Health status statistics

From Statistics Explained

Data from November 2013. Most recent data: Further Eurostat information, Main tables and Database

This article presents recent statistics on the health status of the population of the European Union (EU) Member States and some other European countries, as reported by respondents. The analysis is based on results from the EU-SILC survey.

The article focuses on three key indicators describing the levels and distribution of health status:

  • self-perceived health gives an overall assessment by the respondent of his/her health in general;
  • chronic morbidity assesses the presence of a long-standing illness or health problem;
  • disability or activity limitation assesses the limitations people have had in carrying out usual activities for at least six months because of health problems; this measure is called the global activity limitation indicator (GALI), which is used to calculate the healthy life years indicator.

More detailed data on health status are collected in the European Health Interview Survey (EHIS).

Figure 1: Self-perceived health in European countries in 2011, by sex (% of population aged 16 or over in good or very good health) - Source: Eurostat (hlth_silc_02)
Table 1: Self-perceived health in European countries in 2011 (% of population aged 16 or over) - Source: Eurostat (hlth_silc_10)
Figure 2: Self-perceived health by sex and age in 2011, EU-28 (% of population aged 16 or over) - Source: Eurostat (hlth_silc_10)
Figure 3: Self-perceived health by educational attainment level in European countries in 2011 (% of population aged 16 or over in good or very good health) - Source: Eurostat (hlth_silc_02)
Figure 4: Self-perceived health by income quintile group in European countries in 2011 (% of population aged 16 or over in good or very good health) - Source: Eurostat (hlth_silc_10)
Figure 5: Chronic morbidity in European countries in 2011 (% of population aged 16 or over with long-standing health problem) - Source: Eurostat (hlth_silc_11)
Table 2: Chronic morbidity in European countries in 2011 (% of population aged 16 or over) - Source: Eurostat (hlth_silc_11)
Figure 6: Activity limitation in European countries in 2011 (% of population aged 16 or over with a limitation in usual activities) - Source: Eurostat (hlth_silc_12)
Table 3: Activity limitation in European countries in 2011 (% of population aged 16 or over) - Source: Eurostat (hlth_silc_12)
Figure 7: Activity limitation by sex and age in 2011, EU-28 (% of population aged 16 or over) - Source: Eurostat (hlth_silc_12)

Main statistical findings

Self-perceived health

Two out of three people perceive their health as good or very good

In the EU-28, 69 % of the population aged 16 years or over perceived their health as very good or good in 2011, while 22 % perceived it as fair and 9 % as bad or very bad. Across the European countries, the prevalence of very good and good self-perceived health ranged from 84 % in Ireland, 81 % in Switzerland and 80 % in Sweden to less than half of the population in Latvia (47 %), Lithuania (46 %) and Croatia (45 %) (data broken down by sex are presented in Figure 1).

Assessment of health was fairly stable over time

There was no significant change in the prevalence of good or very good self-perceived health in the EU-28 overall between 2005 and 2011. A slight increase between 2005 and 2008 may be explained, at least partly, by methodological factors such as slight changes to model questions in some countries. The situation differed among individual countries. Among Member States for which data are available for the whole period 2005 to 2011, the prevalence of good and very good perceived health increased most in Latvia (from 35 to 47 %) and decreased most in Denmark (from 77 to 71 %).

Men tend to rate their health better than women

Men rated their health better than women did in all countries in 2011: in the EU-28 countries, 71 % of men and 65 % of women perceived their health as very good or good. The difference between the sexes measured in percentage points (pp) was highest in Lithuania and Romania (both about 10 pp). On the other hand, almost no difference between men and women was observed in Croatia and Ireland.

Negative perception of health increases with age

Self-perceived health also has a distinct age pattern: in higher age groups more men and women tend to rate their health as being bad or very bad than in lower age groups (see Figure 2). A gap between the sexes was observed in all age groups, with the tendency increasing up until the age of 75 – 84 years.

Higher educated people perceive their health as better

Clear differences appear when looking at the relationship between self-perceived health and educational attainment level. On average in the EU-28, 55 % of the population with education below upper secondary level, 72 % of the population with upper secondary education and 81 % of the population with tertiary education perceived their health as good or very good. The progressive gap between educational attainment levels is obvious in almost all European countries and also applies, to a different degree, to the broad age groups and both sexes.

