Germany – Health Issues

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

Diseases of the circulatory system were responsible for the greatest share of deaths in Germany in 2022, trailed by cancer and mental or behavioural disorders. This pattern closely mirrors other high-income European nations and reflects the compounding effects of changing lifestyle habits across generations, a progressively older population, and the mounting toll of long-term chronic illness.

Across both sexes, hypertension, hyperlipidaemia, chronic back pain, obesity, and osteoarthritis rank among the most widespread individual health conditions, all of which become more prevalent with advancing age. Cardiometabolic and musculoskeletal disorders together form the two most dominant disease categories across all age and gender groups, and the most frequently observed combinations of conditions include cardiovascular and musculoskeletal disease alongside depression, sensory impairment, and cancer.

Breast cancer was the most frequently diagnosed malignancy in Germany in 2022, accounting for more than 75,000 cases — or 14.2% of all new cancer diagnoses — followed by prostate and colorectal cancer. While not the most commonly diagnosed type, lung and bronchial cancer claimed the highest number of lives, at 45,200 deaths.

The upward trajectory of Alzheimer’s disease and other forms of dementia is especially notable, underscoring how critical it is for public health monitoring to track disease incidence and prevalence alongside broader trend estimates. Deaths attributable to Alzheimer’s disease climbed from 6,000 in 2000 to 35,000 in 2014.

Germany also shows meaningful regional variation in health outcomes. Bremen, Saarland, and the former East German federal states record higher prevalence and mortality rates for major cardiovascular conditions and shorter average lifespans. These disparities are rooted in longstanding socioeconomic differences between the former East and West Germany, though the gap is slowly closing over time.

Research from the Institute of Health Metrics’ Burden of Disease study identifies the six principal risk factors driving mortality and disability in Germany as elevated blood pressure, smoking, obesity, high blood glucose, poor diet, and excessive alcohol use, with air pollution occupying tenth place on the list.

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

Germany’s overall life expectancy stood at roughly 81.5 years in 2024 — 83.5 years for women and 78.7 years for men. Although these figures place Germany well ahead of many countries worldwide, a closer look reveals a more complicated picture when set against its immediate European neighbours.

Cross-country comparisons within Europe show that Germany occupies a middle position for life expectancy. Relative to other Western European nations, Germany records higher mortality among middle-aged and older adults, and the gap in life expectancy between Germany and its Western European peers has actually widened over the past two decades — a finding that concerns both researchers and those responsible for health policy, especially given the sophistication of Germany’s healthcare infrastructure.

Despite ranking third among OECD nations in per-capita health expenditure and operating a highly advanced healthcare and social support system, Germany’s overall life expectancy remains comparatively modest, driven primarily by elevated cardiovascular mortality. Both Germany and the United States significantly underperform on longevity relative to what their levels of health spending would predict, lagging behind countries that achieve greater longevity at equivalent or lower cost.

Available cross-national data also suggest that the German population tends toward relatively poor dietary habits — consuming less fruit and vegetables than recommended while eating more sugar and sweeteners than in peer countries. There is further evidence that German public health policy has historically been less assertive in targeting the risk behaviours most closely linked to poor health outcomes.

For the most current and authoritative statistics on Germany’s health indicators, expats should consult the WHO Germany country health profile and the Federal Statistical Office (Destatis). Both are updated on a regular basis and supply government-verified data. From 2026 onwards, readers should check these sources directly for revised figures on life expectancy, mortality, and disease prevalence.

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

As a high-income country with rigorous sanitation standards and clean drinking water, Germany keeps most serious infectious diseases firmly under control. Nevertheless, certain specific risks exist that expats — particularly those relocating from tropical or subtropical regions — should familiarise themselves with before and after their arrival.

