The European health report 2012 Dr Claudia Stein Director Division of Information, Evidence, Research and Innovation (DIR)
The European health report 2012 Purposes and four sections of the report 1. Provide epidemiological evidence base underpinning Health 2020 and analyse social, economic and environmental determinants of health Where we are 2. Describe the development of targets and indicators for Health 2020 What we are aiming for 3. Put well-being on the agenda as a marker of social progress in the WHO European Region How we are getting there and what we value 4. Identify key challenges for health measurement and outline the collaborative agenda to collect, analyse and report on health Region-wide What challenges we face marking progress WHO s express mandate to monitor and report on health in Europe
1. Where we are health status in Europe: the baseline for Health 2020 Basic facts 1. Population nearly 900 million in 53 countries; ~53% live in the European Union (EU) and 33% in the Commonwealth of Independent States (CIS) 2. Nearly 70% of Europeans live in urban areas 3. About 73 million migrants accounting for ~8% of the population 4. People in the WHO European Region live longer than ever before average life expectancy (for males and females combined) was 76 years in 2010
Life expectancy at birth, 1980 2010 1981 60 Region 62 64 66 68 70 72 74 76 78 80 82 84 6.5 years 1.5 years
Life expectancy at birth in 2009 Years gained, 1990 2009 Males Females Spain France Italy Switzerland Israel Iceland Luxembourg Sweden Finland Norway Austria Netherlands Spain France Italy Switzerland Israel Iceland Luxembourg Sweden Finland Norway Austria Netherlands Germany Germany Malta Malta Greece Greece Slovenia Slovenia Portugal Portugal United United Kingdom Kingdom Ireland Ireland Czech Republic Czech Republic Estonia Estonia Poland Poland Croatia Croatia Slovakia Slovakia Lithuania Lithuania Hungary Hungary Latvia Latvia Montenegro Montenegro Georgia Georgia Bulgaria Bulgaria Romania Romania Armenia Armenia Azerbaijan Azerbaijan Belarus Belarus Ukraine Ukraine Russian Russian Federation Federation Turkey Turkey Kazakhstan Kazakhstan Republic of of Moldova Kyrgyzstan Kyrgyzstan Males Females 85 80 75 70 65 60 0 2 4 6 8 10
Mortality from all causes of death, 2006 2010 (latest year) SDR: age- and sex-standardized death rate
Causes of death, 2006 2010 (latest year) < 0% Cause 1 of death P Age group (years)
Causes of death by European regions, 2010 1.00 0.90 0.80 0.70 Proportionate mortality 0.60 0.50 0.40 0.30 0.20 0.10 0.00 European Region EU15 EU12 CIS Region Circulatory system Neoplasms External causes Infectious and parasitic Respiratory system Other causes
Country Indicator Circulatory system Neoplasms External causes Digestive system Respiratory system Infectious and parasitic Ukraine Republic of Moldova Kyrgyzstan Russian Federation Kazakhstan Bulgaria Belarus Azerbaijan Romania Armenia Serbia Lithuania Latvia Georgia Montenegro Slovakia Hungary Estonia Croatia Poland Czech Republic Greece Slovenia Finland Germany Austria Denmark Cyprus Ireland Malta Luxembourg Belgium Sweden Portugal Italy Iceland United Kingdom Switzerland Norway Netherlands Spain France Israel 18.3 9.9 9.8 7.9 9.2 5.5 7.0 2.8 7.7 17.1 7.9 13.4 15.8 0.9 3.5 4.1 9.6 4.7 9.1 4.2 3.0 4.6 3.4 5.4 5.3 7.6 3.3 4.9 0.9 5.3 11.5 11.9 4.0 9.1 10.1 5.6 11.2 6.4 19.4 22.5 21.8 18.8 30.4 36.1 27.6 50.2 48.1 45.3 27.3 69.6 39.4 28.6 60.5 27.3 60.2 39.8 47.1 65.2 35.9 60.6 27.7 37.0 21.3 35.4 49.5 40.2 40.1 27.9 21.8 43.4 49.4 35.5 14.8 22.7 35.6 35.3 73.4 49.0 55.9 34.8 38.2 64.6 49.7 97.1 69.6 33.5 16.9 24.7 26.6 20.6 16.1 20.5 31.7 14.0 21.4 29.3 16.7 27.6 26.4 16.0 22.5 14.3 38.5 25.3 30.3 32.6 40.7 14.5 34.2 37.0 39.7 35.6 65.6 49.8 20.0 21.8 37.4 56.3 32.4 56.1 58.0 60.4 43.1 31.6 58.0 56.6 78.1 118.6 51.4 26.0 44.4 24.4 25.4 39.1 37.7 27.5 34.7 27.4 33.0 35.4 49.0 43.5 24.8 29.4 33.2 39.0 37.3 27.9 60.5 59.9 29.6 48.1 57.6 52.7 76.3 59.0 51.0 35.2 27.3 86.7 115.8 42.8 39.4 53.3 28.6 133.6 35.0 114.6 147.2 80.9 97.3 88.4 143.9 174.5 157.7 186.7 159.8 149.1 175.9 157.2 168.0 158.3 145.4 175.0 157.7 153.9 181.8 118.8 212.6 159.5 162.5 138.2 199.8 153.6 198.2 207.6 210.8 187.9 246.4 198.9 128.7 92.2 194.8 193.0 205.9 189.9 179.8 87.6 162.9 157.5 156.6 180.4 109.2 164.1 158.2 121.3 126.1 143.1 146.7 151.8 161.4 169.2 172.8 173.8 177.6 182.2 182.7 186.2 189.3 191.6 191.6 193.5 206.6 208.7 213.6 231.8 244.6 344.1 356.3 370.8 408.3 421.2 446.6 460.8 476.0 479.5 496.8 506.6 532.2 539.8 551.6 587.2 604.9 626.4 683.0 692.7 715.2 732.7 Mortality rates by main broad groups of causes of death in the European Region, 2006 2010 (latest year)
