancy relative to pre-pandemic levels, gaining 1.0 years — placing it alongside Lithuania, Czechia, and Latvia at the top of this particular measure within the EU. This positive trajectory reflects real progress, even if the baseline remains comparatively low.

Romania records one of the highest rates of avoidable mortality among OECD nations, pointing to persistent weaknesses in both preventive public health and healthcare delivery. The number of healthy life years for Romanians aged 65 is less than half the EU average. For the most current figures, readers are encouraged to consult the WHO Romania country profile and Eurostat.

Romania placed 37th globally for SDG 3 (Good Health and Well-being) progress, achieving a score of 77.67 according to the SDG Transformation Center’s 2025 report. Notably, most Romanians rate their own health as good — a self-assessment that actually exceeds the EU average.

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

Romania carries a higher burden of certain infectious diseases than many Western European nations, and expats arriving from regions where these conditions are uncommon should familiarise themselves with the local health environment before making the move.

Romania ranks among the top three countries in Eastern Europe for tuberculosis (TB) incidence, with some figures suggesting approximately 30,000 people are infected. TB is considerably rarer in many Western European countries, making this one of the more notable infectious disease contrasts for incoming expats. Anyone who believes they may have been exposed, or who develops persistent respiratory symptoms, should seek medical evaluation without delay.

Roughly 3.7% of Romania’s total population is either a carrier of or directly affected by hepatitis, with hepatitis B and C being the predominant forms. The majority of fatal cirrhosis cases in Romania are associated with hepatitis C and alcohol use. Verifying that your hepatitis B vaccination is current before relocating is strongly advisable.

Romania has experienced two significant measles outbreaks in the past decade — during 2017–2019 and again in 2023–2024 — driven by a sustained decline in measles vaccination uptake among children. Coverage rates are worryingly low, posing a risk to unvaccinated individuals of any age. Confirming that your MMR (measles, mumps, rubella) vaccination is up to date is a sensible and straightforward precaution.

Tick-borne encephalitis (TBE) and Lyme disease are present in Romania’s forested and rural landscapes, particularly in the Carpathian mountain range and areas near the borders with Ukraine and Moldova. Anyone planning hiking trips or extended time in the countryside should use effective insect repellent, wear long-sleeved clothing, and thoroughly check for ticks after outdoor activities. A TBE vaccine is available and is worth discussing with a travel health specialist prior to your move.

More than a third of deaths in Romania are associated with behavioural risk factors, and environmental hazards also play a role: poor nutrition, tobacco use, and air pollution are all identified as significant contributors to mortality. Air quality in Bucharest and other large cities can deteriorate markedly during winter, when coal-burning heating systems and motor vehicle emissions combine to elevate pollution levels. The European Environment Agency publishes up-to-date air quality data for Romanian cities, which is worth monitoring regularly.

Tap water in major urban centres is generally regarded as safe for consumption, though standards can fall short in rural areas and smaller settlements. Many urban residents choose bottled water as a precaution regardless. Before travelling or moving, consult the Romanian Ministry of Health website and your home country’s official travel health advisory for the latest vaccination recommendations and disease alerts.

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

The number of active smokers in Romania was estimated at 4.1 million as of 2024. The adult smoking rate — recorded at 18.7% in 2019, the most recently available data at the time of reporting — was modestly below the average of neighbouring EU nations but remained well above the OECD average of 14.8%.

The gap in smoking rates between men and women is pronounced, with men smoking at approximately four times the rate of women. Despite legislative efforts to curb tobacco use, smoking prevalence remains elevated, especially among younger age groups — something expats will likely observe in everyday social and outdoor settings.

Smoking is banned on public transport and in virtually all enclosed public spaces and indoor workplaces. The law recognises only two exceptions to this prohibition: detention facilities and designated rooms in the transit zones of international airports. This sweeping ban derives from Law No. 349/2002 on tobacco prevention and was considerably reinforced by Law No. 15/2016 on smoking in enclosed public spaces.

Over the past decade, Romania has taken meaningful steps to reduce tobacco use, including the comprehensive indoor smoking ban, the prohibition of advertising for tobacco products and electronic cigarettes, and the introduction of graphic health warnings on cigarette packaging. Electronic cigarettes and heated tobacco products are governed by Law No. 209/2018.