The largest gap between the populations with the highest and the lowest educational attainment level was observed in Poland (39 pp), followed by Croatia (37 pp) and Portugal (36 pp). The smallest gap, 16 pp, was observed in Germany (see Figure 3).

Health inequalities increase with income

On average in the EU-28, 60 % of the population in the first income quintile group (the population with the lowest income) perceived their health as good or very good, compared with 61 % in the second quintile group, 67 % in the third quintile group, 73 % in the fourth quintile group and more than 78 % in the population with the highest income (the fifth income quintile group). The largest difference between the populations with highest and lowest income was observed in Estonia (36 pp), followed by Belgium, Cyprus and Slovenia (about 30 pp difference in all three countries). On the other hand, no significant difference between the income groups in very good and good perceived health was observed in Romania (see Figure 4).

Chronic morbidity

One out of three EU citizens aged 16 years or over suffers from a health problem

In 2011, 32 % of the EU-28 population aged 16 years or over reported suffering from a chronic illness or long-standing health problem. This proportion has been quite stable over time. The lowest prevalence of chronic health problems was observed in Bulgaria (18 %), Luxembourg and Romania (both 20 %). On the contrary, more people in Estonia and Finland (both 45 %) reported long-standing health problems (data broken down by sex are presented in Figure 5).

Men report having chronic health problems less frequently than women

Similar to self-perceived health, men reported long-standing health problems less often than women in all countries (29 % versus 34 % in the EU overall in 2011). The biggest gap was observed between men and women in Norway, Latvia and Lithuania (all 9 pp), followed by Portugal, Slovakia and the Netherlands (all 8 pp). A very small difference (of less than 2 pp) was observed in Ireland, Cyprus, Croatia and Germany.

The most differentiating factor of chronic morbidity is age: while only about 10 % of the population aged 16 – 24 years reported a chronic health problem, the figure was about 70 % for the population aged 85 years and over among the EU-28 Member States overall.

Unemployed persons report more long-standing health problems than employed

Looking at the subpopulation aged 16 – 64, it is interesting to note the relationship between labour status and the presence of chronic illnesses. In the EU-28, 20 % of employed persons reported having a long-standing health problem compared to 27 % of unemployed persons aged 16 – 64 years.

The highest difference between employed and unemployed persons was observed in the Netherlands (24 compared to 55 %) followed by Norway (28 compared to 57 %), Denmark (20 compared to 46 %) and Germany (25 compared to 49 %). The differences in self-reported chronic problems between employed and unemployed persons are higher in the older working-age population (the difference was only 4 pp in persons aged 16 – 44 compared to 14 pp in persons aged 45 – 64 in the EU-28). The data can be found in hlth_silc_04.

Disability (activity limitation)

One in four people live with some activity limitation

This variable on the limitation in people’s usual activities due to health problems and lasting for at least the past six months is considered a good proxy for measuring disability.

In 2011, 26 % of people aged 16 years or over living in the EU-28 reported health-related long-term limitations in usual activities, with 8.2 % reporting severe and 17.5 % some (but not severe) activity limitations.

The prevalence of any activity limitation was the highest in Slovenia (36 %) and Slovakia (34 %), and lowest in Malta (12 %), followed by Sweden and Norway (about 16 % in both) (data broken down by sex are presented in Figure 6). The prevalence of severe activity limitations in at least 10 % of the population aged 16 years or over was reported in Slovenia (13 %), followed by Iceland, Slovakia and Germany (all about 10 %), compared with 5 % or fewer in Malta, Bulgaria, Spain and Ireland.

The gap in activity limitation between men and women is higher in the older age groups

Differences between men and women were evident also for activity limitations: in Europe 23 % of men and 28 % of women reported a limitation in usual activities. The gender divide was highest in the Netherlands, Denmark, Portugal and Romania (about 10 pp). On the other hand, there was no significant difference in activity limitation between men and women in Ireland.

A strong association between activity limitation and age is apparent from Figure 7. The increase in activity limitation gradually accelerates with age. The gap between men and women is greater in the higher age groups in the majority of countries and in the EU-28 overall, reaching 7-8 pp in age groups over 75 years.

