state of health in the eu country health profiles · country health profiles bruegel, january 22nd...
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State of Health in the EU
Country Health ProfilesBRUEGEL, January 22nd 2020
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1 The Country Health Profiles
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What is the health status of the population in the EU?
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Life expectancy has risen by almost 4 years in the EU since 2000, but the gap between the countries with the highest and lowest life expectancy still exceeds 8 years
Source: Eurostat Database.
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Inequalities in life expectancy are large within countries, especially for menThe education gap is almost 8 years for men and about 4 years for women in the EU
Education gap in life expectancy at age 30:
EU: 4.1 yearsLatvia: 8.0 yearsSlovakia: 6.9 yearsHungary: 6.4 years
EU: 7.6 yearsSlovakia: 14.4 yearsHungary: 12.6 yearsPoland: 12.0 years
51 years43.4
years
54.9 years
50.8 years
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Poor people are much less likely to report being healthy than rich people
Source: Eurostat Database, based on EU-SILC (data refer to 2017)
60% of people on low income report being healthy compared with 80% among those on high income in the EU
0 20 40 60 80 100
Ireland
Cyprus
Norway
Italy
Sweden
EU
Poland
Estonia
Portugal
Latvia
Lithuania
Low income Total High income
%
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Millions of deaths in the EU can be attributed to modifiable risk factors
Source: IHME (estimates refer to 2017).
Note: The overall number of deaths (2 014 000) related to these risk factors is lower than the sum of each one taken individually (2 273 000) because the same death can be attributed to more than one risk factor. Dietary risks include 14 components such as low fruit and vegetable consumption, and high sugar sweetened beverages and salt consumption.
951 000 deaths 859 000 deaths 310 000 deaths
153 000 deaths
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Good news: Adolescent smoking and binge drinking has decreased across the EU
Share of 15-16-year-olds reporting binge drinking in the past month
Source: ESPAD.
Share of 15-16-year-olds reporting smoking in the past month
Note: Binge drinking is defined as people having 5 alcohol drinks or more in a single occasion in the past months.
Sweden
EU
Italy
0
10
20
30
40
50
2003 2007 2011 2015
%
0
10
20
30
40
50
60
70
2003 2007 2011 2015
%
Sweden
EU
Denmark
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Alcohol consumption remains a serious public health problem in many countries
Source: OECD Health Statistics 2019 (data are estimated for 2017 in Greece).
Overall alcohol consumption among adults
0
20
40
60
Women Men Total% of population aged 15 and over
Binge drinking among adults
Note: Binge drinking is defined as people having 6 alcohol drinks or more in a single occasion, each month, over the past twelve months.Source: Eurostat, based on EHIS survey (data refer to 2014).
0
5
10
15
20
2008 2010 2012 2014 2016
Litres of pure alcohol per population aged 15+
Greece
EU
Lithuania
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More bad news: Overweight and obesity is a growing problem in (nearly) all EU Member States
Source: HBSC Surveys.
Obesity among adults
Source: Eurostat database, based on EU-SILC and OECD Health Statistics 2019.
Overweight and obesity among 15-year-olds
0 20 40
Denmark
Lithuania
France
Netherlands
EU
Finland
Slovenia
Spain
Bulgaria
Greece
Malta
2001-02 2013-14
%
0 10 20 30
Romania
Italy
Sweden
Netherlands
Austria
EU
Finland
Czechia
Estonia
Latvia
Malta
2000 (or nearest year) 2017 (or nearest year)
%
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What can health systems do?1. Increase effectiveness
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More than 1.1 million premature deaths in the EU could be avoided through better prevention and health care
Note: Avoidable mortality is defined as premature deaths (under age 75) that could have been avoided through better prevention and timely and effective health care. Source: Eurostat Database (data refer to 2016).
150 - 300
300 - 450
450 - 550
Avoidable mortality rates for
100 000 population
Spain
74 584
France
113 786
Portugal
22 137
United Kingdom
137 639
Ireland
7 740
Iceland
517
Norway
8 484
Finland
12 815
Sweden
17 216
Germany
185 564
Poland
115 217
Czechia
32 632
Estonia
4 684
Romania
89 300Slovenia
5 004
Latvia
9 530
Lithuania
13 886
Hungary
46 386
Croatia
14 375
Italy
100 041
Malta
867
Cyprus
1 171
Bulgaria
30 198
Greece
23 036
Austria
18 218
Denmark
12 667
Slovakia
19 119
Belgium
22 121
Netherlands
31 758
Luxembourg
945
EU: 254
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All EU Member States have opportunities to improve the quality of care Example: The case of five-year cancer survival rates
Five-year survival rates
EU: 83 %Sweden: 89 %Lithuania: 74 %
EU: 87 %Belgium: 94 %Bulgaria: 68 %
EU: 60 %Belgium: 68 %Latvia: 49 %
EU: 15 %Austria: 20 %Bulgaria: 8 %
Note: Data refer to people diagnosed between 2010 and 2014.
Source: CONCORD programme, London School of Hygiene and Tropical Medicine.
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Coverage against influenza for older people decreased in most EU member states
Source: OECD Health Statistics 2019.
0
20
40
60
80
1002007 (or nearest year) 2017 (or nearest year)
%
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Weaknesses in primary care lead to avoidable and costly hospital admissions
Note: Rates are not adjusted by the prevalence of these conditions. COPD = Chronic obstructive pulmonary diseaseSource: OECD Health Statistics (data refer to 2017 or latest year).
Over 3.5 million people in the EU were admitted to hospital for these four conditions that could be treated in primary care settings
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What can health systems do?2. Improve accessibility
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More than 10% of low-income people in some EU countries report unmet health care needs
Source: WHO Regional Office for Europe 2018 and OECD Health Statistics 2019.
Policies to improve access should especially target and financially protect vulnerable groups
Source: Eurostat Database, based on EU-SILC (data refer to 2017)
More than 10% of people in some EU countries face catastrophic spending when paying for health services
0 10 20
Netherlands
Spain
Austria
Germany
Sweden
EU
Finland
Romania
Latvia
Greece
Estonia
High income Total Low income
%
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What can health systems do?3. Strengthen resilience
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Countries with low spending on health have much higher treatable mortality rates
Note: Treatable mortality is defined as premature deaths that could have been avoided through timely and effective health care.Source: OECD Health Statistics and Eurostat Database (data refer to 2016)
Makes the case for spending more and better on health
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Workforce shortages are a challenge in many countries
Note: In Portugal and Greece, data refer to all doctors licensed to practice, resulting in a large over-estimation of practising doctors (e.g. of around 30% in Portugal). In Austria and Greece, the number of nurses is under-estimated as it only includes those working in hospital.Source: Eurostat Database (data refer to 2017 or nearest year).
Effective policies are needed to train and retain the health workforce, and to transform health service delivery
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Strengthen primary care to effectively manage chronic diseases and avoid unnecessary hospitalisations; improve quality and safety of hospital care, and care integration
Improve sustainability through stable and adequate health system funding, efficient use of resources, prospective workforce and skill-mix planning, and good governance
Ensure timely access, meaningful coverage, and financial protection by reducing reliance on out-of-pocket payments -- particularly for vulnerable groups
Invest in health promotion and disease prevention policies to improve population health and healthy ageing, reduce the impact of risk factors and tackle health inequalities
Healthy lives
Resilience
Effective health systems
Access and coverage
Key findings
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ec.europa.eu/health/stateoecd.org/health/health-systems/country-health-profiles-EU.htm
euro.who.int/en/about-us/partners/observatory/publications/country-health-profiles