Atlas of Health in Europe [Second Edition 2008] 9789289014106, 9289014105

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This statistical atlas presents key health figures for the WHO European Region. They cover basic data on populations, births, deaths, life expectancy and diseases, lifestyle and environmental indicators such as drinking, smoking and traffic accidents, and types and levels of health care. Each indicator is presented as a map to show overall regional variations, a bar chart to indicate country rankings and a time chart to show trends over time in three main country groupings. Using the WHO Regional Office for Europe’s unique Health for All database, combined with the best alternative sources of data around the Region, this atlas offers the most comprehensive overview of health in Europe. In a handy size, this atlas is designed to be an easily accessible resource at all times, in the office or on the road.

ISBN 978-92-890-1410-6 World Health Organization Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø Denmark Tel.: +45 39 17 17 17 Fax: +45 39 17 18 18 E-mail: [email protected] Web site: www.euro.who.int

9 789289 014106

2nd edition 2008

Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Moldova Netherlands Norway Poland Portugal Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan

ATLAS OF HEALTH IN EUROPE

Atlas of health in Europe

The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves.

Atlas of health in Europe

2nd edition 2008

The World Health Organization was established in 1948 as the specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the field of human health. It fulfils this responsibility in part through its publications programmes, seeking to help countries make policies that benefit public health and address their most pressing public health concerns. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces some 880 million people living in an area stretching from the Arctic Ocean in the north and the Mediterranean Sea in the south and from the Atlantic Ocean in the west to the Pacific Ocean in the east. The European programme of WHO supports all countries in the Region in developing and sustaining their own health policies, systems and programmes; preventing and overcoming threats to health; preparing for future health challenges; and advocating and implementing public health activities. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health.

Atlas of health in Europe 2nd edition 2008

Atlas of health in Europe 2nd edition 2008

WHO Library Cataloguing-in-Publication Data Atlas of health in Europe/2nd edition 2008 1. Health surveys – statistics – atlases 2. Health status 3. Morbidity – statistics 4. Mortality – statistics 5. Europe ISBN 978 92 890 1410 6 (print) ISBN 978 92 890 1411 3 (ebook)

(NLM Classification : WA 17)

ISBN 978 92 890 1410 6 (print)

Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest).

© World Health Organization 2008 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Printed in Denmark



Contents Foreword...............................................................................................viii Technical notes......................................................................................... 1 1. Demography...................................................................... 5 Notes.........................................................................................................5 Population Mid-year population, 2006................................................................ 7 Natural population growth........................................................... 8–9 Young population (0–14 years) and old population (65+ years)............................................................................. 9–11 Age pyramid, 2005.......................................................................... 12 Births Birth rate.................................................................................... 13–14 Low-weight births, under 2500 g.............................................. 14–15 Births to young mothers (under 20 years)...................................... 16 Births to older mothers (35+ years)................................................ 16 Abortions Abortions...........................................................................................17 2. Life and death..................................................................19 Notes....................................................................................................... 19 Life expectancy Conventional and estimated life expectancy...................................23 Life expectancy at birth (years).......................................................24 Life expectancy at age 65 (years)..................................................... 25 Percentage of life lived in good health or free of disability, 2002..........................................................26 Life expectancy at birth ................................................................... 27 Deaths Deaths from all causes ..............................................................27–29 Infant deaths .............................................................................30–31 Infant, neonatal and postneonatal deaths....................................... 31 Perinatal deaths................................................................................32 Maternal deaths . ...................................................................... 33–34 Causes of death Main causes of death by age group.................................................. 35 Deaths from: diseases of the circulatory system.......................................36–37

vi



ischaemic heart disease...................................................... 38–39 pulmonary and other heart diseases.................................. 39–40 cerebrovascular diseases.....................................................41–42 selected cancers.................................................................. 42–43 cancer.................................................................................. 44–46 lung cancer.......................................................................... 47–48 female breast cancer and cervical cancer .......................... 49–50 cancer of the colon and anus............................................... 51–52 prostate cancer....................................................................52–53 external causes of injury and poisoning..............................54–55 motor vehicle traffic accidents............................................56–57 suicide..................................................................................57–58 diseases of the respiratory system..................................... 59–60 diseases of the digestive system..........................................61–62 chronic liver diseases and cirrhosis................................... 63–64

3. Diseases.......................................................................... 65 Notes.......................................................................................................65 Some infectious diseases New cases of: tuberculosis......................................................................... 67–68 hepatitis B........................................................................... 69–70 syphilis ................................................................................ 71–72 clinically diagnosed AIDS....................................................73–74 HIV infection.......................................................................74–75 Some noncommunicable diseases Prevalence of diabetes mellitus....................................................... 76 New cases of and deaths from lung cancer..................................... 77 New cases of and deaths from female breast cancer....................... 78 New cases of and deaths from cervical cancer................................ 79 Hospitalization Hospital discharges for: cancer................................................................................. 80–81 diseases of the circulatory system......................................81–82 diseases of the respiratory system..................................... 83–84 diseases of the digestive system........................................ 84–85 diseases of the musculoskeletal system............................. 86–87 injury and poisoning.......................................................... 87–88 Teeth Decayed, missing or filled teeth in 12-year-olds............................89

vii

4. Lifestyles and environment..............................................91 Notes....................................................................................................... 91 Smoking Smokers among adults......................................................................93 Regular daily smokers, 15+ years.....................................................94 Overweight and obesity Prevalence of overweight among adults...........................................95 Prevalence of obesity among adults.................................................96 Traffic accidents Injuries and deaths from motor vehicle traffic accidents................ 97 Road traffic accidents involving alcohol...........................................98 Alcohol Total alcohol consumption...................................................... 99–100 Consumption of spirits and wine.....................................................101 Consumption of spirits, wine and beer........................................... 102 Work accidents Deaths from work-related accidents......................................102–104 5. Health care.....................................................................105 Notes..................................................................................................... 105 Health personnel Number of: physicians........................................................................107–108 dentists............................................................................108–109 nurses .............................................................................. 110–111 Hospitals Hospital beds............................................................................111–112 Psychiatric hospital beds.................................................................113 Hospital beds and length of stay.....................................................114 Length of stay in hospital........................................................ 115–116 Inpatient hospital admissions................................................. 116–117 Some procedures Children vaccinated against measles and diphtheria.....................118 Caesarean sections................................................................. 119–120 Health expenditure Total health expenditure as a percentage of GDP.................. 120–121 Total health expenditure per person...................................... 122–123 References ......................................................................... 125

viii

Foreword Decisions on public health are based on evidence and profound understanding of a wide range of factors, including health data and statistics. Policy-makers take into consideration all available data about health and its determinants in their countries and, on this basis, shape their policies and design their actions. To facilitate the decisionmaking process, however, they also need to have synthetic yet simple ways to review and compare information, such as the graphics and maps used in this atlas. Contrasting national with international health data allows a broader picture of public health: statistical figures backed by subsequent in-depth analyses can be a powerful resource for health authorities in identifying failures and successes, constraints and good practices. The WHO Regional Office for Europe presents the second edition of this publication to a wide range of public health and medical professionals, as well as broader audiences. New data on relevant health issues in the WHO European Region have been incorporated in this edition to better reflect the new challenges confronting public health. Rich and elaborate data from various sources have been gathered, systematized, grouped and reformatted to help readers to go through them and gain an overall picture of health in the Region, to the extent it can be expressed in figures. We at the Regional Office hope that this statistical publication will be useful to those committed to work for the improvement of public health throughout the Region, and stimulate review and discussion of its contents. Marc Danzon WHO Regional Director for Europe



Technical notes This publication contains basic health-related statistics for the 53 Member States in the WHO European Region. The data cover the main aspects of health and its determinants: that is, basic demographic data, health status in terms of mortality and morbidity, and some indicators on lifestyles, environment and health care resources and their utilization. The period covered runs from 1980 at the earliest to 2006 at the latest, depending on the data available in countries. Most of the data used in this publication come from countries themselves, usually from statistical units of health ministries or public health institutions, and national statistical institutions. These data are systematically collected by WHO technical staff (at the Regional Office for Europe or in headquarters) or by WHO collaborating centres. All these data, and more, are available in databases accessible on the Regional Office and headquarters web sites (1,2). For the sake of completeness, some publicly available data collected and published by other international organizations – the Statistical Office of the European Community (EUROSTAT), the International Labour Organization (ILO), the United Nations Economic Commission for Europe (UNECE), the Organisation for Economic Co-operation and Development (OECD), the Food and Agriculture Organization of the United Nations (FAO) – have also been included when appropriate, with the information source acknowledged. Data were compiled, validated and processed in a uniform way to improve the international comparability of statistics. Nevertheless, many factors – such as variations in national definitions, incomplete registration in some countries or other national specificities in data recording and processing – may influence the accuracy and comparability of the national statistics. Statistics, particularly in international comparisons, should therefore always be interpreted with caution. The same applies to statistics for countries with very small populations, where figures tend to “jump” up and down purely because of the small numbers registered. On the other hand, the “statistical noise” from possible data inaccuracies or random fluctuations due to small figures is usually not high enough to mask completely what the statistics show. Most of the data in this publication are presented in three standard graphic forms.



Atlas of health in Europe

The ranked bar chart shows the relative position of each country in relation to other countries according to the latest data available. As the timing of data reporting to WHO varies a lot, data from different years often have to be used. When more recent data are provided, rankings may change. The map aims to reveal specific geographical patterns in the data, such as the east–west mortality gradient. Again, data from different years may have to be used, although 2005 and 2006 are the most common years. The line chart shows health trends for the last 25 years in two parts of the Region. Technically, it is difficult to present trends separately for each of the 53 countries on one line chart. On the other hand, had only the average trends for the whole Region been given, some important subregional differences in health trends would not have been visible. Subregional population-weighted averages for each indicator are therefore calculated for two groups of countries: •

Eur-A, comprising 27 countries in the WHO European Region with very low child and adult mortality: Andorra, Austria, Belgium, Croatia, Cyprus, the Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, the Netherlands, Norway, Portugal, San Marino, Slovenia, Spain, Sweden, Switzerland and the United Kingdom; and

•

Eur-B+C, comprising 26 countries in the Region: Eur-B (17 countries with low child and adult mortality: Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Bulgaria, Georgia, Kyrgyzstan, Montenegro, Poland, Romania, Serbia, Slovakia, Tajikistan, the former Yugoslav Republic of Macedonia, Turkey, Turkmenistan and Uzbekistan) and Eur-C (9 countries with low child but high adult mortality: Belarus, Estonia, Hungary, Kazakhstan, Latvia, Lithuania, Moldova, the Russian Federation and Ukraine).

The names used for countries are those that were correct at the time of going to print. Unless otherwise stated, death rates are age-standardized death rates (SDR): the number of deaths per 100 000 people in a “standard” population. This facilitates international comparability by removing differences in rates caused by different population age structures



Technical notes

between countries. The European “standard population” (see the table below) was used to calculate the SDR. The mortality rates used cover all age groups: those aged under 65 years (so-called premature mortality) or aged 25–64 (representing the working age) in most cases. Readers interested in other, or more detailed age groups may consult the European Health for All or mortality databases (1,3). The European standard population structure Age (years)

Percentage of population

Age (years)

Percentage of population

0

1.6

45–49

7

1–4

6.4

50–54

7

5–9

7

55–59

6

10–14

7

60–64

5

15–19

7

65–69

4

20–24

7

70–74

3

25–29

7

75–79

2

30–34

7

80–84

1

35–39

7

≥ 85

1

40–44

7

All ages

100



1. Demography Notes Population (p. 7) In mid-2006, the population of the 53 countries in the WHO European Region totalled 881.5 million. The six largest countries (the Russian Federation, Germany, Turkey, France, the United Kingdom and Italy) make up more than half of the Region’s population.

Natural population growth (pp. 8–9) In the 1990s, the decline in the number of births and the increase in the number of deaths reached a cross-over point for several countries, mostly in the central and eastern part of the European Region. Nevertheless, there are now again more births than deaths in the Region as a whole.

Age structure (pp. 9–12) In general, European countries have ageing populations. Every seventh person is aged 65 years or more, and this proportion is growing while the proportion of children is declining. The ageing process is more advanced in Eur-A countries: the western part of the Region. The graphs are based on population data by age, as most recently reported by countries to WHO and EUROSTAT.

Births (pp. 13–16) Live birth rates were declining in the Region until the beginning of the 21st century, and this decline was particularly sharp in Eur-B+C countries. This was most likely due to the profound socioeconomic changes in this group and the economic crises in some of the countries. The proportion of infants with low birth weight (below 2500 g) is on average higher in Eur-A countries than in Eur-B+C countries, and is growing in the former. Low-weight births, however, may be high but underreported in some countries of the eastern part of the Region.



Atlas of health in Europe

While births to young mothers are most common in the eastern part of the Region, births to mothers aged over 35 years are most frequent in western countries.

Abortions (p. 17) The legal requirements for abortion vary between countries. In general, the average rates of abortion are higher in countries in the eastern and central parts of the Region than in the western part.

Demography

Population

Mid-year population, 2006 Russian Federation Germany Turkey France United Kingdom Italy Ukraine Spain Poland Uzbekistan Romania Netherlands Kazakhstan Greece Portugal Belgium Czech Republic Hungary Belarus Sweden Azerbaijan Austria Bulgaria Serbia Switzerland Israel Tajikistan Denmark Slovakia Finland Kyrgyzstan Turkmenistan Norway Croatia Georgia Ireland Bosnia and Herzegovina Moldova Lithuania Armenia Albania Latvia MKDa Slovenia Estonia Cyprus Montenegro Luxembourg Malta Iceland Andorra Monaco San Marino

82 716 72 974 60 723 59 847 58 942 46 607 43 379 38 132 26 980 21 584 16 346 15 308 11 149 10 545 10 437 10 109 10 071 9 733 9 070 8 485 8 282 7 671 7 412 7 264 7 054 6 591 5 446 5 401 5 262 5 164 4 899 4 643 4 440 4 398 4 240 3 912 3 585 3 394 3 221 3 147 2 288 2 040 2 009 1 344 771 624 473 403 304 80 32 27 0

50 000

100 000

Population (thousands) a

The International Organization for Standardization (ISO) abbreviation for the former Yugoslav Republic of Macedonia is used throughout this book.

142 537

150 000





Population

Atlas of health in Europe

Natural population growth Tajikistan (2005) Israel (2003) Uzbekistan (2005) Turkmenistan (1998) Kyrgyzstan (2005) Turkey (2006) Azerbaijan (2005) Kazakhstan (2006) Iceland (2005) Ireland (2005) Albania (2004) France (2004) Luxembourg (2005) Cyprus (2004) Armenia (2003) Norway (2005) Netherlands (2004) San Marino (2005) Montenegro (2005) United Kingdom (2005) MKD (2003) Finland (2005) Belgium (2006) Spain (2005) Malta (2005) Denmark (2006) Switzerland (2004) Georgia (2006) Sweden (2004) Portugal (2004) Greece (2006) Austria (2006) Slovenia (2006) Bosnia and Herzegovina (2006) Slovakia (2005) Italy (2006) Poland (2005) Czech Republic (2005) Germany (2004) Moldova (2006) Romania (2006) Croatia (2006) Estonia (2005) Hungary (2005) Lithuania (2005) Serbia (2006) Latvia (2006) Bulgaria (2004) Belarus (2005) Russian Federation (2005) Ukraine (2006)

–10

22.0

15.0 15.0 14.8 14.2 12.4 10.9 9.4 8.3 8.1 8.1 4.3 3.9 3.8 3.6 3.4 3.1 2.8 2.4 2.3 2.2 1.9 1.9 1.8 1.8 1.7 1.7 1.3 1.1 0.6 0.6 0.4 0.4 0.2 0.2 0.0 –0.1 –0.6 –1.4 –1.6 –1.8 –2.0 –2.2 –3.8 –3.9 –4.3 –4.7 –5.2 –5.3 –5.9 –6.4

–5

0

5

10

15

20

Rate per 1000 population Note. Data for Italy, Belgium, Denmark, Bosnia and Herzegovina, Turkey and Georgia are from EUROSTAT.

Rate per 1000 population

25

Demography

Population

Natural population growth

12

Rate per 1000 population

Eur-A Eur-B+C 9

6

3

0

1980

1985

1990

1995

2000

2005

Year

Young population (0–14 years) and old population (65+ years) 30

Natural population growth, 1980–2005

Percentage of population

25

20

15

10 Young, Eur-A

5

Old, Eur-A Young, Eur-B+C Old, Eur-B+C

0

1980

1985

1990

1995 Year

Young population (0–14 years) and

2000

2005



10

Population

Atlas of health in Europe

Young population (0–14 years)

≤ 40 ≤ 30 ≤ 20 ≤ 18 ≤ 15 No data % of population

Old population (65+ years)

≤ 19 ≤ 17 ≤ 14 ≤ 11 ≤7 No data % of population

Demography

Population

Old population (65+ years) 19.8 18.5 18.3 17.2 17.2 17.1 17.1 17.0 17.0 16.9 16.8 16.7 16.6 16.4 16.3 16.0 15.9 15.8 15.8 15.8 15.7 15.2 15.2 14.8 14.7 14.5 14.3 14.2 14.1 13.9 13.8 13.4 13.2 12.6 11.9 11.7 11.7 11.2 11.2 10.6 10.1 9.9

Italy (2006) Greece (2006) Germany (2004) Serbia (2006) Sweden (2004) Bulgaria (2004) Belgium (2006) Croatia (2006) Latvia (2006) Portugal (2004) Spain (2005) Austria (2006) Estonia (2005) France (2004) Ukraine (2006) United Kingdom (2005) Finland (2005) San Marino (2005) Switzerland (2004) Slovenia (2006) Hungary (2005) Lithuania (2005) Denmark (2006) Romania (2006) Norway (2005) Belarus (2005) Luxembourg (2005) Georgia (2001) Czech Republic (2005) Netherlands (2004) Russian Federation (2005) Malta (2005) Poland (2005) Montenegro (2005) Cyprus (2004) Slovakia (2005) Iceland (2005) MKD (2006) Ireland (2005) Armenia (2005) Moldova (2006) Israel (2003) Albania (2004) Kazakhstan (2006) Azerbaijan (2005) Bosnia and Herzegovina (1991) Kyrgyzstan (2005) Uzbekistan (2005) Tajikistan (2005) Turkey (1986) Turkmenistan (1998)

8.2 7.9 7.0 6.3 5.6 4.5 4.4 4.2 3.8 0

5

10

15

20

Population (thousands) Note. Data for Belgium, Denmark, Italy, and the former Yugoslav Republic of Macedonia are from EUROSTAT.

