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    « 'I Have No Enemies: My Final Statement', By Nobel Laureate Liu Xiaobo | Main | Upcoming Nobel Peace Ceremony: UN High Commissioner Too Busy To Attend »

    Europe's Rising Obesity & Health Expenditure 

    Earlier this week the Paris based Organization for Economic Co-operation and Development (OECD), released the 'Health at a Glance: Europe 2010' report. It is a comprehensive assessment of key health indicators in 31 countries; which includes 27 EU member states, 3 European Free Trade Association countries (Iceland, Norway and Switzerland), and Turkey.

    For years, the Europeans have made fun of the Americans for their high obesity rates. The OECD report should give the Europeans a pause. The report says that more than half of the European population is obese or overweight. In general in France, Italy and Switzerland, there are less obese and overweight people, although the rates are increasing even there. In most EU countries, the rate of obesity has more than doubled in the last twenty years. The obesity rate is the highest in the UK. 

    The OECD report says: "In most countries the rise in obesity has affected all population groups regardless of sex, age, race, income or education level, but to varying extents. Evidence from a number of countries, including Austria, England, France, Italy and Spain, indicates that obesity tends to be more common among individuals in disadvantaged socio-economic groups, with this relationship being particularly strong among women (Sassi et al., 2009b). 

    There is a time lag between the onset of obesity and related health problems, suggesting that the rise in obesity over the past two decades will mean higher health care costs in the future. A recent study estimated that total costs linked to overweight and obesity in England in 2015 could increase by as much as 70% relative to 2007 and could be 2.4 times higher in 2025 (Foresight, 2007)."

    The obesity epidemic is unfortunately not just limited to the European adults. Even children in Europe are gaining too much weight. The OECD report says that across most of Europe, one in seven children are obese or overweight. The rate of childhood obesity is even higher in southern Europe, where one in five is either overweight or obese.

    Obesity is a major public health concern, as it is a risk factor for a multitude of illnesses; increasing both morbidity and mortality. Current economic climate in Europe makes short term policy decisions to address the obesity epidemic and other related health issues much more challenging for most governments. When most European states are trying to cut costs and to reign in ballooning budget deficits, it is difficult to commit more financial resources to massive public health projects. 

    Here are some other notable findings from the OECD report about health trends across Europe: 

    • Life expectancy at birth in the EU countries has increased by six years since 1980, reaching 78 years in 2007.
    • Cardiovascular diseases are the main cause of mortality in almost all EU countries, accounting for 40% of all deaths in the region in 2008. Cancer is the second leading cause of mortality in the EU countries. 
    • Many EU countries have achieved remarkable progress in reducing tobacco consumption, although it is still a leading cause of early death. 
    • Alcohol consumption across EU countries is 10.8 litres per adult per year. Traditional wine-producing countries such as Italy, France and Spain have seen their alcohol consumption per capita drop substantially since 1980. On the other hand, consumption rose significantly in a number of countries including Ireland, the United Kingdom and some Nordic countries.  
    • Between 13 and 15 years of age, the prevalence of smoking and drunkenness doubles in many EU countries. behaviours among adolescents. Some of the largest increases in reported drunkenness between the ages of 13 and 15 are seen in Denmark, Finland and Lithuania.  
    • Only one in five children in EU countries undertake moderate-to-vigorous exercise regularly, according to results from the 2005-06 HBSC survey. Children in Switzerland, Luxembourg and Italy are least likely to exercise regularly, whereas the Slovak Republic and Ireland stand out as strong performers with over 40 and 30% respectively of children aged 11 to 15 exercising for a total of at least 60 minutes per day over the past week. 
    • There are concerns in many European countries about shortages of doctors. The number of doctors per capita varies greatly, and is lowest in Turkey, followed by Poland and Romania. Doctor numbers are also relatively low in the United Kingdom and Finland. There are also concerns about shortages of nurses in many European countries. 

    The OECD report further highlights that health care expenditure is rising pretty much all across the board in Europe. The report says: "Health expenditure has risen in all European countries, often increasing at a faster rate than economic growth, resulting in a rising share of GDP allocated to health. In 2008, EU countries spent, on average, 8.3% of their GDP on health, up from 7.3% in 1998. However, the share of GDP allocated to health spending varies considerably across countries, ranging from less than 6% in Cyprus and Romania to more than 10% in France, Switzerland, Germany and Austria."

    The EU countries are estimated to have spent €180 billion on pharmaceuticals in just 2008, accounting for around 18% of total health spending on average. Growth in pharmaceutical spending reached a peak in many countries between 1999 and 2001.

    Another interesting bit of information from the OECD report has to do with the impact of current financial crises in certain European economies on the health care expenditure. The OECD report says: "In some countries, the recent economic downturn resulted in a marked increase in the ratio of health spending to GDP. In Ireland, the percentage of GDP devoted to health increased from 7.5% in 2007 to 8.7% in 2008. In Spain, it rose from 8.4% to 9.0%. The share is likely to increase further when data for 2009 and 2010 become available as economic growth stalled or contracted while health spending growth continued." Incidentally Greece and Ireland - the two economies to get an EU bailout thus far - also spent the most among all EU states on pharmaceuticals in 2008.

    From the report, it is not clear (at least to me) if people are indeed seeking medical care more frequently in countries with economic hardships, or if it's just that the average growth in health care spending that's seen all across the Europe, seems worse for those states with stagnant or declining economies. It is conceivable that the stress of economic hardships drives people to need and seek medical care more frequently. But without conclusive, objective evidence that remains a hypothesis. 

    In any event, having to spend more money on sick (and thus likely - less productive) population is hardly a good news for any economy, but especially those which are struggling. When it rains, it indeed pours. 

    ~ Gauri

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