Tick-borne diseases represent the most significant vector-borne health hazard in Germany. Ticks inhabiting forests, meadows, and parks can transmit two important illnesses: tick-borne encephalitis (TBE), a viral infection that targets the brain, and Lyme disease (caused by Borrelia bacteria). Elevated-risk zones include forested parts of Bavaria, Baden-Württemberg, Hesse, and the Rhine valley, as well as sections of eastern Germany. The Robert Koch Institute (RKI) releases updated TBE risk maps each year. Anyone planning regular outdoor activities in these regions is strongly advised to get vaccinated against TBE and to apply tick repellent routinely.

In Germany, vaccination recommendations are issued by the Standing Committee on Vaccination (STIKO), a federal advisory body whose guidance is compiled and disseminated by the Robert Koch Institute (RKI) in Berlin. Immunisation in Germany is voluntary and carries no formal legal mandate, although individual federal states generally follow STIKO’s recommendations and may extend them to address locally specific risks.

Standard vaccinations recommended for adults residing in Germany include those protecting against influenza (updated annually), tetanus, diphtheria, pertussis, measles, mumps, rubella, and hepatitis B. Expats whose home countries do not routinely administer some of these vaccines should review their immunisation records prior to relocating. Full guidance is available through the STIKO recommendations on the RKI website and from your home country’s travel health authority.

Air quality in Germany’s major urban centres can deteriorate due to traffic emissions, with nitrogen dioxide (NO₂) levels a particular concern in densely populated cities such as Stuttgart and Munich. Air pollution ranks tenth among Germany’s foremost health risk factors. People living with asthma or other respiratory conditions should track local air quality data both before arriving and on an ongoing basis, especially in heavily congested urban zones. The Federal Environment Agency (Umweltbundesamt) provides up-to-date readings. Tap water across Germany is safe to drink and fully complies with stringent EU standards.

Expats arriving from countries where malaria, dengue, or typhoid are endemic should note that none of these diseases circulate within Germany itself, though continued prophylaxis or health monitoring may still be pertinent for visits back to their country of origin. Always review the travel health guidance issued by your own national health authority before making any such trip.

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

Tobacco smoking remains more prevalent in Germany than in most other EU member states, and rates of cessation are lower despite a range of tobacco control measures introduced since the mid-2000s. Roughly 127,000 people in Germany die each year from causes directly attributable to smoking — a substantial public health burden that distinguishes Germany from many of its European counterparts.

Between 2003 and 2023, the proportion of adults who smoke declined from 32.1% to 28.8%, with the sharpest reductions observed among younger people and those with higher levels of education. However, this downward trend has decelerated in recent years, and smoking remains considerably more widespread than in countries such as Sweden, Norway, or the United Kingdom, where comprehensive indoor smoking bans coupled with robust cessation support have pushed rates substantially lower.

Judged against international benchmarks, Germany’s tobacco control efforts to date are relatively modest. This is reflected in the European Tobacco Control Scale — a comparative ranking of European countries by the rigour of their anti-tobacco policies — which consistently places Germany among the bottom five countries on the continent.

Smoking regulations in Germany are split between federal and state (Land) levels, which can be bewildering for newcomers. The introduction of the Non-Smoker’s Protection Act in 2007 marked a significant step forward in German tobacco policy, but its application has been inconsistent across the country. As of 2024, nearly 40% of the German population reside in the three states — Bavaria, North Rhine-Westphalia, and Saarland — that prohibit smoking in all restaurants, pubs, cafés, and nightclubs. The remaining 13 states permit smoking in designated rooms or in bars with a floor area under 75 square metres.

Outdoor advertising for tobacco products was eliminated from January 2022, followed by heated tobacco products from January 2023, and e-cigarettes from January 2024. Cinema advertising for tobacco was banned from 2021. Expats accustomed to stricter smoke-free environments — such as those in Ireland, Australia, or New Zealand, where blanket hospitality bans have long been in place — may find certain areas of Germany’s bar and restaurant scene noticeably smokier than they expect.

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

Obesity constitutes a major public health challenge in Germany. Adult obesity prevalence climbed from 12.2% in 2003 to 19.7% in 2023, rising across both sexes and throughout all age and education groups — a trend that health authorities are working to reverse. The World Obesity Atlas 2024 projects that the adult obesity rate in Germany will continue increasing by approximately 0.5% per year between 2020 and 2035.

