Understanding why people die, where mortality is rising, and which groups are most affected is essential for effective public health policy. In Kazakhstan, the years from 2014 to 2022 were a period of major change, including healthcare reforms, population growth, digitalization of health records, and the shock of the COVID-19 pandemic. Yet despite these shifts, a comprehensive national picture of mortality trends across this period has remained limited.

This research matters because mortality is more than a demographic statistic. It reflects the strength of health systems, the burden of disease, social inequality, and the wider conditions in which people live and work. By identifying patterns in mortality across regions, sexes, age groups, and causes of death, the study helps reveal where Kazakhstan’s health challenges are deepening and where intervention is most urgently needed.

A particularly important reason for this study is its potential to support better decision making. The findings point not only to the direct health impact of chronic disease and the pandemic, but also to possible weaknesses in cause of death reporting and regional inequalities in healthcare access and health determinants. Together, these insights provide a stronger evidence base for designing targeted public health responses.

To answer these questions, the researchers conducted a retrospective analysis of national mortality data from Kazakhstan’s Unified National Electronic Health System for the period 2014 to 2022. The dataset included more than 1.07 million death records, making this one of the most extensive recent mortality studies in the country.

The team examined mortality by year, sex, age, cause of death, and region. They calculated age standardized mortality rates to allow meaningful regional comparison and used years of life lost to measure premature mortality. This helped identify not only the most common causes of death, but also those responsible for the greatest loss of life at younger ages.

The researchers also explored time based patterns in mortality, including monthly and seasonal variation, and assessed regional trends using statistical models. Special attention was given to the pandemic years, when mortality patterns changed sharply. Causes of death were grouped according to the World Health Organization’s Global Health Estimates framework, with some adjustments made to better reflect coding patterns in the Kazakhstan dataset.

The analysis showed that mortality in Kazakhstan increased over the study period, rising from 550.84 deaths per 100,000 population in 2014 to 678.37 per 100,000 in 2022. Mortality rose sharply during the COVID-19 pandemic, with total deaths increasing from 107,330 in 2019 to 141,211 in 2020, peaking at 177,071 in 2021, and then declining to 132,303 in 2022.

Across nearly all age groups, mortality rates were higher in males than in females. The difference became especially pronounced after age 55. Deaths were concentrated in older age groups, particularly among people aged 70 to 84, although patterns varied across the life course. In infancy, perinatal conditions and congenital anomalies were prominent, while in younger populations, injuries, drownings, road traffic accidents, and self inflicted injuries contributed substantially to premature mortality.

One of the most striking findings was the rise of “other disorders of the brain” as a cause of death. This category increased dramatically over time and became the leading cause of premature mortality by years of life lost in 2022. The result suggests either a genuine increase in neurological burden or possible problems in cause of death classification, where broad diagnostic labels may be masking underlying cardiovascular, cerebrovascular, or other conditions.

The study also revealed substantial regional disparities. In 2022, the highest age standardized mortality rates were observed in Ulytau, Karaganda, and East Kazakhstan, while the lowest rates were recorded in Almaty Region, Turkestan, and Mangystau. Some regions, especially Karaganda, Kyzylorda, and Kostanay, showed particularly steep upward trends over time, pointing to unequal health risks and uneven healthcare conditions across the country.

Overall, the findings show that Kazakhstan faces an evolving mortality landscape shaped by chronic disease, regional inequality, pandemic disruption, and possible weaknesses in mortality coding. The study highlights the need for closer investigation of brain related mortality, improved cause of death reporting, and region specific public health interventions to reduce preventable deaths and improve health equity.