European good and bad health trends explained
The World Health Organization has urged Europe to put health at the heart of its socio-economic recovery from the coronavirus pandemic.
Its European Health Report 2021, released on Thursday, describes the challenge as daunting but suggests there is a “critical window” in which meaningful action can be taken.
The report identifies several hits and misses in Europe’s health outlook, with a reduction in cardiovascular disease countered by an overall worsening of mental health.
“We have a tough choice at this point, almost two years into the pandemic,” said Dr Hans Henri P Kluge, WHO Regional Director for Europe.
“We can prioritize the health sector like never before, focusing urgently on long-neglected issues, including mental health, recognizing health systems and health workers as essential pillars of recovery. socio-economic and essential to prepare for future shocks.”
The Russian-Ukrainian war is less of a future shock, and a strong diaspora of two million largely Covid-unvaccinated migrants from a country in the midst of a polio outbreak is well within the purview of the WHO, with a point of press on the potential impact of the crisis this week.
A WHO representative said The National the body has been monitoring the crisis but does not believe it will distract European countries from tackling existing health inequalities.
In addition to setting a framework for action, the triennial report monitors health indicators such as universal health coverage, non-communicable diseases and environmental health.
Together with the co-author of the report, Dr Ausra Zelviene, WHO Consultant and Head of the Division of Substance Use, Prevention and Coordination in the Department of Drugs, Tobacco and Lithuanian government alcohol, The National highlights some of Europe’s health successes and failures.
Europe’s successes in health
Cardiovascular deaths decrease by nearly 20%
Between 2010 and 2018, premature mortality from cardiovascular disease decreased by almost 20%.
The trend is not new, with heart-related deaths now declining for 25 years.
Dr. Zelviene identifies two factors in this reduction: better health behavior and improved health care that now acts as an early warning system for problems.
“Primary health care [now] sees the intermediate risk factors like breed blood compression, breed blood sugar, breed blood lipids and obesity…and responds to those conditions,” she said.
Digging deeper into the data, four out of five incidences of cardiovascular disease are either heart attacks or strokes, and one-third are in those under 70.
The risk of cardiovascular disease is also much higher in women than in men.
“There is a greater prevalence of behavioral risk factors in men like unhealthy diets, physical inactivity, smoking,” Dr. Zelviene said.
Cancer deaths down 10%
The picture for cancer is less clear than that for cardiovascular disease, as cancer still accounts for more than 20% of all deaths, a situation exacerbated by the impact of the pandemic on detection and treatment.
Still, the decrease in deaths should be seen as a success, and new lifestyle interventions and the reduction of health disparities could ease the trajectory.
One of the main messages would be that many cancers can be cured if caught early and treated effectively.
Dr Ausra Zelviene, WHO consultant
“About a third of cancer deaths are due to smoking and other unhealthy behaviors like heavy alcohol consumption and low fruit and vegetable intake,” Dr. Zelviene said.
“One of the main messages would be that many cancers can be cured if caught early and treated effectively.”
This is where health inequities need to be urgently addressed.
“Many healthcare systems in low- and middle-income countries are not well prepared to handle this burden and a large number of cancer patients do not have access to timely, quality diagnosis and treatment” , said Dr. Zelviene.
“Comprehensive treatment is available in more than 90% of high-income countries and less than 15% of low-income countries.
Reduction of maternal, neonatal and infant mortality
All countries in the WHO European Region have met the WHO maternal mortality target of less than 70 per 100,000 live births by 2030. The region’s average rate is 13 per 100 000 live births in 2017.
Almost all countries in the WHO European Region have achieved the target neonatal and infant mortality rates of less than 12 and 25 deaths per 1000 live births, respectively.
Dr. Zelviene said the main driver of this auspicious trend is improving access to care and the provision of care to the poor.
“Women who have problems, i.e. before and during pregnancy, will receive appropriate care and if anything serious happens, these events will be investigated, and knowledge passed on. in order to avoid them in the future,” she said.
“One more [very important factor] is the ongoing education of health care providers and patients to see the early signs of medical complications of pregnancy.”
Europe’s health failures
More smokers than the world average
Twenty-six percent of the adult population still smoke tobacco, compared to a global average of 23.6 percent.
But that’s not all, because Europe started from a very high level – 35% in the millennium.
Interestingly, while the prevalence of male smokers dropped over this period, the prevalence of female smokers plateaued at around 18%.
One of the reasons for the slow decline is regulatory.
“Only 14 of the 53 countries in the region ban smoking in all outdoor places and public places,” Dr Zelviene said.
She also pointed to fierce opposition from the tobacco industry as an obstacle to robust regulatory change, and many countries in Europe do not tax large tobaccos proportionately.
The common denominator in countries like Finland, Iceland and Denmark, where smoking prevalence is very low, is “clear and restrictive rules on smoking in outdoor public spaces, as well as indoors and in the workplace,” she said.
“The situation is very uneven in the region and needs to be improved.”
Worsening mental health
The coronavirus pandemic has had a rapid and profound impact on mental health and wellbeing in the region.
The direct threat of the outbreak of infections and the containment measures have led to feelings of loneliness, fear and pessimistic outlook, as well as an increase in symptoms of depression and anxiety among some parts of the population.
One of the highest suicide rates in the world
Each year in the world, 700,000 people commit suicide and make even more suicide attempts.
Despite a downward trend, the region still has one of the highest standardized suicide death rates in the world.
In 2019, before the pandemic, 119,000 people in the region died by suicide.
The WHO has prioritized reducing mortality from suicide and aims to cut the suicide rate by a third by 2030.
Increase in HIV infections
Europe is one of two WHO regions where the number of HIV infections is increasing.
New HIV infections increased by 6% per 1,000 people between 2015 and 2019.
One in three obese children
Nearly one in three children in the region are overweight or obese
Obesity is one of the greatest public health challenges of the 21st century and a complex, multifactorial disease.
The prevalence of obesity also varies between boys and girls and between Member States: 13% for boys and 9% for girls.
Higher rates are seen in Mediterranean countries, while Central Asian countries have the lowest prevalence.
Updated: March 10, 2022, 11:00 a.m.