A 2016 study by the Romanian Institute for Evaluation and Strategies (IRES) found that 25% of Romanians smoke regularly, while 79% expressed support for the smoking ban. Public sentiment broadly favours the indoor prohibition, and compliance in restaurants, bars, and public buildings is generally consistent. That said, smoking remains a conspicuous feature of outdoor and semi-enclosed spaces, and expats accustomed to more stringent tobacco control environments may find the ambient exposure to cigarette smoke higher than expected.

As part of broader fiscal health policy, the Romanian government has introduced a phased tax increase on tobacco products scheduled to take effect across the three-year period from 2024 to 2026.

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

Unhealthy diets and insufficient physical activity are growing public health concerns in Romania, with obesity figures that — depending on the measurement approach — place the country either on par with or above the EU average.

Using 2019 OECD data (the most recent available), more than two-thirds (67%) of Romanian adults were classified as overweight or obese, against an OECD average of 54%. WHO/Europe’s European Health Report 2024 cites Romania’s adult obesity rate as the highest within the EU in 2022, at 34%, based on model-derived estimates using measured height and weight — a methodology that reduces the self-reporting bias inherent in survey data.

Overweight rates among adolescents are also elevated relative to most OECD countries, with one in four 15-year-olds reporting being overweight or obese in 2022. In the same year, only around one in five adults engaged in physical activity more than three times per week. Low levels of physical activity contribute directly to the high burden of cardiovascular disease described earlier.

Traditional Romanian cooking is substantial and often centred on meat, featuring dishes rich in animal fats, salt, and refined carbohydrates. While this reflects a vibrant culinary heritage, it can heighten the risk of cardiovascular disease and metabolic disorders when not offset by regular exercise and an adequate intake of fresh produce. In cities such as Bucharest, Cluj-Napoca, and Timișoara, the range of healthier dining options, fitness facilities, and wellness services has expanded considerably in recent years.

In response to poor dietary habits across the general population and among young people in particular, the Romanian government has recently introduced a tax on sugar-sweetened beverages and has prohibited the sale of foods high in fat, salt, and sugar in and around school premises. A central pillar of the country’s prevention strategy is the “riskogramme” — a screening questionnaire that allows primary care physicians to assess patients aged 40 and over for a range of conditions and risk factors, including cardiovascular disease, cancer, diabetes, kidney disease, and high cholesterol.

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

Reported rates of mental illness and unmet mental healthcare needs appear low in Romania relative to EU norms, but this is likely a reflection of cultural stigma obscuring the true scale of need rather than genuinely better mental health outcomes. Historically, mental health difficulties have carried social stigma in Romania, and many individuals may be reluctant to seek professional assistance or discuss their struggles in work or social environments.

The most commonly diagnosed mental health conditions in Romania are anxiety and depressive disorders. During the COVID-19 pandemic, Romanians living in households experiencing financial hardship faced roughly double the risk of depression compared to those without such difficulties — a pattern observed internationally but particularly acute in Romania given existing socioeconomic pressures.

Mental healthcare in Romania is predominantly delivered through hospital-based settings, though there are plans to develop community services and broaden access to care. This stands in contrast to systems in countries such as Germany or the Netherlands, where community-based mental health provision, outpatient therapy, and integration with primary care are more mature. In Romania’s public system, access to a psychiatrist typically requires a referral, and waiting times can be considerable.

Private mental health services are available and expanding, especially in major cities. Expats who are not fluent in Romanian may find it more straightforward to obtain care through private clinics, some of which provide consultations in multiple languages. Bucharest, in particular, has a growing number of licensed psychologists and psychiatrists who offer sessions in English and other languages.

The Estuar Foundation, in partnership with Mental Health Europe, has developed an interactive platform that maps free mental health support services available throughout Romania — a practical starting point for anyone unsure where to seek help.

For expats, the transition to a new country, language, and social context can itself generate stress and anxiety. Actively building social networks, connecting with expat communities, and acquainting yourself with local resources before arrival can make a tangible difference to mental wellbeing during the adjustment period.