11

12

Population

Atlas of health in Europe

Age pyramid, 2005 Males

Females Eur-A

85+

Eur-B+C

80–84 75–79 70–74 65–69 60–64 Age group (years)

55–59 50–54 45–49 40–44 35–39 30–34 25–29 20–24 15–19 10–14 5–9 0–4 21 000

15 000

9000

3000 0 3000 Population (thousands)

9000

15 000

21 000

Births

Demography

Birth rate 26.2

Tajikistan (2005) Kyrgyzstan (2005) Turkmenistan (1998) Israel (2005) Uzbekistan (2005) Kazakhstan (2006) Turkey (2005) Azerbaijan (2005) Ireland (2005) Iceland (2005) Albania (2004) France (2004) Norway (2005) United Kingdom (2005) Denmark (2004) Montenegro (2005) Luxembourg (2005) Armenia (2005) Netherlands (2005) Belgium (2005) Sweden (2005) MKD (2005) Finland (2005) Cyprus (2005) Spain (2005) Georgia (2005) Estonia (2005) Andorra (2005) Moldova (2005) Portugal (2005) Russian Federation (2005) Romania (2006) Slovakia (2005) San Marino (2005) Greece (2006) Czech Republic (2005) Ukraine (2006) Switzerland (2005) Latvia (2006) Hungary (2005) Serbia (2006) Malta (2005) Poland (2005) Italy (2005) Slovenia (2006) Austria (2006) Croatia (2006) Belarus (2005) Bulgaria (2005) Lithuania (2005) Bosnia and Herzegovina (2005) Germany (2005)

21.5 21.1 20.8 20.4 19.7 18.9 16.9 14.8 14.5 13.8 12.7 12.3 12.0 11.9 11.8 11.8 11.7 11.5 11.3 11.2 11.0 11.0 10.9 10.8 10.7 10.7 10.5 10.5 10.4 10.2 10.2 10.1 10.1 10.1 10.0 9.9 9.8 9.8 9.7 9.6 9.6 9.6 9.5 9.4 9.4 9.3 9.2 9.2 9.0 8.8 8.3 5

10

15

20

Live births per 1000 population Note. Data for Bulgaria and Germany are from EUROSTAT.

25

13

Births

Atlas of health in Europe

Birth rate 22

Eur-A Eur-B+C

Per 1000 population

19

16

13

10 1980

1985

1990

1995

2000

2005

Year

Low-weight births, under 2500 g 8

Birth rate Percentage of live births

14

Eur-A Eur-B+C

7

6

5

4 1980

1985

1990

1995 Year

Low-weight births, under 2500 g

2000

2005

Births

Demography

Low-weight births, under 2500 g MKD (2003) Andorra (2005) Bulgaria (2006) Greece (2003) Hungary (2006) Israel (2006) Romania (2006) France (2003) Armenia (2006) United Kingdom (2001) Portugal (2005) Spain (2004) Azerbaijan (2006) Slovakia (2006) Czech Republic (2006) Austria (2006) Italy (2004) Germany (2006) Malta (2006) Kyrgyzstan (2006) Switzerland (1999) Belgium (1997) Poland (2005) Slovenia (2006) Russian Federation (2006) Tajikistan (2006) Ireland (2004) Kazakhstan (2006) Serbia (2006) Norway (2006) Georgia (2006) Belarus (2006) Ukraine (2006) Montenegro (2006) Croatia (2006) Denmark (2005) Luxembourg (2003) Albania (2006) Uzbekistan (2005) Moldova (2006) Lithuania (2006) Latvia (2006) Turkmenistan (2006) Iceland (2006) Estonia (2006) Finland (2006) Sweden (2004) Turkey (2006)

26.2 13.0 9.3 8.6 8.3 8.2 8.1 8.0 7.9 7.5 7.5 7.4 7.3 7.3 7.1 7.1 6.9 6.8 6.7 6.5 6.3 6.1 6.1 5.9 5.9 5.7 5.7 5.6 5.5 5.4 5.3 5.2 5.1 5.0 4.9 4.9 4.9 4.7 4.6 4.6 4.6 4.6 4.5 4.4 4.4 4.3 4.2 1.9 0

5

10

15

Percentage of live births

20

25

15

16

Births

Atlas of health in Europe

Births to young mothers (under 20 years)

≤ 15 ≤ 12 ≤9 ≤5 ≤2 No data % of all births

Births to older mothers (35+ years)

≤ 26 ≤ 21 ≤ 16 ≤ 11 ≤6 No data % of all births

Demography

Abortions

Abortions

≤ 1100 ≤ 900 ≤ 600 ≤ 400 ≤ 200 No data Per 1000 live births

Abortions per 1000 live births

17

19

2. Life and death Notes Life expectancy (pp. 23–27) Life expectancy, or the average number of years that a newborn baby can expect to live if mortality patterns remain unchanged, is one of the most common measurements of a population’s health. As it is calculated using mortality statistics, its accuracy depends on the accuracy and completeness of official national mortality data. The table on p. 23 shows two different estimates of life expectancy. One is the conventional life expectancy based on reported official mortality statistics. The other estimate is calculated using special demographic techniques to counteract possible underreporting of deaths (see The world health report 2006 (4) for details on methodology). Countries with the largest differences between these two estimates most probably have life expectancy well below the level calculated from official statistics. This problem occurs mainly in countries in central Asia, the Caucasus and the Balkans. These were affected by armed conflict and severe socioeconomic difficulties during the 1990s and many countries’ national vital statistics systems (registration of marriages, births and deaths) were damaged. This should be kept in mind when making comparisons between life expectancy in these areas and in other countries. The trends in life expectancy show a still growing gap between western and eastern parts of the Region. The average trend for Eur-B+C countries is particularly complex, as it reflects the effects of both the anti-alcohol campaigns introduced in the USSR in 1985 and the deep socioeconomic crises of the 1990s in some countries. The trends in cause-specific mortality show the same pattern. Nevertheless, life expectancy showed a remarkable increase in several Eur-B+C countries since the mid-1990s. Disability-adjusted life expectancy (often called healthy life expectancy) shows the estimated number of years of life expected to be lived in full health, while taking account of years lived in less than full health due to disease and/or injury. WHO calculated these estimates by using special techniques developed to maximize comparability across populations

20

Atlas of health in Europe

(see The world health report 2004 (5) for details on methodology). The bar chart shows what percentage of expected length of life that a child born in 2002 could expect to live in good health.

Deaths from all causes (pp. 27–29) Mortality gradually increases from the western to the eastern part of the Region. The level of premature mortality (deaths in people aged below 65 years) varies particularly dramatically in relative terms. East–west differences in mortality of the elderly population (those aged 65 years and over) are relatively less pronounced. Excess male mortality is presented as a percentage of the excess of male over female death rates on the left side of the bar charts. Particularly high premature male mortality in some eastern countries makes the largest contribution proportionally to the east–west gap in total mortality.

Infant deaths (pp. 30–31) Infant mortality shows the number of deaths of children below 1 year of age per 1000 live births. Unfortunately, some countries are not able to ensure complete registration of infant deaths and live births or to report them according to the WHO definition. Infant mortality rates reported by those countries are therefore lower than the actual rates, and intercountry comparisons should be treated with caution. For that reason, the bar chart with reported infant mortality rates also presents the most recent (2006) estimated infant mortality rates, which are based on the work of the Inter-agency Group for Child Mortality Estimation, which includes the United Nations Children’s Fund (UNICEF), WHO, the World Bank and the United Nations Population Division (6). Levels of underregistration are particularly high in countries in central Asia and the Caucasus and in some other countries, such as Albania and Bosnia and Herzegovina. Infant mortality is higher in the eastern part of the Region, with the highest levels in some south-eastern countries. Taking into account the above-mentioned underregistration, the real infant mortality in these countries is likely to be even higher.

Perinatal deaths (pp. 31–32)

The rate shows the number of deaths of fetuses weighing 1000 g or more and of newborn babies aged 0–6 full days per 1000 births (live and

Life and death

stillborn). Where weight-specific data were not available, calculations were based on the data provided by countries, whatever the national criteria. For that reason and owing to possible incomplete registration of perinatal deaths in the countries where infant mortality is incomplete, intercountry comparisons should be treated with caution.

Maternal deaths (pp. 33–34) A maternal death is the death of a woman while pregnant or within 42 days of the end of a pregnancy, from any cause related to or aggravated by the pregnancy or its management. The maternal mortality ratio (deaths per 100 000 live births) was calculated using mortality data from routine vital statistics reported to WHO and hospital data reported by health ministries, taking the larger figure where they differed. Even in countries with good vital statistics systems, however, maternal mortality is believed to be higher than reported. For that reason, the bar chart with the reported maternal mortality ratios also presents the most recent (2005) estimated maternal mortality ratios, which are based on the work of WHO, UNICEF, the United Nations Population Fund (UNFPA) and the World Bank (7).

Deaths by cause and age (p. 35) The importance of specific causes of death differs significantly in the different phases of the lifespan. Respiratory and some other diseases are leading causes of death in childhood, replaced by accidents and other external causes of death among adolescents and young adults. Cancer and diseases of the circulatory system become leading causes of death in older age groups.

Deaths from diseases of the circulatory system (pp. 36–42) The average trends in mortality from cardiovascular diseases are declining in Eur-A countries. The average rates for Eur-B+C countries do not show improvement; they are stable in females and still rising in males. Nevertheless, this group of countries is not homogeneous; mortality trends have been declining in a number of them, while increasing in others, for several years. A clear east–west gradient contributes a large part of the east–west difference in total mortality and life expectancy. The pattern of trends and differences in death rates from ischaemic heart disease and cerebrovascular diseases are similar to those for all diseases

21

22

Atlas of health in Europe

of the circulatory system, while average death rates for pulmonary heart disease and other heart diseases in Eur-B+C countries show a striking increase. Deaths from cancer (pp. 42–53) Trends in cancer death rates show some general improvement in the European Region. The average cancer mortality in western countries is relatively low in younger age groups and relatively high among the older population. The opposite is true in the eastern part of the Region, although mortality is relatively low in both the younger and older age groups in some central Asian countries and Georgia. In the central part of the Region, cancer mortality is high in both younger and older age groups. Female mortality from lung cancer is steadily increasing in Eur-A countries; in Eur-B+C as a whole, there is no progress in reducing deaths from colorectal cancer among older people, breast cancer in older women and cancer of the cervix uteri in younger women. Deaths from external causes of injury and poisoning (pp. 54–58) External causes of death from injury and poisoning include accidents, homicide, suicide and other causes that are not diseases. The remarkable increase in mortality from these causes in Eur-B+C in the first half of the 1990s is attributable to the combined effect of the end of the anti-alcohol campaigns that started in the USSR in 1985 and the socioeconomic crises of the 1990s. The excess mortality in Eur-B+C in relation to mortality in the Eur-A group is striking, especially in males. Deaths from diseases of the respiratory system (pp. 59–60) In general, deaths from respiratory conditions are declining in both groups of countries. While mortality in males is higher in Eur B+C than in Eur-A, rates for females show little difference. Deaths from diseases of the digestive system (pp. 61–64) Deaths from chronic liver disease and cirrhosis are responsible for about a half of all deaths from diseases of the digestive system. Mortality is steadily declining in Eur-A countries, but increasing in the Eur-B+C group.

Life and death

Life expectancy

Conventional and estimated life expectancy Males Country (year)

Albania (2004) Andorra Armenia (2003) Austria (2006) Azerbaijan (2004) Belarus (2005) Belgium (1997) Bosnia and Herzegovina (1991) Bulgaria (2004) Croatia (2006) Cyprus (2004) Czech Republic (2005) Denmark (2001) Estonia (2005) Finland (2005) France (2004) Georgia (2004) Germany (2005) Greece (2006) Hungary (2005) Iceland (2005) Ireland (2005) Israel (2003) Italy (2002) Kazakhstan (2006) Kyrgyzstan (2005) Latvia (2006) Lithuania (2005) Luxembourg (2005) Malta (2005) Moldova (2006) Monaco Montenegro (2005) Netherlands (2004) Norway (2005) Poland (2005) Portugal (2004) Romania (2006) Russian Federation (2005) San Marino (2005) Serbia (2006) Slovakia (2005) Slovenia (2006) Spain (2005) Sweden (2004) Switzerland (2004) Tajikistan (2005) MKD (2003) Turkey (2002) Turkmenistan (1998) Ukraine (2006) United Kingdom (2005) Uzbekistan (2005)

Conventional life expectancy (years)

73.7 70.0 77.3 69.3 62.9 74.2 69.5 69.1 72.6 77.0 73.0 75.1 67.3 75.8 76.9 69.3 76.6 77.5 68.8 79.5 77.3 77.6 77.3 60.7 63.8 65.4 65.4 77.0 77.2 64.6 71.4 77.0 78.0 70.8 74.9 69.2 59.0 78.9 70.8 70.3 74.6 77.1 78.3 78.8 71.2 71.1 67.9 62.5 62.3 77.1 68.2

Females

 

Estimated life expectancy,   2004 (years)

69.0 77.0 65.0 76.0 63.0 63.0 75.0 70.0 69.0 72.0 77.0 73.0 75.0 66.0 75.0 76.0 70.0 76.0 77.0 69.0 79.0 75.0 78.0 78.0 56.0 59.0 66.0 66.0 76.0 76.0 64.0 78.0 77.0 77.0 71.0 74.0 68.0 59.0 79.0 70.0 73.0 77.0 78.0 78.0 62.0 69.0 69.0 56.0 62.0 76.0 63.0

Conventional life expectancy (years)

Estimated life expectancy, 2004 (years)

78.9

74.0 83.0 72.0 82.0 68.0 74.0 81.0 77.0 76.0 79.0 82.0 79.0 80.0 78.0 82.0 83.0 77.0 82.0 82.0 77.0 83.0 81.0 82.0 84.0 67.0 67.0 76.0 78.0 81.0 81.0 71.0 85.0

75.9 82.9 74.0 75.1 80.8 76.0 76.3 79.4 82.2 79.3 79.5 78.2 82.8 84.0 76.7 82.0 82.1 77.2 83.6 81.8 81.7 83.3 72.0 71.9 76.4 77.4 82.2 81.4 72.4 76.9 81.7 82.9 79.4 81.6 76.2 72.4 83.2 76.2 78.2 82.0 83.8 82.7 83.9 76.3 76.1 72.2 69.8 73.8 81.4 73.0

81.0 82.0 79.0 81.0 76.0 72.0 84.0 78.0 81.0 83.0 83.0 83.0 64.0 76.0 73.0 65.0 73.0 81.0 69.0

23

24

Life expectancy

Atlas of health in Europe

Life expectancy at birth (years) Iceland (2005) San Marino (2005) Switzerland (2004) Sweden (2004) Norway (2005) Israel (2003) Greece (2006) Ireland (2005) Austria (2006) Italy (2002) Malta (2005) United Kingdom (2005) Spain (2005) Netherlands (2004) Luxembourg (2005) Cyprus (2004) France (2004) Germany (2005) Finland (2005) Denmark (2001) Portugal (2004) Slovenia (2006) Belgium (1997) Albania (2004) Czech Republic (2005) Croatia (2006) Montenegro (2005) Tajikistan (2005) MKD (2003) Serbia (2006) Poland (2005) Slovakia (2005) Armenia (2003) Bosnia and Herzegovina (1991) Azerbaijan (2004) Georgia (2004) Romania (2006) Bulgaria (2004) Hungary (2005) Uzbekistan (2005) Turkey (2002) Estonia (2005) Latvia (2006) Lithuania (2005) Moldova (2006) Kyrgyzstan (2005) Belarus (2005) Turkmenistan (1998) Ukraine (2006) Kazakhstan (2006) Russian Federation (2005)

83.6 83.2 83.9 82.7 82.9 81.7 82.1 81.8 82.9 83.3 81.4 81.4 83.8 81.7 82.2 82.2 84.0 82.0 82.8 79.5 81.6 82.0 80.8 78.9 79.3 79.4 76.9 76.3 76.1 76.2 79.4 78.2 75.9 76.0 74.0 76.7 76.2 76.3 77.2 73.0 72.2 78.2 76.4 77.4 72.4 71.9 75.1 69.8 73.8 72.0 72.4 90

80

70 Females

79.5 78.9 78.8 78.3 78.0 77.6 77.5 77.3 77.3 77.3 77.2 77.1 77.1 77.0 77.0 77.0 76.9 76.6 75.8 75.1 74.9 74.6 74.2 73.7 73.0 72.6 71.4 71.2 71.1 70.8 70.8 70.3 70.0 69.5 69.3 69.3 69.2 69.1 68.8 68.2 67.9 67.3 65.4 65.4 64.6 63.8 62.9 62.5 62.3 60.7 59.0 60

50

60

70 Males

80

90

Life and death

Life expectancy

Life expectancy at age 65 (years) Iceland (2005) Switzerland (2004) France (2004) Greece (2006) Sweden (2004) Austria (2006) Israel (2003) San Marino (2005) Spain (2005) Norway (2005) United Kingdom (2005) Italy (2002) Luxembourg (2005) Finland (2005) Ireland (2005) Germany (2005) Cyprus (2004) Netherlands (2004) Portugal (2004) Malta (2005) Slovenia (2006) Denmark (2001) Belgium (1997) Albania (2004) Azerbaijan (2004) Tajikistan (2005) Czech Republic (2005) Poland (2005) Croatia (2006) Montenegro (2005) Bosnia and Herzegovina (1991) Romania (2006) Serbia (2006) Slovakia (2005) Hungary (2005) MKD (2003) Bulgaria (2004) Estonia (2005) Lithuania (2005) Georgia (2004) Uzbekistan (2005) Latvia (2006) Armenia (2003) Turkmenistan (1998) Kyrgyzstan (2005) Ukraine (2006) Moldova (2006) Belarus (2005) Kazakhstan (2006) Russian Federation (2005)

21.1 21.7 22.3 19.6 20.8 20.8 19.8 21.3 21.4 21.0 19.8 21.2 20.4 21.1 20.1 20.2 19.5 20.0 19.8 19.5 20.1 18.5 19.6 17.8 16.6 17.8 17.8 18.6 17.8 16.5 15.7 16.5 15.7 17.3 17.2 15.5 16.3 18.1 17.7 15.7 15.0 17.4 15.4 14.9 15.2 15.6 14.4 16.1 15.1 15.4 25

20

15

18.4 18.3 17.8 17.6 17.6 17.5 17.4 17.4 17.3 17.3 17.1 17.1 17.1 17.0 16.9 16.8 16.6 16.4 16.3 16.3 16.0 15.4 15.2 14.9 14.7 14.5 14.5 14.4 14.3 14.1 13.9 13.7 13.5 13.4 13.4 13.4 13.3 13.1 13.1 13.0 13.0 12.7 12.7 12.4 12.2 11.7 11.4 11.3 11.3 11.0 10

Females

5

0

5

10 Males

15

20

25

26

Life expectancy

Atlas of health in Europe

Percentage of life lived in good health or free of disability, 2002 Sweden Norway Germany Italy Iceland Spain San Marino Finland Malta Netherlands Denmark Belgium Luxembourg Ireland Switzerland Slovenia France Israel Greece United Kingdom Czech Republic Bulgaria Estonia Georgia Andorra Monaco Austria Portugal Belarus Russian Federation Slovakia Turkey Hungary Bosnia and Herzegovina Croatia Latvia Romania MKD Kazakhstan Moldova Poland Ukraine Lithuania Armenia Azerbaijan Albania Cyprus Uzbekistan Turkmenistan Tajikistan Kyrgyzstan

90.6 90.1 90.7 90.6 90.0 90.7 90.4 90.2 90.0 89.5 89.4 89.9 90.2 89.6 90.4 89.8 89.5 88.8 89.9 89.6 89.8 88.7 89.5 88.8 89.1 89.0 89.4 89.1 87.4 89.2 88.6 87.0 88.8 86.9 88.2 89.1 86.9 86.6 86.1 87.2 87.0 87.2 87.2 85.8 85.6 85.4 86.6 86.0 85.5 Females 84.8 Males 84.8 92

