Gains in life expectancy in Europe have slowed markedly since 2011, with disadvantaged groups being left behind, according to the latest Health at a Glance report issued by the OECD and the European Commission on November 22nd. In the EU28, life expectancy at birth reached 81 years in 2016, with Spain and Italy reporting life expectancy of over 83 years. However, European women still live 5.5 years longer than men, on average, while a 30-year man with a university degree can expect to live eight years longer than his less-educated counterpart.
Circulatory diseases remain the main cause of death, accounting for 1.9m of the 5.2m deaths in 2016. However, survival rates for circulatory diseases are improving faster than those for cancer, with the result that cancer's share of total deaths has risen to 22% for women and 19% for men. The incidence of lung cancer is rising particularly rapidly, up 20% in the past decade, largely reflecting the rise in smoking among women over the past 50 years. This highlights the long-term benefits of investing in public health initiatives to reduce risky behaviours, including use of tobacco or poor diets.
It estimates that in 2018 there will have been 3m new cancer cases across the continent. The highest incidence rates are in Norway, the lowest in Romania, but that primarily reflects screening policies and the countries' age profiles, rather than actual risk factors. In most countries, moreover, better screening, earlier diagnosis and advances in treatment are driving improvements in cancer care, albeit with noticeable variations between countries.
The report also highlights other areas where there are huge and mostly unwarranted variations in care across the continent, which suggests resources are being wasted. The rate of caesarian births, for example, is more than three times higher in Cyprus than in the Netherlands. Pharmaceuticals swallow more than 40% of health expenditure in Bulgaria, but just 7% in Denmark. It concludes that wider adoption of the most efficient care, including better use of day surgery and fewer unnecessary delays in hospital discharges, could free up funding to drive health improvements.
These would include a greater focus on mental health problems, which result in 84,000 deaths a year across the continent. The report estimates the total cost of poor mental health at around 4.1% of the EU's GDP, including loss of productivity, with the costs particularly high in Belgium, the Netherlands and the Nordic region.