Foreword
This 2018 edition of Health at a Glance: Europe marks the start of a new State of Health in the EU cycle by the European Commission designed to assist EU Member States in improving the health of their citizens and the performance of their health systems.
Two overarching trends warrant special mention. First, the steady increase in life expectancy has slowed considerably in many EU countries due to a slower rate of reduction of cardiovascular deaths and an increase in the number of deaths among the elderly during winter months in recent years. Second, large inequality in life expectancy persists. Across the EU, people with a low level of education can expect to live six years less than those with a high level of education.
We need more protection and prevention. More than 1.2 million people die prematurely every year in EU countries – this could be avoided through better disease prevention policies and more effective health care interventions. On the one hand, we must tackle the misinformation about vaccines and address population hesitancy about childhood vaccination, as outlined in the recommendation proposed to the Council of the EU earlier this year. At the same time, many lives could be saved by redoubling efforts to prevent unhealthy lifestyles. Some 790 000 EU citizens die prematurely each year from tobacco smoking, alcohol consumption, unhealthy diets and lack of physical activity. Policies to control tobacco and harmful consumption of alcohol or to halt obesity therefore need to be actively pursued.
This edition of Health at a Glance: Europe also makes a strong case for promoting mental health and preventing mental illness. The total costs of mental health problems – which include the costs to health systems and social security programmes, but also lower employment and worker productivity – are estimated to amount to more than 4% of GDP across EU countries, equivalent to over EUR 600 billion per year. Promoting mental health and improving access to treatment for people with poor mental health should be a priority.
We need more effective and people-centred health systems. Health systems have achieved remarkable progress in treating life-threatening diseases such as heart attacks, strokes and various cancers, yet wide disparities in survival rates persist not only between countries but also among hospitals and health care providers within each country.
It is not enough to only collect data on mortality. Health care needs to place people at the centre, which requires asking patients more systematically whether they are better, or worse, following different health care interventions. We must also measure how well the primary care sector is managing the growing number of people living with one or more chronic conditions. The OECD and the European Commission are working together with countries to fill these critical data gaps on patient-reported experience and outcome measures.
We need to improve access to health care. Universal health coverage – a key Sustainable Development Goal – and timely access to affordable, preventive and curative health care – a key principle of the European Pillar of Social Rights – should remain central to policy action. Recent data on the unmet health care needs are encouraging; fewer EU citizens report foregoing care due to financial reasons, distance from services or waiting times. The gap between the poor and the wealthy, however, remains too large. Poor Europeans are on average five times more likely to have problems accessing health care than richer ones, and policies must prioritise financial protection for disadvantaged groups.
Finally, we need more resilient health systems. As health systems evolve, they must become more resilient and adapted to rapidly changing environments and needs. In this edition of Health at a Glance: Europe, we highlight the importance of reducing wasteful spending, and the potential gains for efficiency and sustainability of health systems. Evidence from various countries suggests that up to one-fifth of health spending is wasteful and could be reallocated to better use. For example, too many hospital admissions reflect failures in the management of health problems in the community and consume over 37 million bed days each year across the EU. The digital transformation of health and care, a key component of the EU’s Digital Single Market, offers tremendous potential for improving the prevention, detection and management of chronic diseases, as well as improving health system management and research.
The OECD and the European Commission will work closely together with policymakers and other key stakeholders throughout the State of Health in the EU cycle, to help promote policies that will deliver both longer and healthier lives for all EU citizens.
Angel Gurría
Secretary-General Organisation for Economic Co-operation and Development
Vytenis Andriukaitis
European Commissioner for Health and Food Safety