90

88

86

92.2 92.2 92.1 92.1 92.0 91.9 91.8 91.8 91.8 91.7 91.7 91.6 91.6 91.5 91.5 91.5 91.3 91.2 91.2 91.2 91.0 91.0 90.9 90.9 90.9 90.9 90.7 90.6 90.4 90.4 90.3 90.1 89.9 89.9 89.9 89.8 89.7 89.7 89.6 89.4 89.4 89.0 89.0 88.7 88.6 88.4 88.3 88.3 87.8 87.1 86.4 84

82

80

82

84

86

88

90

Percentage of years of life expectancy at birth

92

94

Life and death

Life expectancy/Deaths

Life expectancy at birth 80

Years

75 Males, Eur-A Females, Eur-A Males, Eur-B+C Females, Eur-B+C

70

65

60 1980

1985

1990

1995

2005

2000

Year

Deaths from all causes

≤ 1600 ≤ 1300 ≤ 1000 ≤ 800 ≤ 600 No data Per 100 000

Life expectancy at birth, Eur-A and Eur-B+C

27

28

Deaths

Atlas of health in Europe

Deaths from all causes, 0–64 years Russian Federation (2005) Kazakhstan (2006) Turkmenistan (1998) Ukraine (2006) Belarus (2005) Kyrgyzstan (2005) Moldova (2006) Latvia (2006) Lithuania (2005) Uzbekistan (2005) Estonia (2005) Azerbaijan (2004) Hungary (2005) Tajikistan (2005) Romania (2006) Bulgaria (2004) Serbia (2006) Poland (2005) Slovakia (2005) Armenia (2003) Montenegro (2005) MKD (2003) Georgia (2001) Czech Republic (2005) Croatia (2006) Slovenia (2006) Belgium (1997) Denmark (2001) Finland (2005) Albania (2004) Portugal (2004) France (2004) Germany (2004) United Kingdom (2005) Luxembourg (2005) Austria (2006) Netherlands (2004) Ireland (2005) Spain (2005) Israel (2003) Greece (2006) Italy (2002) Norway (2005) Sweden (2004) Malta (2005) Cyprus (2004) Switzerland (2004) Iceland (2005) San Marino (2005)

206 162

782.2 701.0 629.7 629.3 603.7 591.0 581.7 525.8 503.3 455.7 431.4 427.3 420.6 395.4 387.2 383.3 342.5 335.6 332.4 328.0 323.4 314.2 294.3 266.9 265.9 237.0 233.7 233.2 222.3 221.3 219.9 204.8 198.0 191.9 191.5 182.5 181.3 177.6 176.7 172.8 170.9 170.1 165.7 162.4 160.4 158.7 156.2 140.7 135.8

83 192 217 105 109 183 226 64 206 64 153 47 126 138 103 164 161 110 104 89 132 127 148 154 90 52 125 90 134 120 97 61 95 107 48 58 144 75 133 96 58 54 50 117 84 67 18 200 Excess mortality, males compared to females (%)

0

200

400 Per 100 000 population

600

800

Life and death

Deaths

Deaths from all causes, 65+ years Moldova (2006) Kazakhstan (2006) Russian Federation (2005) Armenia (2003) Ukraine (2006) Turkmenistan (1998) Kyrgyzstan (2005) Belarus (2005) MKD (2003) Uzbekistan (2005) Bulgaria (2004) Serbia (2006) Romania (2006) Montenegro (2005) Slovakia (2005) Latvia (2006) Hungary (2005) Lithuania (2005) Azerbaijan (2004) Albania (2004) Estonia (2005) Croatia (2006) Czech Republic (2005) Tajikistan (2005) Poland (2005) Denmark (2001) Georgia (2001) Belgium (1997) Cyprus (2004) Malta (2005) Portugal (2004) Slovenia (2006) Netherlands (2004) Greece (2006) Ireland (2005) United Kingdom (2005) Israel (2003) Germany (2004) Luxembourg (2005) San Marino (2005) Sweden (2004) Finland (2005) Norway (2005) Italy (2002) Austria (2006) Spain (2005) Iceland (2005) Switzerland (2004) France (2004)

7738 7524 7398 7194 7064 7005 6992 6940 6856 6760 6502 6481 6195 6073 5901 5857 5829 5761 5729 5575 5543 5505 5455 5351 5125 4924 4704 4655 4502 4432 4349 4268 4266 4225 4158 4152 4115 4113 4008 3878 3849 3845 3844 3819 3809 3738 3607 3463 3443

41 54 67 35 52 35 36 70 32 22 39 25 36 30 54 66 53 65 21 42 77 50 46 39 60 42 14 67 44 43 50 62 54 21 44 36 32 46 49 72 46 61 53 60 49 61 37 50 67

2000 1000

0

Excess mortality, males compared to females (%)

1000 2000 3000 4000 5000 6000 7000

8000

Per 100 000 population

Excess mortality, males compared to females (%)

Per 100 000 population

29

30

Deaths

Atlas of health in Europe

Infant deaths Azerbaijan (2004) Tajikistan (2005) Turkmenistan (1998) Uzbekistan (2005) Kyrgyzstan (2005) Georgia (2005) Kazakhstan (2006) Turkey (2004) Armenia (2006) Ukraine (2006) Romania (2006) Moldova (2006) MKD (2006) Albania (2006) Russian Federation (2005) Bosnia and Herzegovina (2005) Bulgaria (2006) Belarus (2005) Montenegro (2005) Latvia (2006) Serbia (2006) Slovakia (2005) Lithuania (2005) Poland (2005) Hungary (2005) Malta (2005) Estonia (2005) Croatia (2006) United Kingdom (2005) Belgium (1997) Israel (2003) Switzerland (2006) Netherlands (2004) Ireland (2005) Italy (2004) Germany (2006) Denmark (2006) Spain (2005) Greece (2006) Austria (2006) France (2006) Luxembourg (2005) Liechtenstein Andorra (1999) Monaco (1999) Portugal (2004) Czech Republic (2005) Slovenia (2006) Finland (2005) Cyprus (2006) Norway (2005) Sweden (2006) San Marino (2005) Iceland (2005)

28.0 26.0 24.0 21.0 20.0 16.0 16.0 15.0 15.0 14.0 13.0 12.0 12.0 9.0 8.0 7.0 7.0 7.0 6.0 6.0 5.0 5.0 5.0 5.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 2.0 0

10

20

30

38.0 36.0

45.0

73.0

56.0

Estimated 2006 Latest year reported

40

Per 1000 live births

50

60

70

Life and death

Deaths

Infant deaths

≤ 33 ≤ 20 ≤ 15 ≤ 10 ≤5 No data Per 1000 live births

40

Infant, neonatal and postneonatal deaths Infant, Eur-A Neonatal, Eur-A Postneonatal, Eur-A Infant, Eur-B+C Neonatal, Eur-B+C Postneonatal, Eur-B+C

Per 1000 live births

30

20

10

0 1980

1985

1990

1995

Year

2000

2005

31

32

Deaths

Atlas of health in Europe

Perinatal deaths Kyrgyzstan (2006) Turkey (2006) Georgia (2006) Armenia (2006) 16.6 MKD (2006) 15.2 Tajikistan (2006) 15.1 Kazakhstan (2006) 13.6 Albania (1992) 11.5 Bulgaria (2006) 10.7 Moldova (2006) 10.5 Azerbaijan (2006) 10.2 Romania (2006) 10.0 Ukraine (2006) 9.0 Montenegro (2006) 9.0 Russian Federation (2006) 9.0 Uzbekistan (2005) 8.8 Turkmenistan (2006) 8.3 United Kingdom (2004) 8.1 Ireland (2004) 7.9 Switzerland (2006) 7.6 Latvia (2006) 7.4 Belgium (1997) 7.4 Belarus (2006) 7.3 Serbia (2006) 6.9 France (2001) 6.9 Netherlands (2006) 6.0 Slovakia (2006) 5.6 Germany (2006) 5.6 Croatia (2006) 5.3 Poland (2005) 5.3 Luxembourg (2005) 5.0 Greece (2006) 4.9 Hungary (2006) 4.9 Israel (2005) 4.7 Spain (2005) 4.7 Italy (2003) 4.6 Lithuania (2006) 4.6 Portugal (2005) 4.2 Estonia (2006) 4.2 Sweden (2004) 3.9 Czech Republic (2006) 3.6 Norway (2006) 3.6 Slovenia (2006) 3.5 Denmark (2005) 3.3 Austria (2006) 3.2 Finland (2006) 3.0 Iceland (2005) 1.9 Malta (2006) 1.8 Andorra (2005) 0.0 0

5

10

15

Per 1000 live births

24.8 22.7 19.6

20

25

Life and death

Deaths

Maternal deaths Tajikistan (2005) Kyrgyzstan (2005) Kazakhstan (2005) Turkmenistan Albania Azerbaijan (2005) Armenia (2005) Georgia (2005) Turkey 44.0 Russian Federation (2004) 28.0 Estonia (2005) 25.0 Uzbekistan (2004) 24.0 Romania (2005) 24.0 Moldova (2005) 22.0 18.0 Ukraine (2005) 18.0 Belarus (2005) 12.0 Luxembourg (2004) 11.0 Lithuania (2004) 11.0 Bulgaria (2003) 11.0 Portugal (2003) 10.0 Cyprus (2000) 10.0 MKD (2005) 10.0 Latvia (2005) 8.0 Belgium (1996) 8.0 France (2003) 8.0 United Kingdom (2004) Poland (2004) 8.0 Malta (2005) 8.0 Croatia (2005) 7.0 Finland (2004) 7.0 Norway (2004) 7.0 Slovenia (2005) 6.0 Netherlands (2005) 6.0 Hungary (2005) 6.0 Slovakia (2005) 6.0 Switzerland (2004) 5.0 Czech Republic (2005) 4.0 Germany (2005) 4.0 Spain (2004) 4.0 Austria (2005) 4.0 Iceland (2005) 4.0 Israel 4.0 Denmark 3.0 Bosnia and Herzegovina (1990) 3.0 Sweden (2003) 3.0 Italy (2001) 3.0 Greece (2005) 3.0 Ireland (2005) 1.0 Serbia (2005) Andorra (2004) 0

25

50

170.0 150.0 140.0 130.0 92.0 82.0 76.0 66.0

2005 estimate Reported three-year moving average

75

100

125

Per 100 000 live births

150

175

33

Deaths

Atlas of health in Europe

Maternal deaths 80

Eur-A Eur-B+C

60 Per 100 000 live births

34

40

20

0 1980

1985

1990

1995

Year

Maternal deaths

2000

2005

Life and death

Causes of death

35

Main causes of death by age group, males Diseases of the circulatory system

All deaths in each group (%)

100

Cancer

External causes of injury and poisoning

Infectious and parasitic diseases

Diseases of the respiratory system

Other diseases

75

50

25

0 0

1–14

15–24

25–34

35–44 45–54 Age group (years)

55–64

65–74

75–84

85+

Main causes of death by age group, females Diseases of the circulatory system

Cancer

External causes of injury and poisoning

Infectious and parasitic diseases Main causes of death by age group, males Diseases of the respiratory system Other diseases

75

50

10

25

0 0

1–14

15–24

25–34

35–44 45–54 Age group (years)

55–64

65–74

75–84

85+

all death in each group

All deaths in each group (%)

100

7

5

Causes of death

Atlas of health in Europe

Deaths from diseases of the circulatory system 1000

800 Per 100 000 population

36

600

400

200

0 1980

Males, Eur-A

Males, Eur-B+C

Females, Eur-A

Females, Eur-B+C

1985

1990

1995

2005

2000

Year

Deaths from diseases of the circulatory system

≤ 900 ≤ 750 ≤ 600 ≤ 400 ≤ 250 No data Per 100 000

Life and death

Causes of death

Deaths from diseases of the circulatory system, 25–64 years Russian Federation (2005) Kazakhstan (2006) Belarus (2005) Ukraine (2006) Latvia (2006) Kyrgyzstan (2005) Uzbekistan (2005) Lithuania (2005) Bulgaria (2004) Moldova (2006) Estonia (2005) Hungary (2005) Romania (2006) Tajikistan (2005) Azerbaijan (2004) Armenia (2003) Slovakia (2005) MKD (2003) Poland (2005) Croatia (2006) Czech Republic (2005) Albania (2004) Finland (2005) Greece (2006) Slovenia (2006) Cyprus (2004) Germany (2004) United Kingdom (2005) Ireland (2005) Malta (2005) Portugal (2004) Luxembourg (2005) Austria (2005) Netherlands (2004) Sweden (2004) Spain (2005) Norway (2004) Iceland (2005) France (2004) Israel (2003) Switzerland (2004)

241.9 252.2 184.0 199.1 149.9 229.8 246.7 105.3 154.8 206.7 90.9 103.7 122.5 209.7 187.1 104.0 76.3 126.5 69.6 58.7 59.8 70.9 32.8 39.1 34.6 38.0 37.0 39.2 32.8 37.9 36.3 37.0 29.2 36.6 27.4 24.4 25.6 14.3 21.6 25.7 20.2 200

762.8 672.3 603.2 595.9 516.5 457.4 428.1 417.4 416.9 389.4 358.0 323.2 308.2 305.9 299.1 291.3 257.5 235.2 233.7 194.5 180.6 153.4 135.9 126.9 126.1 117.1 107.4 104.9 103.6 102.9 101.8 96.5 85.8 83.7 81.8 80.7 75.4 72.7 Females 68.0 Males 66.3 64.4 0

200

400

Per 100 000 population

600

800

37

38

Causes of death

Atlas of health in Europe

Deaths from ischaemic heart disease, 25–64 years Russian Federation (2005) 99.8 Ukraine (2006) 114.1 84.9 Belarus (2004) 89.4 Kazakhstan (2006) Azerbaijan (2004) 108.3 62.7 Latvia (2006) 45.8 Lithuania (2005) Moldova (2006) 97.7 78.4 Kyrgyzstan (2005) Uzbekistan (2005) 98.4 43.7 Armenia (2003) 47.8 Hungary (2005) 32.8 Estonia (2005) 78.1 Tajikistan (2005) 43.9 Romania (2006) 35.0 Bulgaria (2004) 31.2 Slovakia (2005) 41.0 MKD (2003) 20.2 Poland (2005) 20.2 Croatia (2006) 22.1 Czech Republic (2005) 17.4 Greece (2006) 11.9 Finland (2005) 24.2 Albania (2004) 18.6 Malta (2005) 16.9 United Kingdom (2005) 15.1 Ireland (2005) 11.2 Cyprus (2004) 13.0 Germany (2004) 4.5 Iceland (2005) 8.1 Slovenia (2006) Austria (2006) 11.5 11.2 Sweden (2004) Luxembourg (2005) 5.9 Portugal (2004) 9.7 Norway (2005) 10.6 Spain (2005) 7.4 Netherlands (2004) 12.5 Israel (2003) 8.7 Switzerland (2004) 6.6 France (2004) 4.9 100

406.3 366.8 326.5 305.5 280.4 269.8 245.2 225.4 212.2 203.0 200.3 175.3 174.7 147.4 143.5 134.7 123.4 104.0 95.4 93.5 91.9 81.9 80.4 78.0 76.3 68.6 65.5 64.6 56.0 50.0 49.8 49.6 49.4 47.5 45.1 44.4 40.4 37.6 Females 35.9 Males 33.7 28.6 0

100

200

Per 100 000 population

300

400

Life and death

350

Causes of death

Deaths from ischaemic heart disease, 25–64 years

Per 100 000 population

300 250 200

Males, Eur-A Females, Eur-A Males, Eur-B+C

150

Females, Eur-B+C 100 50 0 1980

1985

1990

1995

2000

2005

Year

Deaths from pulmonary and other heart diseases, 25–64 years Males, Eur-A 100

Females, Eur-A

Per 100 000 population

Males, Eur-B+C 80

60

Females, Eur-B+C

Deaths from ischaemic heart diseases, 25–64 years, Eur-A

40

20

0 1980

1985

1990

1995

Year

2000

2005

39

40

Causes of death

Atlas of health in Europe

Deaths from pulmonary and other heart diseases, 25–64 years Kazakhstan (2006) Russian Federation (2005) Bulgaria (2004) Latvia (2006) Ukraine (2006) Lithuania (2005) Estonia (2005) Poland (2005) MKD (2003) Hungary (2005) Uzbekistan (2005) Croatia (2006) Romania (2006) Kyrgyzstan (2005) Slovenia (2006) Albania (2004) Czech Republic (2005) Slovakia (2005) Belarus (2005) Azerbaijan (2004) Germany (2004) Netherlands (2004) Finland (2005) Luxembourg (2005) Cyprus (2004) Tajikistan (2005) Spain (2005) Moldova (2006) France (2004) Portugal (2003) Ireland (2005) Greece (2006) Switzerland (2004) Armenia (2003) Israel (2003) Sweden (2004) Norway (2005) Austria (2006) Iceland (2005) United Kingdom (2005) Malta (2005)

49.4 47.6 56.6 33.8 22.2 17.4 13.7 18.4 28.6 14.1 21.5 14.1 12.7 11.9 8.7 16.8 12.6 10.0 8.2 13.6 10.7 11.9 7.2 17.5 15.5 10.4 6.8 6.3 6.8 8.1 6.2 8.7 6.6 5.7 6.7 4.7 4.4 4.9 0.0 5.9 6.5 50

156.7 153.5 145.9 124.1 91.0 75.7 70.1 65.1 45.2 45.0 44.6 40.1 38.5 37.7 34.8 32.9 30.1 28.3 28.3 27.3 26.6 26.1 24.8 24.5 24.0 22.0 18.7 18.5 18.4 17.4 16.3 15.2 15.0 13.6 13.1 12.5 12.2 11.8 11.4 11.3 6.2 0

50

Females Males

100

Per 100 000 population

150

Life and death

Causes of death

Deaths from cerebrovascular diseases, 25–64 years Kyrgyzstan (2005) 120.2 Russian Federation (2005) Kazakhstan (2006) Belarus (2005) Moldova (2006) Ukraine (2006) Uzbekistan (2005) Bulgaria (2004) Latvia (2006) Romania (2006) MKD (2003) Azerbaijan (2004) Estonia (2005) Lithuania (2005) Armenia (2003) Hungary (2005) Tajikistan (2005) Croatia (2006) Poland (2005) Slovakia (2005) Portugal (2004) Albania (2004) Czech Republic (2005) Slovenia (2006) Greece (2006) Finland (2005) Cyprus (2004) United Kingdom (2005) Spain (2005) Malta (2005) Ireland (2005) Germany (2004) Sweden (2004) Netherlands (2004) Luxembourg (2005) France (2004) Israel (2003) Norway (2005) Austria (2006) Switzerland (2004) Iceland (2005)

180.0 165.1 140.6 118.6 118.3 110.8 93.3 90.7 88.2 88.0 74.1 74.1 68.4 59.1 58.5 56.6 51.4 48.5 46.0 32.0 31.3 30.8 27.8 27.4 23.0 19.0 16.6 14.3 14.3 13.4 13.3 13.2 12.8 12.0 11.7 11.2 11.2 9.3 Females 9.2 Males 8.2 5.7