800 Changing disease patterns by European regions, 1980 2008 SDR, by cause, per 100 000 population 700 600 500 400 300 200 100 0 EU15, 1980 EU15, 2008 EU12, 1980 EU12, 2008 CIS, 1981 CIS, 2008 Region Cardiovascular Cancer External causes Infectious disease Respiratory system
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0 1991 HIV and AIDS incidence by European regions, all ages, 1990 2010 1991 0246810 12 14 16 Region HIV AIDS
Burden of disease, 2004 (percentage of disability-adjusted life-years (DALYs) lost) TFYR Macedonia: the former Yugoslav Republic of Macedonia.
Pure alcohol consumption per capita, people aged 15 years and over 1990 5678910 11 12 13 14 15 Region
Tobacco smoking prevalence, people aged 15 years and over 1992 20 22 24 26 28 30 32 34 Region 1992 20 22 24 26 28 30 32 34 Region
Input/process/outcome 2. What we are aiming for setting targets for Health 2020
Process of target setting 1. In May 2011, Standing Committee of the Regional Committee (SCRC) and Member States endorsed process and formed SCRC targets working group, which is leading the process 2. WHO/Europe s technical divisions proposed long list of 51 high-level targets for each major area of Health 2020 3. SCRC group reduced number to shortlist of 21, based on agreed criteria 4. WHO/Europe sent these 21 to Member States for consultation 5. SRCR group reviewed comments made and reduced 21 to 16 6. High-level forum in April 2012 proposed 6 overarching regional goals/targets 7. In May 2012, SCRC proposed submitting 6 targets to sixty-second session of Regional Committee
Health for All (1978) 2. What we are aiming for setting targets for Health 2020 HEALTH21 (1999) Health 2020 area Overarching goals or targets Content and quantification PLACEHOLDERS ONLY 1. Burden of disease and risk factors 2. Healthy people, well-being and determinants 1. Reduce premature mortality in Europe by 2020 1. 1.5% relative annual reduction in overall mortality from cardiovascular disease, cancer, diabetes, and chronic respiratory disease until 2020 2. Achieve and sustain elimination of selected vaccine-preventable diseases (poliomyelitis, measles, rubella, prevention of congenital rubella syndrome) 3. 30% reduction in road traffic accidents by 2020 2. Increase life expectancy in Europe Continued increase in life expectancy at current rate coupled with (1) 50% or (2) 25% reduction in the difference in life expectancy between European populations by 2020 3. Reduce inequities in health in Europe (social determinants target) Reduction of the gap in health status between population groups experiencing social exclusion and poverty and the rest of the population 4. Enhance well-being of the European population (to be further elaborated during 2012/2013) To be developed 3. Processes, governance and health systems 5. Universal coverage and right to health Funding systems for health care that guarantee universal coverage, solidarity and sustainability by 2020 6. Member States set national targets/goals National target-setting processes established and targets formulated 6 targets and about 20 indicators
3. How we are getting there and what we value The case for measuring well-being Develop definition and framework for well-being in the context of health Advise on measurement and target setting for well-being Form core of an international alliance to measure well-being Development of target and indicators
4. What challenges we face marking progress Discussion of main challenges Data availability (and harmonization) at country level to monitor progress with Health 2020 Interpretation of information Translation of evidence into policy How will WHO support Member States?
Publication date, December 2012 The European health report 2012 Thank you Merci bien Danke благодарю