Data drawn from the national GEDA (German Health Update) survey covering 2019 and 2020 reveal persistently high rates of overweight — affecting around 47% of all women and 61% of all men — with obesity itself present in approximately 19% of adults of both sexes. These numbers place Germany among the countries with higher obesity burdens in Western Europe.

On average, people in Germany consume fewer fruits and vegetables than nutritional guidelines recommend while eating relatively large quantities of sugar and sweeteners. Traditional German food culture tends towards hearty, meat-centred dishes, though cities such as Berlin, Hamburg, and Munich offer extensive international dining options and a rapidly expanding plant-based food scene. Expats from countries with Mediterranean-style eating habits or well-established public nutrition campaigns may notice a different food culture, particularly in smaller towns and rural communities.

The National Action Plan IN FORM was established to raise awareness of the links between nutrition, physical activity, and overall wellbeing, encouraging people to adopt healthier day-to-day habits. Germany also benefits from a well-developed cycling culture, with infrastructure in many cities and towns that makes embedding regular physical activity into daily life straightforward — a genuine practical advantage for expats keen to stay active.

The unbroken increase in obesity rates between 2003 and 2023 suggests that measures implemented to date have not been sufficient, and experts emphasise that meaningful progress will require not only individual behavioural change but also broad, population-level prevention strategies across multiple settings. Expats managing pre-existing weight-related conditions such as type 2 diabetes or high blood pressure should register promptly with a German general practitioner (Hausarzt) to ensure uninterrupted care.

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

Anxiety and depression are the mental health conditions most frequently encountered in Germany. Public awareness has grown considerably in recent years, and attitudes — especially among younger urban populations — are becoming more open and less stigmatising. That said, prejudice surrounding mental illness persists in some communities and professional environments, and expats may encounter varying levels of understanding depending on their social context.

Outpatient mental health care is delivered by an expanding network of office-based psychiatrists, neurologists, and psychotherapists operating within the ambulatory sector. Germany’s statutory health insurance system (Gesetzliche Krankenversicherung, or GKV) funds a broad range of mental health treatments, including psychotherapy, psychiatric consultations, and inpatient admission. This coverage is broadly comparable to what publicly funded systems such as Australia’s Medicare or Canada’s provincial health programmes provide — but as with those systems, translating theoretical entitlement into timely access is far from guaranteed.

Waiting times present a practical obstacle, and both the volume and quality of outpatient psychotherapeutic services vary — sometimes considerably — between localities and regions across the country. In some areas, patients may wait many months before beginning outpatient psychotherapy. Expats experiencing mental health difficulties are advised not to postpone seeking a referral from their Hausarzt (general practitioner), as early engagement with the system can help in managing wait lists.

Those covered by private health insurance (Private Krankenversicherung, or PKV) typically enjoy faster access to private psychiatrists and psychotherapists. Some expats — particularly those in higher income brackets or specific professions — may be eligible for or choose private coverage, which can substantially shorten waiting times for specialist mental health appointments.

Language poses an additional challenge for many expats. The public system operates primarily in German, although larger cities are home to a growing number of therapists able to work in other languages, particularly through private practices or international mental health directories. Resources such as the Expat Counselling network and therapist listings on platforms like Psychology Today Germany can assist expats in locating practitioners who work in their preferred language.

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

Germany does not present the kind of tropical or unusual environmental disease risks found in other parts of the world, but expats can face a distinct cluster of health challenges connected to relocation, cultural adaptation, and unfamiliarity with the local system. Understanding these risks in advance makes it possible to take concrete steps to safeguard your health from day one.