76.3 74.7 57.5 86.4 51.5 58.2 43.2 40.3 47.1 49.6 47.8 27.0 27.4 39.8 24.2 45.1 19.9 22.2 11.3 14.4 24.1 13.9 12.3 11.1 10.7 8.6 10.0 7.3 8.7 7.3 8.3 8.3 9.4 11.0 6.4 6.3 6.5 8.3 4.6 8.3

150 125 100

75

50

25

0

25

50

75 100 125 150 175 200

Per 100 000 population

Deaths from cerebrovascular diseases, 25–64

41

Causes of death

Atlas of health in Europe

Deaths from cerebrovascular diseases, 25–64 years 140 120 Per 100 000 population

42

Males, Eur-A

100

Females, Eur-A Males, Eur-B+C Females, Eur-B+C

80 60 40 20 0 1980

1985

1990

1995

2005

2000

Year

Deaths from selected cancers, WHO European Region Breast 17.2 5.5

Ovary

3.6

Other parts of uterus

2.9

Cervix Trachea, bronchus and lung

26.9

10.3 10.9

Deaths from cerebrovascular diseases, 25–64 years, Eur

Colon, rectum and anus

13.2

8.8

Prostate

Stomach Lymph node and haematopoietic tissue Pancreas

8.1

7.0

6.5

7.3

4.7

5.7

4.0

3.0

Liver, bile ducts Bladder

3.9

1.6

Lip, oral cavity and pharynx

1.1

Oesophagus

1.3

Melanoma of skin

1.2 20

15

10

5

Females Males

3.5 3.2 1.0 0

5

10

Proportion (%)

15

20

25

30

Life and death

Causes of death

43

Deaths from selected cancers, Eur-A Breast 17.4 5.4

Ovary

3.0

Other parts of uterus

1.4

Cervix Trachea, bronchus and lung

25.9

11.8 11.3

12.8

Colon, rectum and anus

10.7

Prostate Lymph node and haematopoietic tissue Stomach

7.5

8.6

5.4

4.8

4.8

6.2

Pancreas

4.4

2.9

Liver, bile ducts

4.1

1.9

Bladder Oesophagus

1.4

Lip, oral cavity and pharynx

1.1

Melanoma of skin

1.1 20

15

10

5

Females Males

3.3 2.8 1.1 0

5

10

15

20

25

30

Proportion (%)

Deaths from selected cancers, Eur-B+C Breast

16.9

Ovary

5.6

Proportion of deaths by selected cancers in all countries 5.2

Cervix Other parts of uterus

4.4

Trachea, bronchus and lung

7.9

Stomach

28.5

10.4

Colon, rectum and anus

12.2

13.7

10.3

Prostate Lymph node and haematopoietic tissue Lip, oral cavity and pharynx

5.4

Pancreas

5.0

6.0 4.8 1.2

4.6 4.6

1.1

Bladder

3.7

3.0

Liver, bile ducts Oesophagus

1.2

Melanoma of skin

1.2 20

15

10

5

Females Males

3.2 3.1 0.9 0

5

10

Proportion (%)

Breast 17.4

15

20

25

30

44

Causes of death

Atlas of health in Europe

Deaths from cancer, 25–64 years Hungary (2005) Russian Federation (2005) Belarus (2005) Slovakia (2005) Ukraine (2006) Moldova (2005) Romania (2006) Lithuania (2005) Latvia (2006) Poland (2005) Croatia (2006) Estonia (2005) Czech Republic (2005) Kazakhstan (2006) Bulgaria (2004) MKD (2003) France (2004) Slovenia (2006) Armenia (2003) Spain (2005) Azerbaijan (2004) Portugal (2004) Germany (2004) Kyrgyzstan (2005) Netherlands (2004) Austria (2006) Luxembourg (2005) Greece (2006) United Kingdom (2005) Albania (2004) Switzerland (2004) Ireland (2005) Finland (2005) Norway (2004) Iceland (2005) Israel (2003) Sweden (2004) Malta (2005) Uzbekistan (2005) Tajikistan (2005) Cyprus (2004)

157.1 123.3 109.1 117.7 127.8 126.0 126.0 118.2 130.1 131.8 112.0 110.4 120.7 118.3 110.5 106.8 98.4 103.0 123.7 80.3 97.6 86.0 100.6 94.1 125.2 92.6 90.7 76.5 110.0 74.0 83.7 112.5 86.4 106.4 87.6 97.7 102.5 102.3 76.1 65.6 64.8 200

150

100

301.2 224.5 222.2 219.7 219.4 218.0 213.0 212.5 211.1 208.7 205.5 203.5 192.1 188.4 186.1 179.1 178.9 176.6 165.1 155.5 152.2 148.5 136.1 133.8 133.7 131.2 130.6 127.0 116.0 110.4 109.7 108.6 103.7 101.0 99.6 98.8 86.8 85.7 Females 80.2 Males 73.9 71.5 50

0

50

100

150

Per 100 000 population

200

250

300

350

Life and death

Causes of death

Deaths from cancer, 0–64 years

≤ 135 ≤ 105 ≤ 95 ≤ 80 ≤ 70 No data Per 100 000

Deaths from cancer, 65+ years

≤ 1400 ≤ 1100 ≤ 900 ≤ 800 ≤ 600 No data Per 100 000

45

Causes of death

Atlas of health in Europe

Deaths from cancer 300

Per 100 000 population

46

250

Males, Eur-A

200

Females, Eur-A Males, Eur-B+C Females, Eur-B+C

150

100 1980

1985

1990

1995

Year

Deaths from cancer

2000

2005

Life and death

Causes of death

Deaths from lung cancer, 25–64 years Hungary (2005) Poland (2005) Croatia (2006) Romania (2006) Belarus (2005) Russian Federation (2005) Latvia (2006) Bulgaria (2004) MKD (2003) Czech Republic (2005) Ukraine (2006) Moldova (2006) Slovenia (2006) France (2004) Lithuania (2005) Estonia (2005) Kazakhstan (2006) Slovakia (2005) Armenia (2003) Greece (2006) Spain (2005) Netherlands (2004) Germany (2004) Portugal (2003) Luxembourg (2005) Austria (2006) Azerbaijan (2004) Iceland (2005) Switzerland (2004) United Kingdom (2005) Kyrgyzstan (2005) Ireland (2005) Albania (2004) Finland (2005) Israel (2003) Norway (2005) Cyprus (2004) Malta (2005) Sweden (2004) Uzbekistan (2005) Tajikistan (2005)

35.3

99.7 20.9 15.9 12.6

72.0 70.3 69.5 67.4 67.1 64.4 60.9 59.1 58.7 58.2 57.9 57.6 56.3 56.2 56.1 55.0 54.8 53.3 53.0 50.2

4.7 6.7 7.9 9.5 7.3 16.0 6.5 7.1 17.5 13.8 6.9 10.3 7.2 10.5 9.1 9.2 8.3 27.6

39.3 39.0 38.0 37.7 37.5 37.2 30.3 30.2 28.9 28.2 26.8 25.6 25.0 24.7 24.5 21.3 19.1 16.9 14.6

16.1 6.7 18.0 16.4 6.2 29.0 15.5 18.9 5.3 17.7 7.9 9.6 9.6 19.7 2.6 7.2 19.7 4.4 4.4 50

25

Females Males

7.6 0

25

50

Per 100 000 population

75

100

47

Causes of death

Atlas of health in Europe

Deaths from lung cancer, 25–64 years 100 90

Per 100 000 population

80 70 60 50 40 30 20

Males, Eur-A Females, Eur-A Males, Eur-B+C Females, Eur-B+C

10 0 1980

1985

1990

1995

2000

2005

2000

2005

Year

Deaths from lung cancer, 65+ years 400 Per 100 000 population

48

300

200

Males, Eur-A Females, Eur-A Males, Eur-B+C

100

Females, Eur-B+C

0 1980

1985

1990

1995

Year

Deaths from lung cancer

Life and death

Causes of death

Deaths from female breast cancer and cervical cancer, 25–64 years Belgium (1997) Armenia (2003) Denmark (2001) Netherlands (2004) Ukraine (2006) Serbia (2006) Malta (2005) Moldova (2006) Latvia (2006) Ireland (2005) Russian Federation (2005) United Kingdom (2005) San Marino (2005) Israel (2003) MKD (2003) France (2004) Hungary (2005) Estonia (2005) Germany (2004) Lithuania (2005) Italy (2002) Kazakhstan (2006) Belarus (2005) Croatia (2006) Georgia (2001) Romania (2006) Azerbaijan (2004) Slovakia (2005) Bulgaria (2004) Poland (2005) Finland (2005) Austria (2006) Slovenia (2006) Czech Republic (2005) Switzerland (2004) Sweden (2004) Luxembourg (2005) Norway (2005) Cyprus (2004) Spain (2005) Bosnia and Herzegovina (1991) Greece (2006) Kyrgyzstan (2005) Iceland (2005) Uzbekistan (2005) Albania (2004) Turkmenistan (1998) Tajikistan (2005) Portugal (2004)

37.2 37.1 35.4 31.1 31.0 30.8 30.8 30.7 29.4 29.3 28.5 27.7 27.6 27.4 27.1 26.6 26.5 25.9 25.8 25.7 25.2 25.0 24.9 24.6 24.4 24.3 23.6 23.1 23.1 22.7 22.7 22.6 22.6 22.6 22.5 21.8 21.8 20.0 19.5 19.3 19.0 18.5 15.7 15.7 15.2 13.7 Cervical cancer 11.3 Breast cancer 9.8

4.2 8.8 4.1 3.2 10.7 13.5 1.8 2.3 10.0 4.9 8.5 3.1 0.0 2.3 5.8 2.5 9.4 8.3 3.5 12.9 1.1 10.6 8.0 3.7 7.1 20.8 2.4 9.6 10.6 3.8 1.3 3.3 4.9 7.0 1.7 2.8 0.9 10.2 1.5 2.6 3.9 1.8 10.5 0.0 7.7 2.2 4.2 4.6 3.8 30

20

10

8.3 0

10

20

Per 100 000 females

30

40

50

49

Causes of death

Atlas of health in Europe

Deaths from female breast cancer, 25–64 and 65+ years 140

Per 100 000 females

120 100 80

25–64, Eur-A 65+, Eur-A 25–64, Eur-B+C 65+, Eur-B+C

60 40 20 0 1980

1985

1990

1995

2000

2005

Year

Deaths from cervical cancer, 25–64 and years Deaths from 65+ female breast cancer, 25–64 years and 65 years and ove 25–64, Eur-A 65+, Eur-A

30

25–64, Eur-B+C 65+, Eur-B+C

Per 100 000 females

50

20

10

0 1980

1985

1990

1995

Year

2000

2005

Life and death

Causes of death

Deaths from cancer of the colon and anus, 65+ years Slovakia (2005) 127.2 Czech Republic (2005) 146.1 Hungary (2005) 148.1 Croatia (2006) 132.1 Slovenia (2006) 119.8 Estonia (2005) 103.3 Lithuania (2005) 97.8 Latvia (2006) 105.0 Ireland (2005) 106.8 Portugal (2004) 96.3 Poland (2005) 103.9 Russian Federation (2005) 108.1 Spain (2005) 90.2 Israel (2003) 121.4 Germany (2004) 114.2 Austria (2006) 94.1 Norway (2005) 118.5 Moldova (2006) 78.6 Netherlands (2004) 110.1 France (2004) 87.7 Belarus (2005) 82.3 Bulgaria (2004) 80.6 United Kingdom (2005) 93.2 Ukraine (2006) 79.2 Malta (2005) 90.8 Romania (2006) 84.7 Sweden (2004) 96.9 MKD (2003) 76.3 Luxembourg (2005) 115.4 Switzerland (2004) 74.9 Kazakhstan (2006) 70.9 Cyprus (2004) 63.0 Greece (2006) 66.5 Finland (2005) 70.7 Iceland (2005) 92.9 Armenia (2003) 72.8 Kyrgyzstan (2005) 31.7 Albania (2004) 15.7 Azerbaijan (2004) 23.8 Uzbekistan (2005) 16.6 Tajikistan (2005) 10.7 200

150

100

50

299.1 297.6 278.9 272.5 248.0 208.0 203.3 200.3 192.6 190.9 187.6 185.3 181.2 179.5 177.3 176.3 172.9 172.3 170.0 162.8 160.0 159.9 155.3 151.9 143.4 139.3 138.6 138.2 137.2 124.1 110.8 105.7 101.8 100.3 85.3 80.6 55.8 28.5 26.1 19.0 16.3 0

50

100

150

Per 100 000 population

Females Males

200

250

300

350

51

Causes of death

Atlas of health in Europe

Deaths from cancer of the colon and anus, 65+ years

Per 100 000 population

200

150

100

50 1980

1985

1990

Males, Eur-A

Males, Eur-B+C

Females, Eur-A

Females, Eur-B+C

1995

2000

2005

Year

Deaths from prostate cancer, 60–74 and 75+ years 500

400 Per 100 000 males

52

60–74, Eur-A 75+, Eur-A

300

60–74, Eur-B+C 75+, Eur-B+C

200

100

0 1980

1985

1990

1995

Year

2000

2005

Life and death

Causes of death

Deaths from prostate cancer, 65+ years Sweden (2004) Norway (2005) Estonia (2005) Belgium (1997) Denmark (2001) Iceland (2005) Latvia (2006) Slovenia (2006) Lithuania (2005) Ireland (2005) Switzerland (2004) Croatia (2006) Czech Republic (2005) Netherlands (2004) Portugal (2004) Finland (2005) United Kingdom (2005) Cyprus (2004) France (2004) Slovakia (2005) Austria (2006) Malta (2005) Luxembourg (2005) Germany (2004) Poland (2005) Hungary (2005) Spain (2005) Serbia (2006) Greece (2006) Italy (2002) Belarus (2005) Israel (2003) Romania (2006) Russian Federation (2005) Bulgaria (2004) Albania (2004) MKD (2003) Ukraine (2006) Bosnia and Herzegovina (1991) Armenia (2003) Moldova (2006) Azerbaijan (2004) Kazakhstan (2006) Kyrgyzstan (2005) Georgia (2005) Turkmenistan (1998) Uzbekistan (2005) Tajikistan (2005)

32.8 27.0 15.1 13.1 13.0 0

50

314.8 296.7 296.6 294.3 287.5 287.3 287.1 281.8 255.2 240.6 234.4 228.4 228.2 228.0 215.0 211.8 210.3 208.2 201.4 195.8 185.9 185.5 183.2 180.8 178.0 168.7 157.8 155.8 155.0 148.7 132.5 131.1 121.6 113.8 113.7 104.3 103.1 101.4 89.1 77.0 73.6 71.7 64.2

100

150

200

Per 100 000 males

250

300

350

53

Causes of death

Atlas of health in Europe

Deaths from external causes of injury and poisoning 300 250 Per 100 000 population

54

200 Males, Eur-A Females, Eur-A

150

Males, Eur-B+C Females, Eur-B+C

100 50 0 1980

1985

1990

1995

2005

2000

Year

Deaths from external causes of injury and poisoning,

≤ 215 ≤ 150 ≤ 100 ≤ 60 ≤ 40 No data Per 100 000

Life and death

Causes of death

Deaths from external causes of injury and poisoning, 0–64 years Russian Federation (2005) 76.3 Belarus (2005) 58.5 Kazakhstan (2006) 62.1 Lithuania (2005) 52.0 Ukraine (2006) 45.6 Latvia (2006) 46.0 Estonia (2005) 40.9 Moldova (2006) 40.7 Kyrgyzstan (2005) 38.1 Turkmenistan (1998) 29.4 Poland (2005) 17.2 Finland (2005) 25.8 Hungary (2005) 20.8 Slovakia (2005) 17.2 Romania (2006) 20.5 Slovenia (2006) 15.4 Bosnia and Herzegovina (1991) 0.0 Uzbekistan (2005) 19.6 Czech Republic (2005) 17.2 Bulgaria (2004) 16.4 Belgium (1997) 24.4 Croatia (2006) 15.6 Albania (2004) 17.9 Portugal (2004) 14.4 Serbia (2006) 15.7 France (2004) 17.4 Armenia (2003) 8.7 San Marino (2005) 0.0 Tajikistan (2005) 15.6 Luxembourg (2005) 19.2 Sweden (2004) 20.1 Denmark (2001) 15.9 Austria (2006) 15.9 Greece (2006) 13.6 Norway (2005) 17.3 Georgia (2001) 7.9 Cyprus (2004) 8.9 Israel (2003) 10.6 MKD (2003) 8.5 Spain (2005) 9.5 Azerbaijan (2004) 10.6 Switzerland (2004) 13.6 Ireland (2005) 10.2 Italy (2002) 9.5 Germany (2004) 11.1 Iceland (2005) 18.4 United Kingdom (2005) 11.1 Malta (2005) 6.5 Netherlands (2004) 11.2 100

346.1 277.0 260.2 257.2 224.3 211.8 189.2 166.7 142.5 92.3 91.3 87.4 85.9 84.0 82.5 76.8 73.2 72.2 67.3 65.0 64.5 61.7 58.3 57.8 55.8 51.0 50.6 50.4 47.9 47.5 47.1 46.7 46.4 45.8 45.1 43.9 43.6 42.5 39.8 39.8 39.6 39.0 38.4 36.9 36.0 34.8 33.6 29.6 26.6 0

100

Females Males

200

Per 100 000 population

300

400

55

56

Causes of death

Atlas of health in Europe

Deaths from motor vehicle traffic accidents Lithuania (2005)

10.1

36.3

Cyprus (2004) Portugal (2003) Latvia (2006) Ukraine (2004) Kyrgyzstan (2005)

5.2

28.7

6.9

27.5

7.5

27.4

7.3

25.8

7.9

25.5

Greece (2006)

5.0

Croatia (2006)

5.3

Slovenia (2006)

24.0 21.4

4.3

Poland (2005)

5.5

Estonia (2005)

5.9

Kazakhstan (2003)

21.3 21.1 20.6

5.3

20.2

Romania (2006)

6.0

19.6

Hungary (2005)

5.6

19.4

Moldova (2006)

5.8

Uzbekistan (2005)

19.0

4.2

Slovakia (2005)

17.5

5.0

Spain (2005)

17.4

4.0

16.0

Bulgaria (2004)

4.5

15.3

Czech Republic (2005)

4.9

15.2

Albania (2004)

3.6

France (2004)

3.9

Luxembourg (2005)

14.2 12.8

8.9

11.7

Austria (2006)

3.5

11.7

Israel (2003)

3.9

11.3

Finland (2005)

3.1

Armenia (2003) MKD (2003)

10.9

1.9

Germany (2004)

3.2

Tajikistan (2005)

2.7

Switzerland (2004)

10.7 9.7 9.6

2.1

Ireland (2005)

9.4

3.7

United Kingdom (2005)

8.5

2.2

8.2

2.1

Sweden (2004)

7.4

3.3

Iceland (2005) Netherlands (2004)

2.6

Norway (2005)

