Germany ranked 20th in the world in 2013 in life expectancy with 77 years for men and 82 years for women, and it had a very low infant mortality rate (4 per 1,000 live births). , the principal cause of death was cardiovascular disease, at 37%. Obesity in Germany has been increasingly cited as a major health issue. A 2014 study showed that 52 percent of the adult German population was overweight or obese.