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

Expats relocating to Romania encounter a distinct set of health considerations that may differ considerably from what they have been used to at home. Being well-prepared can substantially reduce avoidable risk.

1. Register with a family doctor (medic de familie): Romania’s public healthcare system requires residents to enrol with a local family physician (equivalent to a GP) in order to access state-funded services. Expats covered by the national social health insurance (SHI) should complete this registration as soon as possible after arriving. The SHI is funded through mandatory social insurance contributions made by working residents. Those who are employed in Romania are typically enrolled automatically; self-employed individuals and retirees should clarify registration requirements with the National Health Insurance House (CNAS).
2. Ensure vaccinations are up to date: Before moving, review your immunisation record for hepatitis A, hepatitis B, MMR (measles, mumps, rubella), diphtheria-tetanus-polio, and tick-borne encephalitis (if you anticipate time outdoors). Romania has experienced two major measles epidemic waves within the past decade, in 2017–2019 and 2023–2024, driven by low childhood vaccination coverage.
3. Arrange comprehensive health insurance: Healthcare access remains a challenge in Romania, with nearly 5% of the population unable to obtain needed care due to cost and availability. High out-of-pocket expenses and a shortage of healthcare professionals — many of whom emigrate — compound the problem. Expats are strongly advised to hold private health insurance, particularly during any initial period before SHI contributions make them eligible for full public coverage.
4. Be aware of air quality: Urban air quality — especially in Bucharest — can deteriorate significantly during winter months. Individuals with asthma, COPD, or other respiratory conditions should monitor air quality indices and take appropriate steps during periods of elevated pollution.
5. Adjust to the climate: Romania experiences a continental climate characterised by harsh winters — temperatures can drop well below freezing, particularly in Transylvania and Moldavia — and hot, humid summers. Those coming from warmer or more temperate climates should be mindful of the risk of cold-related illness in winter and heat-related illness in summer, particularly in cities where the urban heat island effect can amplify temperatures.
6. Food and water safety: Tap water in major cities is generally safe, but quality can vary by region. In areas where quality is uncertain, bottled or filtered water is advisable. Exercise caution with unpasteurised dairy products and ensure meats are thoroughly cooked, particularly in rural settings.
7. Take precautions against tick-borne diseases: Anyone planning to hike, camp, or spend extended time in forests or rural areas should take preventive measures against ticks. A TBE vaccination is recommended for those who will spend considerable time outdoors. Check carefully for ticks after any outdoor activity and consult a doctor promptly if flu-like symptoms or a characteristic bull’s-eye rash develop following a tick bite.

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

Identifying trustworthy, current health information is essential both before and after your move. The sources below represent the most important official and practical references for expats in Romania.

• Romanian Ministry of Health (Ministerul Sănătății): The principal government body overseeing public health policy in Romania. Their website at ms.ro publishes official health guidelines, disease notifications, vaccination schedules, and updates on public health programmes. Content is primarily in Romanian, though browser translation tools can render most documents accessible.
• National Institute of Public Health (Institutul Național de Sănătate Publică — INSP): The INSP tracks infectious disease trends, environmental health risks, and national health statistics. Its reports constitute an authoritative source of disease surveillance data within Romania. Visit insp.gov.ro.
• National Health Insurance House (Casa Națională de Asigurări de Sănătate — CNAS): The administrative body for Romania’s public health insurance scheme. Expats who are employed or otherwise contributing to the social insurance system can find information on entitlements, registration procedures, and benefits at cnas.ro.
• WHO Romania Country Profile: The WHO country page for Romania offers current health statistics, mortality data, and SDG progress indicators, providing a valuable international benchmark for understanding Romania’s health landscape.
• European Centre for Disease Prevention and Control (ECDC): The ECDC tracks infectious disease outbreaks across Europe, including those occurring in Romania. Country-specific pages and disease surveillance reports are available at ecdc.europa.eu and are kept regularly updated.
• Your home country’s travel health advisory: Before relocating, review official travel health guidance issued by your home country’s foreign affairs or public health authority. These typically cover recommended vaccinations, current disease alerts, and any health-related entry requirements. Examples include the UK’s NHS Fit for Travel, Germany’s RKI, and the US CDC Traveler’s Health pages.
• Expat communities and forums: Online expat networks — such as InterNations Bucharest and various Facebook groups for expats in Romania — can offer candid, first-hand guidance on locating English-speaking doctors, navigating the insurance system, and accessing private healthcare.