• Adapting to the climate: Germany experiences a temperate continental climate characterised by cold, overcast winters and warm summers. People arriving from warmer or tropical climates may find the prolonged grey winter months a demanding physical and psychological adjustment. Seasonal affective disorder (SAD) and vitamin D deficiency are real concerns for those unaccustomed to limited winter daylight. German doctors widely recommend vitamin D supplementation throughout the winter period.
• Tick exposure: Expats who hike, cycle, or spend time outdoors in forested or rural settings — particularly in southern Germany — should be alert to the risk of tick-borne encephalitis (TBE) and Lyme disease. Wearing long clothing, applying insect repellent, and carefully checking your skin for ticks after outdoor activities are all strongly recommended precautions. The TBE vaccine is advisable for anyone spending regular time in high-risk zones.
• Registering with a GP: Germany does not have a centralised national registration system comparable to the UK’s NHS. To access the statutory health system, expats must enrol with a statutory health insurer (Krankenkasse) and subsequently choose a local Hausarzt (GP). Completing this process promptly on arrival — rather than waiting until illness strikes — is strongly recommended. Your Hausarzt serves as the gateway to specialist referrals throughout the system.
• Expat mental health: Social isolation, language barriers, and the pressures of cultural adjustment are among the most commonly reported stressors for expats in Germany, especially during the first year. Germany’s life expectancy already trails that of comparable EU countries such as Italy, France, and Spain, and socioeconomic stress is a recognised contributor to health outcomes. Actively building social connections and seeking support early can make a meaningful difference to your overall wellbeing.
• Preventive health screenings: Germany’s statutory health insurance system provides routine preventive health check-ups (Gesundheitsuntersuchungen, or “Check-ups”) for adults at defined intervals — generally from age 35 onwards. These appointments cover blood pressure, blood glucose, cholesterol, and kidney function. Expats who have not had a thorough health assessment recently should ask their Hausarzt to arrange one shortly after registering.
• Insurance obligations: Health insurance is compulsory in Germany for all residents. Most employees are enrolled in statutory insurance automatically, while self-employed individuals and higher earners may choose private insurance instead. Confirming your coverage is active before attending your first medical appointment is essential.

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

Finding your way around health information in a new country can feel overwhelming, especially when most of it is available only in German. The resources listed below are authoritative, officially recognised, and practically useful for expats living in or preparing to move to Germany.

• Robert Koch Institute (RKI): Germany’s principal national public health authority, the RKI publishes guidance on infectious diseases, vaccination schedules, health monitoring, and disease surveillance. It is the definitive source for current epidemiological information in Germany and maintains an English-language section on its website.
• Federal Ministry of Health (Bundesministerium für Gesundheit): The Federal Ministry of Health covers healthcare policy, legislative developments, and the overall structure of Germany’s health system. It is an essential reference for understanding your rights and entitlements as a resident.
• Federal Centre for Health Education (BZgA): The BZgA coordinates public health awareness campaigns on subjects including smoking, nutrition, sexual health, and alcohol. It provides accessible information in several languages across a number of its topic-specific sub-sites.
• World Health Organization – Germany profile: The WHO Germany country page offers comparative international health data and is particularly useful for expats wishing to assess Germany’s health indicators alongside those of their home country.
• Federal Statistical Office (Destatis): Destatis publishes demographic and health statistics covering life expectancy and cause-of-death data, making it the go-to source for the most current official figures.
• Your Krankenkasse (health insurer): Statutory health insurers in Germany — including TK (Techniker Krankenkasse), AOK, and Barmer — offer health information portals, telephone nurse helplines, and app-based services. TK in particular has a well-developed English-language support offer and is widely used by the expat community.
• Home country travel health authority: Before relocating, consult your home country’s official travel health guidance for Germany. Relevant examples include the UK’s TravelHealthPro, Australia’s Smartraveller, or the CDC for US residents. These sources provide timely vaccination and health advice tailored to travellers and new residents.

Health information and regulations evolve over time. Vaccination guidance, disease alerts, screening eligibility criteria, and insurance rules should always be verified directly with official sources both before and after your move. Where specific figures — such as fees, thresholds, or processing timelines — are cited in this article, always refer to the relevant official source to confirm that the information remains current.

Frequently Asked Questions About Health Issues in Germany

Do I need any vaccinations before moving to Germany?