3.1

7.1

10

Females Males

7.0 6.9

2.2

Malta (2005) 20

11.0

2.4

6.8 0

10

20

30

40

Per 100 000 population

Death

Life and death

Causes of death

Deaths from motor vehicle traffic accidents Males, Eur-A

40

Females, Eur-A Males, Eur-B+C

Per 100 000 population

Females, Eur-B+C

30

20

10

1980

1985

1990

1995

2000

2005

Year

Deaths from suicide

Per 100 000 population

50

Deaths from motor vehicle traffic accidents, 40 Males, Eur-A Females, Eur-A

30

Males, Eur-B+C Females, Eur-B+C

20

10

0 1980

1985

1990

1995

Year

2000

2005

57

58

Causes of death

Atlas of health in Europe

Deaths from suicide Lithuania (2005) Russian Federation (2005) Belarus (2005) Kazakhstan (2006) Hungary (2005) Slovenia (2006) Latvia (2006) Ukraine (2006) Estonia (2005) Moldova (2006) Poland (2005) Finland (2005) France (2004) Croatia (2006) Czech Republic (2005) Austria (2006) Slovakia (2005) Switzerland (2004) Romania (2006)

11.4

67.4

8.5

56.1

7.8 8.6

53.9 49.3

9.2

40.0

9.2

38.2 36.6

5.1 5.6

36.5

5.8 5.1

34.2 34.1

4.3

26.7 26.3 25.0

9.6 8.6 7.7 4.8 5.5

24.7 23.8 22.3

3.1

21.8 21.4 20.6

9.3 3.8

Kyrgyzstan (2005) Bulgaria (2004) Germany (2004)

3.6 5.2 5.1

17.9 17.7 17.4

Sweden (2004) Luxembourg (2005) Iceland (2005)

6.4 4.0 6.6

17.3 17.1 16.3

Ireland (2005) Portugal (2004) Norway (2005)

3.1 4.4 7.3

Israel (2003) Netherlands (2004) Spain (2005) MKD (2003)

2.4 5.5 3.1

United Kingdom (2005) Uzbekistan (2005) Malta (2005) Albania (2004) Tajikistan (2005) Greece (2006)

12.1 12.0 10.5

3.9 3.1

10.4 9.9

2.4

8.9

0.9 3.5

7.9 6.3

1.7

5.4

1.1 0.7

Armenia (2003) Azerbaijan (2004) Cyprus (2004) 20

16.0 15.7 15.3

5.1 3.8

0.5

2.4

0.3 10

Females Males

1.2 0

10

20

30

40

Per 100 000 population

50

60

70

Life and death

Causes of death

Deaths from diseases of the respiratory system Kyrgyzstan (2005) Moldova (2006) Kazakhstan (2006) Russian Federation (2005) Armenia (2003) Ireland (2005) Belarus (2005) United Kingdom (2005) Spain (2005) Malta (2005) Tajikistan (2005) Ukraine (2006) Slovakia (2005) Lithuania (2005) Uzbekistan (2005) Netherlands (2004) Romania (2006) Portugal (2004) Azerbaijan (2004) Hungary (2005) Slovenia (2006) Poland (2005) Norway (2005) Luxembourg (2005) Czech Republic (2005) Croatia (2006) Latvia (2006) Greece (2006) Germany (2004) Estonia (2005) Cyprus (2004) Iceland (2005) Albania (2004) MKD (2003) Finland (2005) Israel (2003) Bulgaria (2004) Austria (2006) Switzerland (2004) France (2004) Sweden (2004) 150

93.6

188.4 50.1 41.0 27.0 38.3

132.6 127.3 120.9 104.1 99.9 99.1 95.1 95.0 93.3 87.4 85.4 83.9 82.6 79.8 79.5 76.3 76.2 75.0 72.7 70.7 68.9 67.8 66.8 65.9 64.5 61.3 57.9 55.9 55.5 55.5 55.0 54.3 53.5 49.6 48.4 47.9 46.8 Females 44.3 Males 43.7 41.4

72.7 18.1 68.6 39.6 39.2 73.8 18.9 37.2 18.7 55.1 41.4 35.4 37.3 49.5 32.0 29.7 26.5 41.1 32.3 33.5 25.1 15.1 42.5 27.2 11.7 30.6 41.4 32.4 32.2 19.0 32.8 21.4 23.1 21.3 20.7 27.1 100

50

0

50

100

Per 100 000 population

150

200

59

Causes of death

Atlas of health in Europe

Deaths from diseases of the respiratory system 175

Males, Eur-A Females, Eur-A Males, Eur-B+C

150

Females, Eur-B+C Per 100 000 population

60

125 100 75 50 25 0 1980

1985

1990

1995

2005

2000

Year

Deaths from diseases of the respiratory syste

≤ 135 ≤ 105 ≤ 75 ≤ 55 ≤ 35 No data Per 100 000

Life and death

Causes of death

Deaths from diseases of the digestive system Moldova (2006) Hungary (2005) Kyrgyzstan (2005) Kazakhstan (2006) Ukraine (2006) Russian Federation (2005) Romania (2006) Uzbekistan (2005) Lithuania (2005) Slovakia (2005) Azerbaijan (2004) Estonia (2005) Croatia (2006) Belarus (2005) Slovenia (2006) Tajikistan (2005) Armenia (2003) Latvia (2006) Poland (2005) Czech Republic (2005) Finland (2005) Portugal (2004) Bulgaria (2004) Germany (2004) Spain (2005) United Kingdom (2005) France (2004) Austria (2006) Luxembourg (2005) Netherlands (2004) Malta (2005) Cyprus (2004) MKD (2003) Ireland (2005) Switzerland (2004) Israel (2003) Sweden (2004) Iceland (2005) Greece (2006) Norway (2005) Albania (2004) 150

115.4

156.9 42.4 53.1 43.4 35.3 43.4 38.9 55.2 33.1 33.4 49.0 28.0 23.6 28.6 25.8 36.0 25.3 28.8 25.9 26.8 23.6 20.8 14.8 25.9 20.6 29.0 18.9 18.6 23.2 22.1 21.6 17.2 12.1 19.7 15.4 16.4 15.6 13.2 11.3 15.0 9.4 100

50

105.4 103.7 92.6 89.4 87.8 80.3 79.4 70.2 70.1 64.8 63.0 59.5 58.7 58.1 57.0 55.9 55.7 54.8 52.4 48.8 47.7 45.3 44.0 40.4 38.2 36.1 35.9 29.3 29.0 27.1 27.1 26.7 25.0 24.6 23.1 22.3 20.1 Females 19.7 Males 19.3 17.3 0

50

Per 100 000 population

100

150

61

Causes of death

Atlas of health in Europe

Deaths from diseases of the digestive system Males, Eur-A

75

Females, Eur-A Males, Eur-B+C Females, Eur-B+C

Per 100 000 population

62

50

25

0 1980

1985

1990

1995

2005

2000

Year

≤ 135 ≤ 80 ≤ 60 ≤ 40 ≤ 25 No data Per 100 000

Deaths from diseases of the digestiv

Life and death

Causes of death

Deaths from chronic liver diseases and cirrhosis Moldova (2006)

99.4

Kyrgyzstan (2005)

116.0 43.0

84.7

Hungary (2005)

22.9

Kazakhstan (2003)

26.6

Romania (2006)

25.7

Ukraine (2004)

71.0 57.2 55.9

21.2

Uzbekistan (2005)

54.7

38.5

Tajikistan (2005)

51.0

27.1

43.0

Lithuania (2005)

15.3

39.4

Slovakia (2005)

13.8

38.4

Croatia (2006)

9.0

Slovenia (2006)

12.6

Estonia (2005)

13.9

Armenia (2003)

13.0

Finland (2005)

9.6

Bulgaria (2004)

37.0 36.9 32.4 30.4 26.0

5.9

25.5

Czech Republic (2005)

8.9

Poland (2005)

7.3

23.9

Austria (2006)

7.2

23.4

Latvia (2006)

25.3

13.8

Germany (2004)

8.9

Portugal (2004)

6.3

France (2004)

6.2

Luxembourg (2005)

7.5

Spain (2005)

23.2 22.7 21.5 17.2 15.1

4.5

United Kingdom (2005)

14.9

7.5

14.6

MKD (2003)

2.8

Switzerland (2004)

4.0

10.3

Malta (2005)

3.8

9.2 8.7

11.4

Cyprus (2004)

3.7

Greece (2006)

2.4

8.7

Sweden (2004)

3.5

7.3

Ireland (2005)

3.9

6.8

Netherlands (2004)

2.9

6.0

Israel (2003)

3.0

5.6

Iceland (2005)

2.7

5.3

Norway (2005)

2.3 0.0

4.4 0.1

Albania (2004) 150

100

50

0

Females Males

50

Per 100 000 population

100

150

63

Causes of death

Atlas of health in Europe

Deaths from chronic liver diseases and cirrhosis 50

Males, Eur-A Females, Eur-A Males, Eur-B+C

Per 100 000 population

64

40

Females, Eur-B+C

30

20

10

0 1980

1985

1990

1995

2000

2005

Year

Deaths from chronic liver diseases and cirrhosis, Eur-A

65

3. Diseases Notes Tuberculosis (pp. 67–68) The figures present rates of newly diagnosed tuberculosis cases, including relapses, of all forms and in all organs. The average rate for Eur-B+C countries has been stable in recent years, but the situation varies between countries. While the rates have declined for many years in some (for example, Hungary, Poland and Slovakia), they are rising in others.

Syphilis (pp. 71–72) Syphilis is considered a good indicator of the trends in all sexually transmitted diseases. The eastern part of the Region suffered an epidemic-like increase in the incidence of syphilis in the 1990s, but now the rates are declining in all Eur-B+C countries.

HIV/AIDS (pp. 73–75) The data for HIV/AIDS are collected by the European Centre for the Epidemiological Monitoring of AIDS (EuroHIV), a Joint United Nations Programme on HIV/AIDS (UNAIDS)/WHO collaborating centre on AIDS (8). While the AIDS data for the most recent years are adjusted for reporting delays, the data for HIV infections are as reported by countries. The average for reported new HIV infections increased dramatically in Eur-B+C until 2001, particularly owing to increases in Estonia, Latvia and the Russian Federation.

Diabetes (p. 76) The prevalence data represent the number of people with diabetes per 100 population. The data are reported by countries from national diabetes registries, whenever available, routine reporting systems or surveys. For some countries, however, no reported data were available; for them, the bar chart shows WHO estimates for 2000 (9).

66

Atlas of health in Europe

Cancer (pp. 77–79) The right side of each bar chart shows the number of people newly diagnosed with cancer per 100 000 population during a given year. Data sources are usually national cancer registers. The incidence of lung cancer is clearly correlated with the death rate. This correlation is less clear in the case of female breast and cervical cancer. Hospital discharges (pp. 80–88) The rates represent the total number of patients per 100 000 population discharged from all hospitals (including through death) during the year, categorized by the principal diagnosis. Hospital discharge data have limited intercountry comparability, owing to the differences in the organization of hospital datacollection systems in countries and in health care systems in general. Particular caution should be used when discharge data are used to estimate morbidity. Teeth (p. 89) The average number of decayed, missing or filled teeth among 12-year-old children is the index commonly used to assess oral health. The data are collected by WHO and a collaborating centre in Sweden (10).

Diseases

Some infectious diseases

New cases of tuberculosis Kazakhstan Moldova Kyrgyzstan Romania Georgia Russian Federation Ukraine Uzbekistan Tajikistan Azerbaijan Armenia Turkmenistan Lithuania Latvia Belarus Bosnia and Herzegovina Serbia Bulgaria Estonia Portugal MKD Turkey Montenegro Croatia Poland Hungary Spain Albania United Kingdom Slovenia Slovakia Andorra Austria Belgium Czech Republic Ireland Luxembourg France Denmark Switzerland Netherlands Germany Italy Finland Israel Sweden Norway Greece Malta Cyprus Iceland San Marino (2004)

143.0 123.7 120.7 103.2 89.4 84.4 82.2 79.0 71.9 68.6 66.0 61.9 61.3 54.3 54.0 43.1 41.7 35.6 31.5 29.4 27.4 23.7 23.6 21.5 17.9 16.8 16.2 13.6 13.4 13.2 12.9 11.3 10.3 9.5 9.4 8.1 8.1 7.3 7.0 6.9 6.7 6.5 6.5 6.0 6.0 5.8 5.6 5.2 4.5 3.4 0.0 0

50

2005 or latest available year 2000

100 Per 100 000 population

150

169.9

67

Some infectious diseases

Atlas of health in Europe

New cases of tuberculosis 70 60 Per 100 000 population

68

50

Eur-A Eur-B+C

40 30 20 10

1980

1985

1990

1995

2000

2005

Year

≤ 170 ≤ 120 ≤ 70 ≤ 40 ≤ 10 No data Per 100 000

Diseases

Some infectious diseases

New cases of hepatitis B Iceland 13.2 Kyrgyzstan 12.5 Bulgaria 12.2 Turkey 12.0 Moldova 11.4 10.2 MKD Ukraine 9.6 Kazakhstan 9.3 Uzbekistan 8.9 France (1998) 8.7 Russian Federation 8.6 Romania 7.5 Latvia 7.4 Georgia 7.1 Austria 7.0 Estonia 5.8 5.3 Belgium (2004) Turkmenistan 4.4 Serbia 4.3 Lithuania 4.1 Belarus 3.9 Croatia 3.7 Czech Republic 3.5 Bosnia and Herzegovina 3.4 Azerbaijan 3.4 Tajikistan 3.2 Malta 3.2 Norway 3.1 Armenia 2.7 Sweden 2.4 Slovakia 2.3 Netherlands 1.8 Poland 1.7 Greece (2004) 1.6 Ireland 1.6 Israel 1.6 Germany 1.5 Spain 1.5 Hungary 1.2 Luxembourg 1.1 Switzerland 1.0 Slovenia 1.0 Portugal 0.9 Cyprus 0.8 Italy 0.8 Finland 0.7 United Kingdom (2004) 0.7 Denmark 0.5 Andorra 0.0 Albania 0.0 San Marino 0.0 0

10

2005 or latest available year 2000

20

30

Per 100 000 population

40

69

Some infectious diseases

Atlas of health in Europe

New cases of hepatitis B 40

Eur-A Eur-B+C

30 Per 100 000 population

70

20

10

0 1980

1985

1990

1994

2000

2005

Year

New cases of viral hepatitis B

≤ 15 ≤ 12 ≤9 ≤6 ≤3 No data Per 100 000

Diseases

Some infectious diseases

New cases of syphilis Moldova (2005) Russian Federation (2005) Kazakhstan (2005) Kyrgyzstan Belarus Romania Latvia Uzbekistan Georgia Ukraine Lithuania Switzerland Estonia Tajikistan Bulgaria Hungary Ireland (2005) Austria Czech Republic Armenia Netherlands United Kingdom Slovakia Germany Israel Malta Belgium (2005) Azerbaijan (2005) Poland Finland Luxembourg Iceland Sweden Spain Cyprus Slovenia Denmark Portugal (2005) Croatia Italy (2005) Turkey Serbia Bosnia and Herzegovina Turkmenistan France Norway Albania Montenegro (2004) MKD Greece (2001) San Marino Andorra

69.6 62.7 60.9 32.7 27.1 26.2 21.1 16.2 11.0 10.4 9.9 9.7 9.3 8.7 6.6 5.6 5.5 5.2 5.0 4.9 4.8 4.7 4.2 3.8 3.7 3.0 3.0 2.7 2.5 2.4 2.3 2.0 1.9 1.7 1.7 1.4 1.4 1.3 1.1 1.0 1.0 0.8 0.7 0.7 0.7 0.5 0.4 0.3 0.2 0.0 0.0 0.0 0

2006 or latest available year 2000

50

100 Per 100 000 population

150

71

Some infectious diseases

Atlas of health in Europe

New cases of syphilis Eur-A Eur-B+C

125

Per 100 000 population

72

100

75

50

25

0 1980

1985

1990

1995

2000

2005

Year

New cases of syphilis

≤ 70 ≤ 35 ≤ 20 ≤ 10 ≤2 No data Per 100 000

Diseases

Some infectious diseases

New cases of clinically diagnosed AIDS Ukraine Portugal San Marino Spain Georgia Moldova Belarus Latvia Estonia Switzerland Italy Luxembourg France Armenia United Kingdom Netherlands Malta Iceland Romania Belgium Israel Denmark Kazakhstan Finland Greece Serbia Lithuania Austria Sweden Russian Federation Ireland Norway Albania Kyrgyzstan Croatia Germany Cyprus Montenegro Poland MKD Slovenia Hungary Bulgaria Czech Republic Bosnia and Herzegovina Slovakia Turkey Azerbaijan Uzbekistan Turkmenistan Tajikistan Monaco

9.7

6.6 3.7 3.5 3.0 2.9 2.8 2.7 2.4 2.1 1.9 1.9 1.7 1.5 1.4 1.2 1.0 1.0 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.8 0.8 0.7 0.6 0.6 0.6 0.5 0.5 0.5 0.5 0.4 0.4 0.3 0.3 0.3 0.2 0.2 0.2 0.1 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0

2

2006 or latest available year 2000

4

6 Per 100 000 population

8

10

73

Some infectious diseases

Atlas of health in Europe

New cases of clinically diagnosed AIDS Eur-A Eur-B+C

7

Per 100 000 population

6 5 4 3 2 1 0 1980

1985

1990

1995

2000

2005

Year

New cases of HIV infection Eur-A Eur-B+C

25

Per 100 000 population

74

20

New cases of clinically diagnosed AIDS 15

10

5

0 1980

1985

1990

1995 Year

New cases of HIV infection

2000

2005

Diseases

Some infectious diseases

New cases of HIV infection Estonia Ukraine Russian Federation 20.5 Portugal 17.3 Moldova 14.9 United Kingdom 13.1 Latvia 11.9 Luxembourg 11.4 Kazakhstan 10.4 Switzerland 9.5 Belgium 9.5 France 8.2 Uzbekistan 8.0 Ireland 7.5 Belarus 7.4 San Marino 7.2 Malta 6.6 Netherlands 6.3 Georgia 5.8 Norway 5.3 Austria 5.1 Greece 4.8 Israel 4.7 Kyrgyzstan 4.5 Denmark 4.4 Cyprus 4.2 Sweden 3.7 Finland 3.6 Iceland 3.3 Germany 3.1 Tajikistan 3.0 Lithuania 2.9 Azerbaijan 2.1 Armenia 2.0 Poland 1.7 Slovenia 1.5 Croatia 1.3 Andorra 1.2 Serbia 1.2 Bulgaria 1.0 Albania Czech Republic 0.9 Romania 0.8 MKD 0.8 Hungary 0.8 Montenegro 0.6 Slovakia 0.5 Bosnia and Herzegovina 0.4 Turkey 0.4 Spain 0.0 Italy 0.0 Turkmenistan 0.0 0