Health guidelines, vaccination requirements, disease alerts, and official health policies are subject to change. Always verify current information through official channels before and after relocating. Romania is channelling a substantial portion of EU Recovery and Resilience Facility and Cohesion Policy funding into modernising hospitals, enhancing patient safety, and expanding digital health infrastructure. These developments mean Romania’s health landscape is in active transition, making it all the more important to stay informed through official sources.

Frequently Asked Questions About Health Issues in Romania

Is Romania safe to move to from a health perspective?

Romania is broadly safe to live in, and a great many expats maintain good health there. That said, the country has higher incidences of cardiovascular disease, tuberculosis, and measles than much of Western Europe. Keeping your vaccinations current, registering with a local doctor promptly on arrival, and securing comprehensive health insurance are the most important steps you can take to safeguard your health.

Do I need any vaccinations before moving to Romania?

No vaccinations are mandatory for entry into Romania, but several are strongly recommended. These include hepatitis A, hepatitis B, MMR (measles, mumps, rubella), diphtheria-tetanus-polio, and tick-borne encephalitis (TBE) for those intending to spend time in forested or rural areas. Always verify the latest guidance with your home country’s travel health authority and the Romanian Ministry of Health before travelling.

Is the tap water safe to drink in Romania?

In Romania’s principal cities — including Bucharest, Cluj-Napoca, and Timișoara — tap water is treated and generally considered safe to drink. Water quality is less consistent in rural locations and smaller towns, and many residents prefer bottled or filtered water regardless of location. If you are uncertain, particularly in the early stages after arrival, using bottled water until you can confirm local water quality is a sensible precaution.

How does air quality in Romania compare to other European countries?

Poor diet, tobacco smoking, and air pollution are all recognised as significant contributors to mortality in Romania. Urban air quality — particularly in Bucharest — tends to worsen during winter as a result of vehicle traffic, industrial activity, and heating systems burning solid fuels. Those with asthma, COPD, or other respiratory conditions should track air quality data via the European Environment Agency’s website and take appropriate precautions when pollution levels are elevated.

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

Mental healthcare in Romania is primarily delivered through hospital settings, with expansion of community-based services still under development. Public provision is conducted overwhelmingly in Romanian. Private clinics in larger cities — Bucharest especially — are increasingly offering psychological and psychiatric consultations in English and other languages. Expats are encouraged to research available providers before arriving and to confirm whether their health insurance policy extends to mental health treatment.

Is smoking a problem in public spaces in Romania?

Smoking is prohibited on public transport and in virtually all indoor public places and indoor workplaces in Romania. The indoor ban has been in operation since 2016 and is generally enforced consistently. Smoking does, however, remain a common sight in outdoor areas, and expats from countries with more comprehensive tobacco control measures may encounter a higher overall prevalence of smoking in public life.

How do I access public healthcare in Romania as an expat?

Expats employed in Romania who contribute to the social health insurance (SHI) system are entitled to publicly funded healthcare. The initial step is to register with a family doctor (medic de familie) in your locality. In 2024, 11% of the population remained outside the SHI, including individuals living abroad or not enrolled in the social security system. Expats who are not yet covered should arrange private health insurance to bridge any gap in entitlement. The National Health Insurance House (CNAS) at cnas.ro can supply up-to-date information on eligibility and the registration process.

Is tuberculosis a real risk for expats in Romania?

Romania has the third-highest tuberculosis rate among Eastern European countries. While the risk to a healthy adult living in an urban environment is relatively modest, TB is considerably more prevalent in Romania than in most Western European countries. Expats working in healthcare, social services, or other roles involving close contact with vulnerable populations should be aware of this elevated risk and discuss TB screening with their doctor if they have any concerns. The merits of the BCG vaccination are worth exploring with a travel health professional before relocating.