Germany does not require proof of vaccination as a condition of entry, but STIKO (the Standing Committee on Vaccination) advises all adults to ensure they are current on standard immunisations including measles, mumps, rubella, diphtheria, tetanus, pertussis, hepatitis B, and annual influenza. Those planning to spend time in forested or rural settings are also strongly advised to get vaccinated against TBE (tick-borne encephalitis). For the latest guidance, visit the RKI vaccination page and check with your home country’s travel health authority before you leave.

Is the tap water safe to drink in Germany?

Yes. Germany’s tap water is subject to some of the strictest regulation in the world, fully meeting all EU drinking water standards and undergoing continuous monitoring. You can drink freely from the tap anywhere in the country with complete confidence. Indeed, many Germans actively prefer tap water to bottled alternatives, both for environmental reasons and on grounds of taste.

How do I find a doctor as a new expat in Germany?

Once you have enrolled with a statutory health insurer (Krankenkasse), you may freely select any GP (Hausarzt) who accepts patients under your plan. Suitable doctors can be found through your Krankenkasse’s own online search tool, via the National Association of Statutory Health Insurance Physicians (KBV) doctor-finder, or through local expat community networks. In many larger cities you will find international clinics or GPs who are happy to consult in languages other than German.

Are there tick risks in Germany, and how can I protect myself?

Yes. Ticks are found across Germany, with the highest concentrations in forested and rural areas of Bavaria, Baden-Württemberg, Hesse, and the Rhineland. They are capable of transmitting tick-borne encephalitis (TBE) and Lyme disease (borreliosis). Effective precautions include wearing long clothing when walking through woodland or tall grass, applying tick repellent, and thoroughly inspecting your skin after any outdoor activity. The TBE vaccine is recommended for those who live in or regularly visit high-risk zones. The RKI publishes an annually updated TBE risk map at rki.de.

How easy is it to access mental health support in Germany?

Mental health treatment falls within the scope of statutory health insurance coverage in Germany, but outpatient psychotherapy waiting times can be considerable — in some cases several months or longer, particularly away from major cities. Your Hausarzt is the appropriate starting point: they can issue an initial referral and may know of local services worth considering. Holding private health insurance significantly shortens waiting periods. In larger cities, it is increasingly possible to find therapists who work in languages other than German; expat networks and online therapist directories are helpful tools for locating them.

Is air pollution a concern in German cities?

Air quality varies across Germany. Urban centres — Stuttgart and Munich in particular — have recorded elevated nitrogen dioxide (NO₂) concentrations attributable to road traffic. Germany has introduced low-emission zones (Umweltzonen) in numerous cities that restrict access for the most polluting vehicles. If you have asthma, COPD, or another respiratory condition, keep an eye on local air quality data via the Federal Environment Agency (Umweltbundesamt), which publishes current readings online. Across the country as a whole, air pollution occupies tenth place among Germany’s ranked health risk factors.

What is the biggest lifestyle health risk in Germany?

Germany’s own national burden-of-disease data identify the most significant modifiable risk factors for mortality and disability as elevated blood pressure, smoking, obesity, raised blood glucose, an unhealthy diet, and harmful alcohol consumption. Smoking in particular stands out: it is substantially more common in Germany than in many comparable European nations, and the country’s tobacco control legislation is considerably less stringent than that of countries such as Ireland or Australia. Expats should be prepared for the possibility of greater exposure to second-hand smoke in bars, cafés, and restaurants than they are accustomed to, depending on which German state they call home.

Does Germany have a free health check-up programme?

Yes. Under Germany’s statutory health insurance, adults aged 35 and over are entitled to a comprehensive general health check-up (Gesundheitsuntersuchung or “Check-up 35”) once every three years. Adults from the age of 18 are also entitled to a single check-up before reaching 35. These appointments typically include screening for cardiovascular disease, diabetes, and kidney disease. Expats who have recently arrived in Germany are encouraged to ask their Hausarzt about booking a check-up, especially if they have not undergone a thorough health assessment in the recent past.