10

20

49.7 28.4 27.5

2006 or latest available year 2000

30

Per 100 000 population

40

50

75

76

Some noncommunicable diseases

Atlas of health in Europe

Prevalence of diabetes mellitus Malta (2004) Czech Republic (2006) Spain (2000) Monaco (2000) Slovakia (2006) Italy (2006) Netherlands (2003) 3.8 Belgium (2004) 3.5 Croatia (2000) 3.5 Estonia (2000) 3.4 Finland (2006) 3.4 Israel (2000) 3.2 Germany (2000) 3.2 United Kingdom (2000) 3.0 France (2000) 3.0 Poland (2000) 2.9 Austria (2000) 2.9 Albania (2000) 2.8 Luxembourg (2000) 2.7 Denmark (1999) 2.4 Latvia (2006) 2.3 Ireland (2000) 2.3 Ukraine (2006) 2.3 Romania (2006) 2.0 Russian Federation (2006) 1.9 Belarus (2006) 1.8 Lithuania (2006) 1.7 Bulgaria (2000) 1.7 Bosnia and Herzegovina (2005) 1.7 MKD (2005) 1.3 Georgia (2006) 1.3 Moldova (2006) 1.3 Armenia (2006) 1.2 Kazakhstan (2006) 0.9 Azerbaijan (2006) 0.8 Kyrgyzstan (2006) 0.5 Uzbekistan (2005) 0.4 Tajikistan (2006) 0.2 Iceland (2001) 0.2 Greece (2004) 0.2 Switzerland (2005) 0.1 Turkmenistan (2006) 0.1 0

2

7.6 7.4 6.8 6.7 5.5 4.5

4 Percentage of population

6

8

Diseases

Some noncommunicable diseases

New cases of and deaths from lung cancer Hungary (2005) Denmark (2001) Croatia (2005) Italy (2002) United Kingdom (2003) Czech Republic (2004) Slovenia (2004) Netherlands (2003) Germany (2002) Poland (2004) Serbia (2004) Belgium (1997) Estonia (2004) Norway (2005) Austria (2004) France (2000) Latvia (2006) Lithuania (2005) Bulgaria (2004) Ireland (2005) Slovakia (2003) Finland (2005) Belarus (2005) MKD (2003) Russian Federation (2005) Ukraine (2006) Sweden (2004) Luxembourg (2004) Romania (2005) Iceland (2002) Portugal (2000) Malta (2005) Armenia (2003) Kazakhstan (2006) Israel (2003) Moldova (2006) Cyprus (2004) Georgia (2001) Albania (2002) Kyrgyzstan (2005) Azerbaijan (2004) Uzbekistan (2005) Turkmenistan (1997) Tajikistan (2005)

75.1 64.3 59.4 56.5 56.1 55.7 52.1 54.6 47.4 55.5 59.2 67.0 48.6 42.5 41.4 42.2 50.5 40.3 40.6 37.8 37.2 37.2 35.8 31.6 36.9 33.4 36.9 41.9 41.8 34.1 28.1 30.2 27.8 21.5 20.7 23.7 22.5 17.9 19.4

100.7 68.2 67.5 65.0 62.4 61.3 60.8 55.6 54.6 53.3 51.8 51.3 49.1 48.7 47.3 47.1 46.8 46.2 45.8 44.6 42.4 41.7 41.6 41.0 40.3 38.4 36.9 35.7 33.9 31.3 30.5 30.5 29.7 23.8 23.6 21.7 19.8 16.0 12.8 8.5 8.3 Crude death rate 4.5 New cases 3.8 1.8

7.8 11.3 4.0 5.3 2.5 75

25

0

25

Per 100 000 population

75

125

77

78

Some noncommunicable diseases

Atlas of health in Europe

New cases of and deaths from female breast cancer Sweden (2004) Luxembourg (2004) Finland (2005) Denmark (2001) United Kingdom (2003) Netherlands (2003) Hungary (2005) Malta (2005) France (2000) Germany (2002) Italy (2002) Norway (2005) Iceland (2002) Austria (2004) Ireland (2005) Belgium (1997) Israel (2003) Czech Republic (2004) Slovenia (2004) Croatia (2005) Cyprus (2004) Bulgaria (2004) Estonia (2004) Portugal (2000) Latvia (2006) Lithuania (2005) Slovakia (2003) Serbia (2004) Russian Federation (2005) MKD (2003) Belarus (2005) Poland (2004) Ukraine (2006) Romania (2005) Armenia (2003) Moldova (2006) Georgia (2001) Kazakhstan (2006) Azerbaijan (2004) Albania (2002) Kyrgyzstan (2005) Uzbekistan (2005) Turkmenistan (1997) Tajikistan (2005) 100

152.6 151.3 150.1 147.9 143.6 142.6 142.6 140.1 138.2 130.8 124.3 119.3 117.6 114.9 113.5 110.4 107.9 107.5 106.3 100.0 99.2 85.4 84.2 82.4 81.4 72.6 72.4 70.2 64.6 63.6 62.2 61.2 60.4 52.1 49.0 47.7 39.2 37.7 23.0 20.4 19.8 Crude death rate 12.5 New cases 9.4 6.7

34.6 30.9 30.9 49.2 41.5 41.0 39.4 34.9 36.2 42.2 38.4 29.8 25.7 36.4 32.7 46.5 27.5 38.2 36.7 40.0 23.5 28.6 32.2 28.8 36.1 31.9 26.0 40.3 29.4 23.8 24.0 24.8 31.3 28.6 26.8 24.8 23.1 17.4 12.2 6.8 7.7 6.1 4.5 3.2 50

0

50

100

Per 100 000 population

150

Diseases

Some noncommunicable diseases

New cases of and deaths from cervical cancer Romania (2005) 16.2 Lithuania (2005) 11.8 Bulgaria (2004) 9.1 Serbia (2004) 11.9 Estonia (2004) 8.0 MKD (2003) 4.4 Hungary (2005) 7.9 Slovakia (2003) 6.6 Czech Republic (2004) 7.5 Slovenia (2004) 4.7 Ukraine (2006) 8.6 Portugal (2000) 4.3 Latvia (2006) 8.8 Moldova (2006) 11.4 Poland (2004) 9.2 Belarus (2005) 7.0 Russian Federation (2005) 7.8 Kazakhstan (2006) 7.4 Germany (2002) 4.2 Denmark (2001) 5.5 Armenia (2003) 6.1 Croatia (2005) 4.6 Kyrgyzstan (2005) 5.8 Norway (2005) 3.1 Ireland (2005) 3.7 Iceland (2002) 2.1 Italy (2002) 1.3 Luxembourg (2004) 1.3 France (2000) 2.3 Austria (2004) 3.9 Georgia (2001) 6.0 Malta (2005) 1.0 Belgium (1997) 4.3 Sweden (2004) 3.5 United Kingdom (2003) 3.6 Uzbekistan (2005) 3.1 Netherlands (2003) 2.6 Turkmenistan (1997) 3.4 Cyprus (2004) 2.1 Israel (2003) 1.9 Azerbaijan (2004) 1.1 Tajikistan (2005) 1.5 Finland (2005) 2.2 1.3 Albania (2002) 20

15

10

5

28.9 27.4 26.9 25.2 24.9 24.6 20.7 19.8 19.7 19.1 19.0 18.1 17.8 17.6 17.0 16.9 16.9 15.8 15.4 15.3 14.5 13.8 13.6 12.5 12.2 11.8 11.6 11.3 11.2 10.9 10.5 9.8 9.8 9.6 9.2 7.4 7.1 5.7 5.6 5.5 5.1 Crude death rate 4.9 New cases 4.7 4.2 0

5

10

15

Per 100 000 population

20

25

30

79

80

Hospitalization

Atlas of health in Europe

Hospital discharges for cancer Austria (2005)a Hungary France (2005) Germany (2005) Latvia Czech Republic Denmark (2005) Lithuania Greece (2004) Belarus Finland (2005) Slovenia (2005) Norway Luxembourg (2005) Poland (2004) Croatia Slovakia Sweden (2005) Romania Iceland (2005) Serbia Italy (2004) Switzerland (2005) Estonia Belgium (2005) Russian Federation Ukraine United Kingdom (2003) Bulgaria Moldova Spain (2005) Netherlands Montenegro Portugal Ireland MKD (2005) Israel (2004) Kazakhstan Turkey Cyprus (2005) Malta Albania Bosnia and Herzegovina Armenia Andorra Uzbekistan (2005) Kyrgyzstan Georgia Turkmenistan (2004) Azerbaijan Tajikistan

2245 2128 1938 1936 1893 1854 1836 1810 1809 1788 1774 1744 1662 1606 1583 1548 1495 1398 1374 1309 1307 1295 1234 1172 1168 1032 1001 919 916 904 889 880 856 805 799 635 506 486 479 449 435 408 342 240 238 236 166 142 122 0

1000

2000

2006 or latest available year 2000

3000

Per 100 000 population a

4328

2777

Including day cases.

2000

2006 or latest available year

4000

Diseases

Hospitalization

Hospital discharges for cancer Eur-A Eur-B+C

Per 100 000 population

1750

1500

1250

1000

750

500 1980

1985

1990

1995

2000

2005

Year

Hospital discharges for diseases of the circulatory system Eur-A Eur-B+C

Per 100 000 population

2700

2500

Hospital discharges for cancers

2300

2100

1900

1700 1980

1985

1990

1995 Year

2000

2005

81

82

Hospitalization

Atlas of health in Europe

Hospital discharges for diseases of the circulatory system Belarus Lithuania Hungary Austria (2005)a Latvia Ukraine Russian Federation Czech Republic Estonia Romania Finland (2005) Bulgaria Germany (2005) Poland (2004) Slovakia Greece (2004) Denmark (2005) Norway Sweden (2005) Italy (2004) Luxembourg (2005) France (2005) Belgium (2005) Moldova Croatia Switzerland (2005) Kazakhstan Slovenia (2005) Iceland (2005) Serbia Israel (2004) Montenegro Netherlands MKD (2005) United Kingdom (2003) Uzbekistan (2005) Spain (2005) Kyrgyzstan Turkmenistan Ireland Portugal Turkey Armenia Tajikistan Bosnia and Herzegovina Cyprus (2005) Georgia Malta Andorra Albania Azerbaijan

5374 4471 4325 4034 3816 3586 3478 3420 3360 3159 3121 3035 3010 2931 2683 2671 2559 2505 2458 2429 2275 2260 2246 2100 1947 1899 1856 1851 1830 1823 1781 1710 1577 1556 1452 1394 1339 1257 1249 1233 1198 996 975 879 861 813 762 2006 or latest available year 758 2000 677 668 625 0

1000

2000

3000

4000

Per 100 000 population a

Including day cases.

2000

2006 or latest available year

5000

6000

Diseases

Hospitalization

Hospital discharges for diseases of the respiratory system Belarus Ukraine Romania Bulgaria Uzbekistan (2005) Russian Federation Kazakhstan Latvia Lithuania Moldova Estonia Hungary Austria (2005)a Turkmenistan Denmark (2005) Kyrgyzstan Finland (2005) Slovakia Albania Norway Poland (2004) Belgium (2005) Luxembourg (2005) Israel (2004) MKD (2005) Czech Republic Greece (2004) Ireland Tajikistan France (2005) Germany (2005) Slovenia (2005) United Kingdom (2003) Spain (2005) Turkey Montenegro Croatia Italy (2004) Georgia Sweden (2005) Iceland (2005) Switzerland (2005) Serbia Azerbaijan Portugal Andorra Bosnia and Herzegovina Armenia Netherlands Cyprus (2005) Malta

3105 3005 2952 2650 2637 2431 2219 2143 2085 2014 1965 1952 1823 1766 1660 1589 1579 1529 1511 1508 1440 1436 1433 1426 1424 1422 1396 1380 1318 1291 1253 1197 1147 1124 1123 1109 1102 1076 1000 983 958 954 913 884 859 856 827 744 706 672 0

1000

2000

3000

4003

2006 or latest available year 2000

4000

5000

Per 100 000 population a

Including day cases.

a Including day cases.

83

Hospitalization

Atlas of health in Europe

Hospital discharges for diseases of the respiratory system 3250

Eur-A Eur-B+C

3000

Per 100 000 population

2750 2500 2250 2000 1750 1500 1250 1000 1980

1985

1990

1995

2000

2005

Year

Hospital discharges for diseases of the digestive system 1900

Eur-A Eur-B+C

Per 100 000 population

84

1800

Hospital discharges for diseases of the respir 1700

1600

1000 1980

1985

1990

1995

2000

2005

Year

Hospital discharges for diseases of the digestive system

Diseases

Hospitalization

Hospital discharges for diseases of the digestive system France (2005) Belarus Austria (2005)a Romania Ukraine Moldova Germany (2005) Czech Republic Russian Federation Latvia Greece (2004) Lithuania Bulgaria Hungary Slovakia Poland (2004) Belgium (2005) Luxembourg (2005) Estonia Denmark (2005) Switzerland (2005) Kazakhstan Finland (2005) Uzbekistan (2005) Italy (2004) Albania Malta Slovenia (2005) Iceland (2005) Israel (2004) Tajikistan Spain (2005) Norway Kyrgyzstan Ireland Croatia Turkmenistan United Kingdom (2003) Sweden (2005) Montenegro Serbia Portugal Bosnia and Herzegovina MKD (2005) Netherlands Turkey Andorra Armenia Cyprus (2005) Georgia Azerbaijan

2898 2800

2335 2211 2100 2034 2010 1993 1944 1878 1875 1838 1797 1776 1712 1700 1665 1640 1621 1538 1498 1482 1478 1454 1435 1396 1375 1351 1331 1289 1270 1240 1235 1232 1224 1186 1178 1177 1176 1154 1072 1053 1040 942 840 836 2006 or latest available year 783 709 2000 656 634 0

1000

2000 Per 100 000 population

a

Including day cases.

3176

3000

85

86

Hospitalization

Atlas of health in Europe

Hospital discharges for diseases of the musculoskeletal system Austria (2005)a Switzerland (2005) Luxembourg (2005) Hungary Czech Republic Germany (2005) France (2005) Belarus Finland (2005) Latvia Belgium (2005) Romania Estonia Norway Ukraine Denmark (2005) Lithuania Iceland (2005) Bulgaria Slovakia Russian Federation Slovenia (2005) Italy (2004) Sweden (2005) Greece (2004) Netherlands Serbia Moldova United Kingdom (2003) Poland (2004) Spain (2005) Andorra Montenegro Croatia Kyrgyzstan Ireland Armenia Kazakhstan Israel (2004) Uzbekistan (2005) Tajikistan Turkey Turkmenistan MKD (2005) Portugal Malta Bosnia and Herzegovina Cyprus (2005) Albania Azerbaijan Georgia

2145 1976 1824 1733 1680 1670 1654 1618 1600 1375 1367 1229 1173 1120 1112 1105 1015 1010 991 976 892 874 834 804 791 748 733 732 712 710 709 674 586 534 528 504 497 492 485 457 446 431 416 376 327 208 170 114 111 69 0

1000

2000 Per 100 000 population

a

Including day cases.

3467

2006 or latest available year 2000

3000

4000

Diseases

1200

Hospitalization

87

Hospital discharges for diseases of the musculoskeletal system Eur-A Eur-B+C

Per 100 000 population

1100

1000

900

800

700 1980

1985

1990

1995

2000

2005

Year

Hospital discharges for injury and poisoning 1700 Eur-A Eur-B+C

Per 100 000 population

1600

Hospital discharges for diseases of the musculoskeleta 1500

1400

1300

1200 1980

1985

1990

1995 Year

2000

2005

88

Hospitalization

Atlas of health in Europe

Hospital discharges for injury and poisoning Austria (2005)a Latvia Switzerland (2005) Lithuania Belarus Finland (2005) Germany (2005) Denmark (2005) Norway France (2005) Czech Republic Russian Federation Ukraine Belgium (2005) Poland (2004) Greece (2004) Slovenia (2005) Sweden (2005) Kazakhstan Moldova Hungary Israel (2004) Slovakia Romania Ireland Andorra Luxembourg (2005) Italy (2004) United Kingdom (2003) Bulgaria Estonia Kyrgyzstan Croatia Iceland (2005) Cyprus (2005) Spain (2005) Netherlands Malta Turkmenistan Montenegro Uzbekistan (2005) Serbia Portugal MKD (2005) Tajikistan Bosnia and Herzegovina Georgia Armenia Albania Turkey Azerbaijan

3277 2277 2049 2048 1980 1957 1951 1920 1896 1875 1863 1775 1698 1645 1564 1550 1530 1522 1501 1462 1459 1457 1443 1432 1344 1291 1263 1254 1238 1234 1194 1093 1074 1023 985 898 864 772 745 745 723 707 654 580 523 511 478 2006 or latest available year 475 2000 431 387 257 0

1000

2000 Per 100 000 population

a

Including day cases.

3000

Diseases

Teeth

Decayed, missing or filled teeth in 12-year-olds Romania (1998) Bosnia and Herzegovina (2004) Ukraine (1992) Bulgaria (2000) Slovakia (1999) Poland (2000) Hungary (1996) San Marino (1990) Russian Federation (1995) Lithuania (2001) Croatia (1999) Latvia (2004) Albania (2000) MKD (1999) Portugal (2000) Belarus (2000) Turkmenistan (1990) Turkey (1996) Czech Republic (2002) Georgia (1990) Estonia (2000) Armenia (1990) Greece (2000) Kazakhstan (1990) Cyprus (1992) France (1998) Slovenia (2000) Israel (2002) Malta (1991) Norway (2000) Iceland (2000) Moldova (1995) Tajikistan (1990) Ireland (2002) Finland (2000) Spain (2000) Kyrgyzstan (1993) Italy (2004) Belgium (2001) Sweden (2005) Austria (2002) Uzbekistan (2001) Switzerland (2004) Netherlands (2002) Denmark (2005) United Kingdom (2005) Luxembourg (1999) Germany (2005)

7.3 4.8 4.4 4.4 4.3 3.8 3.8 3.7 3.7 3.6 3.5 3.4 3.0 3.0 3.0 2.7 2.6 2.5 2.5 2.4 2.4 2.4 2.2 2.1 2.1 1.9 1.8 1.7 1.6 1.5 1.5 1.3 1.2 1.2 1.2 1.1 1.1 1.1 1.1 1.0 1.0 0.9 0.9 0.8 0.8 0.7 0.7 0.7 0

1

2

3

4

5

Average number per child

6

7

8

89

91

4. Lifestyles and environment Notes Smoking (pp. 93–94) Countries estimate the percentage of regular daily smokers aged 15 years and over on the basis of health interview surveys or other population surveys. The WHO Regional Office for Europe collects the data. Most of the estimates are based on multiple sources, however, and population samples are not always representative of a whole country. Intercountry comparisons should therefore be made with caution. Smoking prevalence among young people (15-year-olds) is estimated in a more uniform way across the European Region through the WHO Health Behaviour in School-aged Children study (11). The study does not collect data for all countries in the Region, however.

Overweight and obesity (pp. 95–96) The WHO Regional Office for Europe collected the data presented here in 2007.

Motor vehicle traffic accidents (pp. 97–98) The main data source for accidents with injury is Statistics of road traffic accidents in Europe and North America (12), regularly published by UNECE. Data on deaths from traffic accidents come from the WHO mortality database (3). Practices in registering traffic accidents vary significantly among countries, thus limiting international comparisons. The available data show that eastern and some central European countries have both the lowest numbers of registered accidents with injury per 100 000 population, and the highest numbers of people killed per 1000 accidents. This correlation most likely results partially from the incomplete registration of all accidents in these countries and the low standard of traffic safety precautions in the eastern part of the Region.

Alcohol (pp. 99–102) The data show the estimated amount of pure ethanol consumed in the form of spirits, wine, beer and other alcoholic drinks, per person per year.