Income inequalities in activity limitation are highest among middle-aged people

On average in the EU-28, about one third of the population in the two lowest income quintile groups (first and second income quintile groups) reported a limitation in usual activities compared to 27 % of the population in the third income quintile group, 21 % in the fourth and 17 % in the highest income group.

The difference between the lowest and highest income groups in activity limitation is about 25 pp or more in Croatia, Estonia, Belgium and Cyprus. The lowest differences were found in Romania and Iceland. When only severe activity limitations are considered, the greatest differences between the lowest and highest income groups were between 13 and 14 pp in Cyprus, Croatia, Germany and Slovenia. The gap in activity limitation between the highest and lowest income groups was highest in the age group 45 – 64 years and tended to decline after that. The data can be found in hlth_silc_12.

Data sources and availability

The data used in the article are derived from the EU statistics on income and living conditions (EU-SILC). The reference population is all private households and their members residing in the territory of the respective country at the time of data collection, which excludes people living in collective households. Data on health status refer to the population aged 16 years or over. The EU-28 aggregate is a population-weighted average of individual national figures.

Limitations of the data

All three indicators are derived from self-reported data so they are, to certain extent, affected by respondents’ subjective perception as well as by their social and cultural background. Despite their subjective nature, those indicators are considered to be relevant and reliable estimators of health status as well as good predictors of health care needs. They are useful for trend analysis and for measuring socio-economic disparities.

The fact that EU-SILC does not cover the institutionalised population — which includes the populations in health and social care institutions whose health status is likely to be worse than in the population living in private households — is likely to contribute to an under-estimation of health problems. Another factor that may influence the results relates to the different organisation of health care services across countries. Furthermore, the indicators are not age-standardised and thus reflect the current age structure of the respective countries.

Another issue is the implementation of the recommended model questions in national surveys which may differ between countries. The EU-SILC legal framework provides a list of variables to be collected. It is accompanied by methodological guidelines which include model questions, and conceptual and explanatory guidelines (so-called output harmonisation). The harmonisation of methodology related to health variables has been continuously improved but discrepancies still exist.

Context

Good health is an asset in itself. It is not only of value to the individual as a major determinant of quality of life and social participation, but it also contributes to general social and economic growth and well-being. Many factors influence the health status of a population and these can be addressed effectively by health policies at regional, national or EU level. Monitoring health status is given high importance in EU health policies, and involves the definition and regular collection of standardised data. This article presents data for the EU Member States and other countries on three key indicators describing the levels and distribution of health status of their populations:

  • self-perceived health gives an overall assessment by the respondent of his/her health in general;
  • chronic morbidity assesses the presence of a long-standing illness or health problem;
  • disability or activity limitation assesses the limitations people have had in carrying out usual activities for at least six months because of health problems; this measure is called the global activity limitation indicator (GALI), which is used to calculate the healthy life years indicator.

Indicators on health status are given high importance in EU health policies and the monitoring of health status of populations in the overarching EU strategy ‘Together for Health: A Strategic Approach for the EU 2008-2013’, as well as in more topical policies such as active and healthy ageing, health inequalities and social protection and social inclusion.

The World Health Organization defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’, which points to its multidimensional nature and possible ways of measuring it.

Three general health questions on self-perceived health, chronic morbidity and long-term activity limitation constitute the Minimum European Health Module (MEHM). The European Health Interview Survey, a comprehensive EU survey on health status, use of healthcare services and health determinants, includes the MEHM which enables a better understanding of the three general questions and their relationship with other health topics. Important EU indicators are calculated from EU-SILC data based on the MEHM: three European Core Health Indicators (ECHI) and two indicators of the health and long-term care strand developed under the Open Method of Coordination on social protection and social inclusion. Data on long-term activity limitation are used to calculate the Healthy Life Years indicator.

The health status of individuals and of the population in general is determined by a complex set of factors: genetic dispositions, individual behaviour, environmental, cultural and socioeconomic conditions, as well as by the functioning of healthcare services. Eurostat provides data on different health determinants that can help to explain the different levels and distribution of health status among population groups or countries, such as:

See also

Further Eurostat information

Database

Health status (hlth_state)
Self-perceived health and well-being (hlth_sph)
Functional and activity limitations (hlth_fal)
Self-reported chronic morbidity (hlth_srcm)

Dedicated section

Methodology / Metadata

Other information

External links

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