Atlas of health in Europe

92

Estimates are calculated from official statistics on local production, sales, imports and exports, taking account of stocks and home production, whenever possible. The WHO Regional Office for Europe collects data and makes calculations mainly from two sources: FAO and data reported directly by countries.

Work-related deaths (pp. 102–104) The data source is the ILO.

Lifestyles and environment

Smoking

Smokers among adults Ukraine (2005) 17.0 Russian Federation (2004) 15.0 Albania (2000) 18.0 Armenia (2006) 2.0 Georgia (2001) 6.3 Belarus (2006) 9.0 7.1 Moldova (2006) 16.6 Turkey (2006) Bosnia and Herzegovina (2002) 29.7 17.8 Latvia (2005) 29.0 Greece (2000) Bulgaria (2001) 23.0 9.8 Lithuania (2005) Andorra (2002) 30.0 1.7 Kyrgyzstan (2005) 14.7 Slovakia (1998) 19.5 Estonia (2006) 8.8 Kazakhstan (2004) MKD (1999) 32.0 10.5 Cyprus (2003) Germany (2003) 30.5 23.0 Poland (2006) 24.6 Hungary (2003) 26.2 Netherlands (2006) 22.4 Spain (2003) 21.7 Croatia (2003) 10.3 Romania (2003) 20.1 Czech Republic (2004) 11.8 Portugal (2006) 22.6 Serbia (2006) 21.2 France (2003) 17.6 Malta (2002) 17.2 Italy (2006) 23.0 Denmark (2004) 21.0 Luxembourg (2006) 17.7 Israel (2006) 16.0 Belgium (2006) 19.4 Austria (2006) 23.0 United Kingdom (2004) 24.7 Ireland (2006) 18.9 Finland (2006) 0.9 Uzbekistan (2002) 24.0 Norway (2006) 22.0 Slovenia (2005) 20.0 Switzerland (2004) 19.5 Iceland (2005) 18.0 Sweden (2005) 40

30

20

10

62.0 61.3 60.0 57.1 53.3 53.2 51.1 50.6 49.2 47.3 46.8 43.8 42.1 42.0 41.4 41.1 40.9 40.7 40.0 38.1 37.1 37.0 36.9 35.5 34.2 33.8 33.2 31.1 30.8 30.7 30.0 29.9 29.2 29.0 29.0 29.0 29.0 27.3 26.0 24.7 24.4 24.1 24.0 24.0 Females 24.0 Males 19.5 13.9 0

10

Percentage

20

30

40

50

60

70

93

94

Smoking

Atlas of health in Europe

Regular daily smokers, 15+ years

Males

≤ 65 ≤ 50 ≤ 40 ≤ 30 ≤ 20 No data Percentage

Females

≤ 35 ≤ 25 ≤ 20 ≤ 15 ≤ 10 No data Percentage

Lifestyles and environment

Overweight and obesity

Prevalence of overweight among adults, latest available year for the period 2000–2006 Malta (20–64 years)

49.4

68.2

Greece (20–70 years)

48.1

67.1

45.2

Spain (18+ years) Hungary (18+ years)

49.5

58.9

41.5

Germany (18+ years)

57.8

43.3

Austria (20+ years)

57.7

40.3

Iceland (15–18 years)

57.0

47.4

56.7 38.3

Ireland (18+ years) Lithuania (20–64 years)

57.9

37.4

Slovakia (15–64 years)

Czech Republic (16+ years)

60.0

56.5

48.9

56.3

41.3

Finland (15–64 years)

55.5

Cyprus (15+ years)

38.7

53.9

Sweden (16–84 years)

39.0

53.0

36.4

Denmark (16+ years)

52.7

34.0

Norway (16+ years)

52.0

41.9

Netherlands (20+ years)

51.1

37.8

Belgium (18+ years)

50.6

42.3

Bulgaria (15+ years)

50.1

36.3

France (15+ years)

47.4

38.1

Romania (15+ years)

45.8

33.6

Italy (18+ years)

45.8

40.6

Estonia (16–64 years)

45.7 29.3

Switzerland (15+ years) Latvia (15–64 years)

45.4

43.4 60

Females Males

42.0 40

20

0 Prevalence (%)

20

40

60

80

95

96

Overweight and obesity

Atlas of health in Europe

Prevalence of obesity among adults, latest available year for the period 2000–2006 Malta (20–64 years) 20.4 Greece (20–70 years) Lithuania (20–64 years) Hungary (18+ years)

26.6

18.2

26.0

19.2

20.6

18.2

17.1 13.8

Slovenia (25–64 years)

16.5

15.0

Spain (18+ years)

15.5

14.1

Finland (15–64 years)

14.6

11.8

Ireland (18+ years)

14.5

12.8

Germany (18+ years)

14.4

Israel (21+ years)

15.8

13.8

Czech Republic (16+ years)

16.3

13.7

Estonia (16–64 years)

14.9

13.7

Slovakia (15–64 years)

15.0

13.5

11.8

Cyprus (15+ years)

13.4

Austria (20+ years)

12.8

12.3

Iceland (15–18 years) Latvia (15–64 years)

12.9

12.4

19.5

11.9

Belgium (18+ years)

13.4

11.9

France (15+ years)

13.0

11.8

11.0

Denmark (16+ years)

11.8

Bulgaria (15+ years)

13.5

11.3

Sweden (16–84 years)

13.0

11.0

Netherlands (20+ years)

12.7

9.8

Norway (16+ years)

8.0

Switzerland (15+ years)

7.5

7.9

9.5

Romania (15+ years)

20

15

10

Females Males

7.7

8.9

Italy (18+ years) 25

9.0

7.4 5

0

5

Prevalence (%)

10

15

20

25

30

Lifestyles and environment

Traffic accidents

Injuries and deaths from motor vehicle traffic accidents Slovenia (2005) Austria (2005) Belgium (1997) Italy (2002) Germany (2004) Portugal (2003) Croatia (2005) United Kingdom (2005) Switzerland (2004) Iceland (2004) Cyprus (2004) Israel (2003) Czech Republic (2005) Spain (2005) Hungary (2004) Sweden (2004) Lithuania (2005) Latvia (2005) Norway (2005) Estonia (2005) Netherlands (2004) Luxembourg (2004) Ireland (2005) Slovakia (2005) France (2004) Greece (2004) Finland (2005) Denmark (2001) Poland (2005) Russian Federation (1998) Bulgaria (2004) Ukraine (2004) MKD (2003) Kazakhstan (2003) Moldova (2003) Kyrgyzstan (2004) Belarus (2001) Uzbekistan (1999) Georgia (2001) Turkmenistan (1998) Romania (2005) Armenia (2003) Albania (2004) Tajikistan (2005) Azerbaijan (2000)

24 17 29 30 16 46 38 16 19 26 65 27 43 51 63 26

515.2 496.7 492.4 416.1 411.3 396.2 353.0 330.1 309.8 276.8 267.3 265.3 246.6 210.1 206.0 200.5 198.5 194.1 174.7 173.9 170.5 152.7 149.4 146.7 140.8 140.5 133.8 128.1 126.0 110.0 97.8 96.5 95.5 94.0 74.0 66.5 63.5 48.9 42.7 34.3 33.4 31.9 25.6 24.9 24.7

119 99 29 75 29 78 42 78 61 125 55 61 111 184 107 174 66 118 182 235 239 155 95 205 409

500

192 303 168 196 400

300

200

Deaths per 1000 accidents

100

0

100

200

300

400

500

Accidents with injuries per 100 000 population

600

97

98

Traffic accidents

Atlas of health in Europe

Road traffic accidents involving alcohol Turkey (2003)

28.1

Estonia

25.4

Croatia (2003)

21.1

Luxembourg (2003)

19.6

Denmark

17.5

Lithuania

15.6

Finland

14.9

Russian Federation

14.9

Latvia

14.7

Slovenia

13.9

Hungary

13.8

Slovakia

13.3

Poland

11.3

Switzerland (2002)

10.6

Czech Republic

10.5

Moldova (2003)

10.5

Belarus

10.5

MKD

10.2

Kyrgyzstan

9.5

Greece (2003)

9.3

Kazakhstan

8.1

Germany (2003)

6.8

Austria

6.7

Ukraine

6.6

Netherlands (2003)

6.5

Armenia

6.4

Georgia (2003)

6.3

Sweden

5.9

Bulgaria

5.5

Andorra (2002)

5.5

United Kingdom

5.4

Romania (2003)

4.5

Albania (2003)

4.1

Azerbaijan (2003)

3.7

Iceland

2.8

Israel

1.8

Tajikistan (2001)

2004 or latest available year 2000

1.5

Italy (2002)

1.2

Cyprus

0.9

0

10

20

Percentage of all road traffic accidents with injury

2000

2004 or latest available year

30

Lifestyles and environment

Alcohol

Total alcohol consumption Luxembourg Czech Republic Estonia (2004) Hungary Germany Ireland (2005) Austria Croatia Moldova (2002) Spain France Denmark Slovakia Switzerland Portugal United Kingdom Cyprus Belgium Russian Federation Slovenia (2005) Lithuania Latvia Bosnia and Herzegovina Finland (2005) Netherlands Greece Italy Romania Poland Sweden Iceland Malta Ukraine Bulgaria Norway Belarus Azerbaijan Kyrgyzstan Kazakhstan MKD Albania Israel Georgia Armenia Uzbekistan Turkey Turkmenistan Tajikistan

14.6 13.7 13.4 11.6 10.7 10.6 10.5 10.3 10.2 10.0 10.0 9.8 9.5 9.4 9.4 9.3 9.0 8.9 8.9 8.8 8.6 8.4 8.3 8.2 7.8 7.7 7.6 7.4 6.7 5.6 5.5 5.4 5.2 5.0 4.8 4.8 3.1 2.4 2.2 1.9 1.7 1.7 1.3 1.1 1.0 1.0 0.7 0.3 0

2003 or latest available year 2000

5

10

Litres (pure alcohol equivalent) per person

15

99

Alcohol

Atlas of health in Europe

Total alcohol consumption Litres (pure alcohol equivalent) per person per year

100

12

Eur-A Eur-B+C

10

8

6

4 1980

1985

1990

1995

2000

2005

Year

total alcohol consumption

≤ 15 ≤ 12 ≤9 ≤6 ≤3 No data Litres (pure alcohol equivalent) per person, per year

Lifestyles and environment

Alcohol

Consumption of wine and spirits Moldova (2003) Russian Federation (2003) Latvia (2003) Bosnia and Herzegovina (2003) Estonia (2004) Cyprus (2003) Czech Republic (2003) Lithuania (2003) Hungary (2003) Slovakia (2003) Belarus (2003) Ukraine (2003) Finland (2005) Spain (2003) France (2003) Azerbaijan (2003) Bulgaria (2003) Kyrgyzstan (2003) Germany (2003) Ireland (2005) United Kingdom (2003) Luxembourg (2003) 7.9 Switzerland (2003) Greece (2003) Romania (2003) Portugal (2003) Austria (2003) Belgium (2003) Poland (2003) Croatia (2003) Iceland (2003) Denmark (2003) Kazakhstan (2003) Sweden (2003) Slovenia (2005) Armenia (2003) Israel (2003) Malta (2003) MKD (2003) Uzbekistan (2003) Albania (2003) Italy (2003) Turkey (2003) Tajikistan (2003) Georgia (2003) Turkmenistan (2003) 8

0.6 1.0 0.4 0.2 1.1 2.1 2.0 1.0 4.5 1.6 0.7 0.6 1.9 3.7 5.8 0.8 2.6 0.2 2.8 2.2 2.4 4.9 4.1 2.8 5.0 3.6 2.8 1.4 4.8 1.4 3.9 0.3 2.0 4.4 0.1 0.1 2.7 2.3 0.2 0.4 5.7 0.0 0.1 0.9 0.6 6

4

2

8.8 6.2 6.1 6.0 5.8 3.9 3.8 3.7 3.5 3.5 3.2 2.9 2.5 2.4 2.4 2.3 2.1 2.0 2.0 2.0 1.8 1.6 1.6 1.6 1.6 1.4 1.4 1.4 1.3 1.3 1.2 1.1 1.0 0.9 0.9 0.8 0.8 0.7 0.7 0.6 0.6 0.4 0.4 0.1 0.1 0.0 0

2

4

Wine Spirits

6

Litres (pure alcohol equivalent) per person

8

101

Alcohol/Work accidents

Atlas of health in Europe

Litres (pure alcohol equivalent) per person per year

Consumption of spirits, wine and beer 6

Spirits, Eur-A Wine, Eur-A Beer, Eur-A

5

Spirits, Eur-B+C Wine, Eur-B+C Beer, Eur-B+C

4

3

2

1

0 1980

1985

1990

1995

2000

2005

Year

Deaths from work-related accidents 5

Eur-A Eur-B+C

4 Per 100 000 population

102

Consumption of spirits, wine and beer

3

2

1

0 1980

1985

1990

1995 Year

2000

2005

Lifestyles and environment

Work accidents

Deaths from work-related accidents Portugal (2001) Lithuania Russian Federation (2001) Kazakhstan 2.3 Belarus 2.3 Cyprus 2.3 Latvia 2.2 Turkey 2.1 Estonia 2.0 Malta 1.9 Ukraine 1.9 Romania (2004) 1.8 Slovakia 1.7 Croatia 1.7 Luxembourg 1.6 Italy 1.6 Slovenia 1.6 Spain (2004) 1.5 Austria (2005) 1.5 Czech Republic 1.5 Bulgaria (2003) 1.3 Poland 1.2 Hungary 1.2 Israel 1.2 Ireland 1.1 Belgium (2005) 1.1 France (2003) 1.1 Moldova 1.0 Germany (2005) 1.0 Iceland (2005) 1.0 Finland (2005) 1.0 Azerbaijan 0.9 Greece (2002) 0.9 Denmark (2001) 0.7 Sweden (2005) 0.7 Norway 0.6 Switzerland (2003) 0.5 Armenia 0.4 Kyrgyzstan 0.4 Netherlands 0.4 Tajikistan 0.3 United Kingdom (2003) 0.2 Montenegro (2002) MKD 0.1 San Marino (2003) 0.0 0

1

3.5 3.2 3.1 2.7

2 Per 100 000 population

2006 or latest available year 2000

3

4

103

104

Work accidents

Atlas of health in Europe

Deaths from work-related accidents

≤4 ≤3 ≤2 ≤ 1.5 ≤1 No data Per 100 000

105

5. Health care Notes Physicians (pp. 107–108) The data show the number of practising physicians working in public or private health services. Countries do not all report the data strictly according to the recommended definitions, and they differ in the way they compile national statistics on employment in the health sector. The number of physicians per head of population in Eur-A countries in the Region steadily rose until recently. The previously high and increasing rates in Eur-B+C countries declined in the first half of the 1990s and then stabilized.

Dentists (pp. 108–109) The data include dentists who have completed university-level studies in dentistry and are actually working in dental care. The gap between average rates for the Eur-A and Eur-B+C groups of countries has steadily grown.

Nurses (pp. 110–111) The data show nurses who have completed a programme of nursing education (either basic or university level) and are qualified and authorized in their countries to practise nursing in all settings for health promotion, illness prevention, the care of the sick and rehabilitation. The international comparability of statistics on nurses is particularly limited, owing to the variations in national definitions and practices. Nevertheless, the average rates for Eur-A and Eur-B+C countries show opposite trends. The rate in Eur-A grew sharply; Eur-B+C showed a much higher rate before 1990, which sharply declined from the early 1990s into the 2000s and then became stable. Thus, the gap between average rates for the two groups of countries has steadily grown since the mid-1990s.

Hospital beds (pp. 111–116)

The number of available beds includes beds in all hospitals, regardless

106

Atlas of health in Europe

of specialty. The main limitation of intercountry comparability is that some countries count nursing homes and similar institutions as hospitals, while others do not. Most countries show a steady reduction in psychiatric beds. The number of hospital beds per 100 000 population and the average length of stay are clearly declining throughout the Region, but levels in Eur-B+C remain higher than those in Eur-A. Inpatient hospital admissions (pp. 116–117) Average inpatient hospital admissions rates show opposite trends in Eur-A and Eur-B+C. The previously high rates in Eur-B+C dropped during the 1990s, but increased again since 1998; the rates for Eur-A rose until 1998 and then declined. Nevertheless, admission rates vary significantly between countries. Childhood vaccination (p. 118) The bar chart shows the percentage of infants reaching their first birthday in the given calendar year who have been fully vaccinated (with 3 doses) against diphtheria and the percentage of children reaching their second birthday who have been vaccinated against measles. Caesarean sections (pp. 119–120) The number of Caesarean sections performed is rising throughout the Region. The rates are highest in the western and central countries, and lowest in the eastern ones. Health expenditure (pp. 120–123) Estimates for this indicator were produced by WHO. These estimates are, to the extent possible, based on the national health accounts classification (see The world health report 2006 (4) for details). The sources include both nationally reported data and estimates from international organizations – such as the International Monetary Fund, the World Bank, the United Nations and OECD – so they may differ somewhat from official national statistics reported by countries. Health expenditure, both as a percentage of gross domestic product (GDP) and in international dollars (purchasing power parities expressed in US$: US$ PPP) per person, varies significantly between countries. Expenditure is increasing faster in Eur-A than in Eur-B+C, thus further increasing the east–west gap.

Health care

Health personnel

Number of physicians 500 476 468

Greece (2005) Belarus Georgia Russian Federation Belgium Lithuania Switzerland Malta Norway Kazakhstan Netherlands (2005) Iceland Bulgaria Italy Austria Azerbaijan Czech Republic Denmark (2004) Israel Armenia Portugal (2005) Germany France Finland Estonia Sweden (2004) Spain (2003) Latvia Slovakia (2004) Moldova Ukraine Andorra Hungary Ireland Luxembourg (2004) Uzbekistan (2005) Serbia MKD Croatia Cyprus Turkmenistan Kyrgyzstan Slovenia (2005) United Kingdom (2002) Tajikistan Poland (2005) Montenegro Romania Turkey Bosnia and Herzegovina (2005) Albania

431 423 398 397 388 377 376 371 368 366 365 363 363 362 357 356 346 344 344 341 330 329 325 322 315 313 311 308 305 304 292 277 270 264 254 253 253 249 246 236 213 201 199 198 2006 or latest available year 192 2000 159 142 115 0

100

200

300

Per 100 000 population

400

500

107

Health personnel

Atlas of health in Europe

Number of physicians 350

Per 100 000 population

Eur-A Eur-B+C

300

250

200 1980

1985

1995

1990

2000

2005

Year

Number of dentists 70 Eur-A Eur-B+C

Number of physicians

60 Per 100 000 population

108

50

40

30

20 1980

1985

1990

1995 Year

2000

2005

Health care

Health personnel

Number of dentists Sweden (1997) Greece Israel Iceland Cyprus Norway Estonia Finland Bulgaria Denmark (2004) Belgium Germany (2005) Luxembourg (2004) Croatia Czech Republic Latvia France Lithuania Italy Slovenia (2005) Portugal (2005) MKD Andorra Ireland Austria Spain Switzerland Hungary Netherlands (2005) Belarus Malta Slovakia (2004) United Kingdom Moldova Montenegro Ukraine Armenia Kazakhstan Serbia (2002) Albania Turkey Russian Federation Poland (2005) Georgia Azerbaijan Romania Uzbekistan Kyrgyzstan Bosnia and Herzegovina (2005) Tajikistan Turkmenistan (2004)

152

121 110 94 93 89 87 85 85 84 80 79 76 73 69 68 68 66 63 60 59 58 58 57 54 54 53 50 49 48 47 45 44 42 42 41 39 37 33 33 33 32 31 29 29 20 20 20 16 15 14 0

25

2006 or latest available year 2000

50

75

100

Per 100 000 population

125

150

109

110

Health personnel

Atlas of health in Europe

Number of nurses Monaco (1995) Norway Ireland Netherlands (2005) Belgium (2004) Belarus Uzbekistan (2005) Sweden (2002) Denmark (2004) Luxembourg (2004) Iceland (2004) Hungary Czech Republic Finland Switzerland Russian Federation Ukraine Germany (2005) France Slovenia (2005) Spain Lithuania Azerbaijan Moldova Italy Kazakhstan Estonia Slovakia (2005) Austria Israel Malta (2003) Kyrgyzstan Latvia Serbia (2003) Croatia Montenegro San Marino (1990) United Kingdom (1999) Poland (2005) Portugal (2005) Turkmenistan (2004) Tajikistan Bosnia and Herzegovina (2005) Cyprus Armenia Bulgaria Albania Romania Georgia MKD Greece Andorra Turkey

1024 1017 978 946 943 896 860 856 833 806 783 780 772 752 744 742 726 703 684 682 655 632 628 586 566 557 542 538 526 511 508 499 469 459 449 447 437 436 418 412 405 397 379 370 338 310 239 0

300

600

900

1195

2006 or latest available year 2000

1200

Per 100 000 population

1621 1571 1543 1452 1341

1500

1800

Health care

Health personnel / Hospitals

Number of nurses

800 Eur-A Eur-B+C

Per 100 000 population

750

700

650

600

550

500 1980

1985

1990

1995

2000

2005

Year

Hospital beds

1100

Per 100 000 population

Eur-A Eur-B+C

900

Number of nurses

700

500 1980

1985

1990

1995 Year

2000

2005

111

112

Hospitals

Atlas of health in Europe

Hospital beds Monaco (1995) Belarus Russian Federation Ukraine Czech Republic Germany Azerbaijan Lithuania Hungary Kazakhstan Austria Malta Latvia Iceland (2002) France (2005) San Marino (1990) Finland Slovakia Romania Luxembourg (2004) Moldova Bulgaria Tajikistan Israel Switzerland (2005) Estonia Ireland (2005) Croatia Serbia Belgium Poland (2005) Sweden (1997) Uzbekistan (2005) Kyrgyzstan Netherlands (2003) Slovenia Greece MKD Armenia Turkmenistan Montenegro Norway Italy (2005) United Kingdom (2004) Denmark (2004) Cyprus (2005) Georgia Portugal (2005) Spain (2005) Bosnia and Herzegovina Albania Turkey Andorra

966 873 838 826 806 799 792 778 765 761 761 751 734 716 697 681 654 633 627 622 612 597 568 565 557 546 543 528 523 522 519 509 498 476 473 463 443 433 414 413 400 390 382 376 374 365 336 304 297 270 258 0

500

1000

1957

1118

2006 or latest available year 2000

1500

Per 100 000 population

Per 100 000 population

2000

Health care

Hospitals

Psychiatric hospital beds Monaco (1995) Netherlands (2003) Malta Germany Belgium Latvia Luxembourg (1998) Iceland (1995) Russian Federation Czech Republic Switzerland (2005) Lithuania Ireland (2005) France (2005) Ukraine Croatia Greece (2005) Finland Slovakia United Kingdom (1997) Romania Slovenia Belarus Denmark (2004) Kazakhstan Portugal (2005) Poland (2005) Israel Norway Austria MKD Moldova Bulgaria Estonia Montenegro Azerbaijan Sweden (2005) Spain (2005) Armenia Kyrgyzstan Hungary Bosnia and Herzegovina (2005) Georgia Turkmenistan Uzbekistan (2005) Cyprus (2005) Albania Tajikistan Andorra Italy (2005) Turkey

210.7 186.5 170.2 153.0 149.7 137.2 123.6 117.9 112.3 110.6 108.5 102.4 96.2 94.7 93.9 93.1 86.7 86.4 83.6 82.9 77.3 71.2 70.0 66.5 63.5 62.1 62.1 60.1 59.6 58.9 58.5 58.4 58.1 55.3 52.4 48.7 48.5 45.8 45.3 43.5 38.3 37.2 35.0 34.1 30.8 30.6 25.3 2006 or latest available year 24.7 2000 15.0 13.2 9.8 0

50

100

150

200

Per 100 000 population

2000

2006 or latest available year

250

113

114

Hospitals

Atlas of health in Europe

Hospital beds and length of stay Belarus (2006) Russian Federation (2006) Ukraine (2006) Czech Republic (2006) Germany (2006) Azerbaijan (2006) Lithuania (2006) Hungary (2006) Kazakhstan (2006) Austria (2006) Malta (2006) Latvia (2006) Iceland (2002) France (2005) Finland (2006) Slovakia (2006) Romania (2006) Luxembourg (2006)a Moldova (2006) Bulgaria (2006) Tajikistan (2006) Israel (2006) Switzerland (2005) Estonia (2006) Ireland (2005) Croatia (2006) Serbia (2006) Belgium (2006) Poland (2005) Sweden (1997) Uzbekistan (2005) Kyrgyzstan (2006) Netherlands (2003) Slovenia (2006) Greece (2005) MKD (2006) Armenia (2006) Turkmenistan (2006) Montenegro (2006) Norway (2006) Italy (2005) United Kingdom (2006)a Denmark (2004) Cyprus (2005) Georgia (2006) Portugal (2005) Spain (2005) Bosnia and Herzegovina (2006) Albania (2006) Turkey (2006) Andorra (2006)

1118

11.8 13.6 13.3 10.8 10.1 14.5

966

1.0 7.9 12.9 0.8 9.7 5.4 11.7 1.0 8.8 7.8 15.3 1.0 7.5 1.2 11.9 11.7 7.8 7.6 9.9 9.6 8.5 6.7 6.3 10.2 11.5 12.5 7.1 7.9 11.1 9.4 9.5 9.7 7.2 7.6 9.8 0.5 7.4 8.7 8.5 9.6 6.2 5.1

20 Average number of days a

873 838 826 806 799 792 778 765 761 761 751 734 697 681 654 633 627 622 612 597 568 565 557 546 543 528 523 522 519 509 498 476 473 463 443 433 414 413 400 390 382 376 374 365 336 304 297 270 258 0

250

500

750

Beds per 100 000 population

For Luxembourg and United Kingdom, the data for length of stay come from 1996.

1000

1250

Health care

Hospitals

Length of stay in hospital Luxembourg (1996) Azerbaijan Russian Federation Ukraine Kazakhstan Netherlands (2001) Tajikistan Israel Belarus France (2003) Switzerland (2005) Kyrgyzstan MKD (2005) Czech Republic Uzbekistan (2005) Germany Moldova Lithuania Finland (2004) Croatia United Kingdom (1996) Montenegro Latvia Serbia Bosnia and Herzegovina (2005) Turkmenistan Armenia Slovakia Portugal (2005) Spain (2005) Belgium (2005) Austria (2005) Hungary Greece (2003) Estonia Romania Italy (2004) Ireland (2005) Bulgaria Georgia Norway Slovenia Poland Sweden (2005) Albania Iceland (2005) Turkey Denmark (2004)

15.3 14.5 13.6 13.3 12.9 12.5 12.0 11.9 11.8 11.7 11.7 11.5 11.1 10.8 10.2 10.1 10.0 10.0 10.0 9.9 9.8 9.7 9.7 9.6 9.6 9.5 9.4 8.8 8.7 8.5 8.5 8.0 7.9 7.9 7.8 7.8 7.6 7.6 7.5 7.4 7.2 7.1 6.7 6.3 2006 or latest 6.2 available year 5.4 2000 5.1 5.0

0

5

10 Average number of days

15

115

Hospitals

Atlas of health in Europe

Length of stay in hospital 17

Average number of days

Eur-A Eur-B+C

15

13

11

9 1980

1985

1990

1995

2000

2005

Year

Inpatient hospital admissions Length of stay in hospital 21 Eur-A Eur-B+C

20

Per 100 population

116

19

18

17

16

15 1980

1985

1990

1995 Year

2000

2005

Health care

Hospitals

Inpatient hospital admissions 53.9

Monaco (1995) Belarus Austria (2005) Finland (2004) Hungary Romania Russian Federation Lithuania Latvia Germany Denmark (2004) Ukraine Czech Republic Bulgaria Luxembourg (1994) France (2005) Estonia Norway Slovakia Greece (2003) Israel Slovenia Poland (2005) Iceland (2005) Switzerland (1998) Croatia Moldova Belgium (2005) Sweden (2005) Kazakhstan United Kingdom (1998) Uzbekistan (2005) Italy (2004) Ireland (2005) Kyrgyzstan Turkmenistan Serbia Spain (2005) Portugal (2005) Tajikistan Montenegro Turkey MKD (2005) Netherlands (2001) Albania (2005) Armenia Bosnia and Herzegovina (2005) Cyprus Georgia Azerbaijan

28.4 27.3 25.8 24.8 24.3 23.7 23.2 23.1 22.6 22.1 21.9 21.9 21.7 19.4 19.0 18.8 18.8 18.5 18.5 18.2 17.8 17.7 17.2 17.0 17.0 16.7 16.4 15.6 15.5 15.3 15.0 15.0 14.2 14.1 13.8 11.9 11.8 11.5 11.2 10.9 10.6 9.9 9.3 8.7 8.4 8.2 7.9 6.2 5.9 0

10

20

30

2006 or latest available year 2000

40

Average number of days

50

60

117

118

Some procedures

Atlas of health in Europe

Children vaccinated against measles and diphtheria Kazakhstan 99.4 Hungary 99.9 Luxembourg 95.4 Turkmenistan 99.0 Monaco 99.0 Slovakia 98.4 Poland 98.2 Sweden 95.4 Russian Federation 99.3 Belgium 91.9 Ukraine 98.4 Belarus 97.0 Czech Republic 96.9 Spain 96.9 Netherlands 96.3 Latvia 95.3 Moldova 96.4 Albania 94.8 Portugal 96.7 Romania 96.7 Finland 97.0 Iceland 95.0 France 86.0 Slovenia 96.1 Cyprus 87.0 Israel 96.0 Tajikistan 95.9 Italy 87.0 Croatia 95.5 Azerbaijan 95.9 Bulgaria 95.7 Uzbekistan 94.9 Estonia 96.1 San Marino 94.0 Switzerland 86.0 Lithuania 96.6 Andorra 91.4 Denmark 100.0 Norway 91.0 MKD 93.9 Kyrgyzstan 97.3 United Kingdom 84.9 Serbia 88.0 Ireland 86.2 Germany 94.0 Turkey 98.0 Montenegro 90.0 Bosnia and Herzegovina 96.0 Greece 88.0 Georgia 95.1 Armenia 92.0 Malta 94.0 Austria

100

95

90

80.0

100.0 99.8 99.6 99.0 99.0 99.0 99.0 98.7 98.7 98.5 98.0 98.0 98.0 97.9 97.8 97.8 97.4 97.2 97.2 97.1 97.0 97.0 97.0 96.8 96.8 96.0 96.0 96.0 95.9 95.3 95.3 95.3 95.2 95.0 95.0 94.0 93.4 93.0 93.0 92.8 92.4 92.1 91.6 91.0 90.1 90.0 90.0 88.0 Infants 88.0 (diphtheria) 87.0 Children 86.8 (measles) 85.0 83.0

85 80 85 90 Percentage vaccinated

95

100

Health care

Some procedures

Caesarean sections Italy (2004) Malta Portugal (2005) Switzerland (2005) Hungary Germany Austria Ireland (2004) Spain (2005) Albania Greece (1991) Luxembourg (2004) Andorra (1999) Bulgaria United Kingdom (2004) Romania (2005) Latvia Georgia Denmark (2004) Slovakia (2005) Belarus Lithuania Israel Estonia France (2003) Czech Republic Russian Federation (2005) Norway Sweden (2004) Slovenia Finland (2005) Croatia Poland (1997) Belgium (1999) Iceland (2005) Serbia Ukraine Netherlands (2004) Turkey (1998) Armenia MKD (2003) Montenegro Moldova Kazakhstan Azerbaijan Kyrgyzstan Uzbekistan (2005) Turkmenistan Tajikistan

374.5 342.5 339.8 289.0 279.6 277.8 258.1 254.2 250.1 243.0 240.0 239.6 237.3 236.3 220.1 213.8 210.8 207.6 202.5 200.1 195.4 192.3 190.5 189.6 188.0 183.7 172.1 165.6 164.7 162.8 162.7 162.0 161.2 159.2 155.6 146.6 142.0 137.2 136.0 119.9 114.4 113.9 110.5 99.8 61.5 51.0 49.4 33.5 21.0 0

100

2006 or latest available year 2000

200 Per 1000 live births

300

400

119

Some procedures/Health expenditure

Atlas of health in Europe

Caesarean sections 250 225

Eur-A Eur-B+C

Per 1000 live births

200 175 150 125 100 75 50 1980

1985

1990

1995

2000

2005

Year

Total health expenditure as a percentage of GDP 10 9

Eur-A Eur-B+C

8 Percentage of GDP

120

7

Caesarean sections

6 5 4 3 1980

1985

1990

1995 Year

2000

2005

Health care

Health expenditure

Total health expenditure as a percentage of GDP Switzerland Germany France Austria Monaco Iceland Portugal Norway Belgium Netherlands Malta Sweden Slovenia Israel Italy Denmark Bosnia and Herzegovina Spain United Kingdom Bulgaria MKD Luxembourg Greece Hungary Croatia Turkey San Marino Finland Moldova Czech Republic Ireland Slovakia Andorra Latvia Albania Lithuania Ukraine Belarus Poland Russian Federation Cyprus Kyrgyzstan Armenia Estonia Georgia Uzbekistan Romania Turkmenistan Tajikistan Kazakhstan Azerbaijan

11.5

3.8 3.6 0

2

4

10.6 10.5 10.3 9.9 9.9 9.8 9.7 9.7 9.2 9.2 9.1 8.7 8.7 8.7 8.6 8.3 8.1 8.1 8.0 8.0 8.0 7.9 7.9 7.7 7.7 7.4 7.4 7.4 7.3 7.2 7.2 7.1 7.1 6.7 6.5 6.5 6.2 6.2 6.0 5.8 5.6 5.4 5.3 5.3 5.1 5.1 2004 or latest 4.8 available year 4.4 2000

6

8

Percentage of GDP

10

12

121

122

Health expenditure

Atlas of health in Europe

Total health expenditure per person 5178

Luxembourg Monaco Norway Switzerland Andorra Austria Iceland San Marino Germany Belgium Netherlands France Sweden Denmark Ireland United Kingdom Italy Finland Greece Spain Israel Portugal Slovenia Malta Czech Republic Hungary Cyprus Slovakia Croatia Latvia Lithuania Poland Estonia Bulgaria Bosnia and Herzegovina Russian Federation Turkey MKD Romania Belarus Ukraine Albania Kazakhstan Turkmenistan Armenia Georgia Uzbekistan Moldova Azerbaijan Kyrgyzstan Tajikistan

4744 4080 4011 3546 3418 3294 3198 3171 3133 3092 3040 2828 2780 2618 2560 2414 2203 2179 2099 1972 1897 1815 1733 1412 1308 1128 1061 917 852 843 814 752 671 603 583 557 471 433 427 427 339 264 245 226 171 160 138 138 102 54 0

1000

2000

3000

4000

US$ PPP per person

2004 or latest available year 2000

5000

6000

Health care

Health expenditure

Total health expenditure per person

3000 Eur-A Eur-B+C

US$ PPP per person

2500

2000

1500

1000

500 0 1980

1985

1990

1995

2000

Year

Total health expenditure per person

2005

123

125

References 1.

European Health for All database (HFA-DB) [online database]. Copenhagen, WHO Regional Office for Europe, 2008 (http://www. euro.who.int/hfadb, accessed 23 April 2008).

2. WHOSIS (WHO Statistical Information System) [web site]. Geneva, World Health Organization, 2008 (http://www.who.int/whosis/ en/, accessed 23 April 2008). 3. Mortality indicators by 67 causes of death, age and sex (HFAMDB) [online database]. Copenhagen, WHO Regional Office for Europe, 2008 (http://www.euro.who.int/InformationSources/ Data/20011017_1, accessed 23 April 2008). 4. The world health report 2006. Working together for health. Geneva, World Health Organization, 2006 (http://www.who.int/ entity/whr/2006/en/index.html, accessed 23 April 2008). 5. The world health report 2004. Changing history. Geneva, World Health Organization, 2004 (http://www.who.int/whr/2004/en/ index.html, accessed 23 April 2008). 6. The state of the world’s children 2008. Child survival [web site]. New York, United Nations Children’s Fund, 2007 (http://www. unicef.org/sowc08, accessed 23 April 2008). 7. Maternal mortality in 2005. Estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/whosis/mme_2005.pdf, accessed 23 April 2008). 8. European Centre for the Epidemiological Monitoring of AIDS. EuroHIV. HIV/AIDS surveillance in Europe [web site]. Stockholm, European Centre for Disease Prevention and Control, 2008 (http:// www.eurohiv.org, accessed 16 May 2008). 9. Prevalence of diabetes in the WHO European Region. Geneva, World Health Organization, 2008 (http://www.who.int/diabetes/ facts/world_figures/en/index4.html, accessed 16 May 2008). 10. WHO Oral Health Country/Area Profile Programme [web site]. Geneva, World Health Organization, 2008 (http://www.whocollab. od.mah.se, accessed 16 May 2008).

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11. HBSC. Health Behaviour in School-aged Children. A World Health Organization cross-national study [web site]. Edinburgh, HBSC International Coordinating Centre, 2008 (http://www.hbsc.org/ index.html, accessed 16 May 2008). 12. Statistics of road traffic accidents in Europe and North America. Geneva, United Nations Economic Commission for Europe, 2008 (http://www.unece.org/trans/main/wp6/transstatpub.html, accessed 16 May 2008).

This statistical atlas presents key health figures for the WHO European Region. They cover basic data on populations, births, deaths, life expectancy and diseases, lifestyle and environmental indicators such as drinking, smoking and traffic accidents, and types and levels of health care. Each indicator is presented as a map to show overall regional variations, a bar chart to indicate country rankings and a time chart to show trends over time in three main country groupings. Using the WHO Regional Office for Europe’s unique Health for All database, combined with the best alternative sources of data around the Region, this atlas offers the most comprehensive overview of health in Europe. In a handy size, this atlas is designed to be an easily accessible resource at all times, in the office or on the road.

ISBN 978-92-890-1410-6 World Health Organization Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø Denmark Tel.: +45 39 17 17 17 Fax: +45 39 17 18 18 E-mail: [email protected] Web site: www.euro.who.int

9 789289 014106

2nd edition 2008

Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Moldova Netherlands Norway Poland Portugal Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan

ATLAS OF HEALTH IN EUROPE

Atlas of health in Europe

The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves.

Atlas of health in Europe

2nd edition 2008