The COVID-19 crisis has generated enormous human, social and economic costs, claiming millions of lives and with many more suffering ill-health as a direct or indirect consequence of the virus. It has placed immense pressure on health care services, ones often already overstretched before the pandemic, and the pandemic is far from over.
Ensuring COVID-19 vaccines are accessible to all and containing and mitigating the virus continue to be essential. But so is making health systems stronger and more resilient, including through effective investment in primary care, health promotion and disease prevention. The pandemic has brought some encouraging signs of emerging systemic changes, with advances in digital healthcare delivery and better integrated care.
Obesity is a serious public health problem across the OECD area. People in the obese category are more likely to have poor health outcomes and a shorter life expectancy, partly because they face a higher risk of developing type two diabetes, several cancers, stroke, or asthma.
It is predicted that between 2020 and 2050, overweight and obesity will cause an additional 462 million cases of cardiovascular disease and 212 million new cases of diabetes, leading to a reduction in average life expectancy in the OECD of 2.7 years.
The issue was brought to the forefront in 2020 when it was noticed that people living with obesity were at greater risk of developing severe symptoms and dying from COVID-19. One study found morbidly obese patients were 2.7 times more likely to die from COVID-19 than patients of a healthy weight, and for patients of an even higher weight, the risk was 4.2 times greater.
The pandemic and its associated measures also resulted in a reduction in physical activity for many people, and changes in how people ate and consumed alcohol. While it’s too soon to say whether the pandemic worsened obesity or not, it was found that, on average, more people gained weight than those who lost weight.
While there is no “silver bullet” solution, effective policy tools are available. Policy makers should implement comprehensive policy packages that include both “downstream” interventions focused on changing people’s behaviour as well as “upstream” interventions that change the environment in which people live, through food reformulation and increased green spaces.
It must also be recognised that obesity disproportionately affects people with a lower socio-economic status: the same people who have were disproportionately impacted by the pandemic. Targeting the needs of disadvantaged groups by subsidising healthy foods and communicating programmes in diverse languages can have a significant impact.
The pandemic forced countries to develop near real-time data on case numbers, test results, mortality, vaccinations, hospitalisations and hospital saturation in order to make public-health decisions like when to impose or lift restrictions, triggering advances in the timeliness and quality of national health datasets in numerous countries.
Before COVID-19, only a handful of countries produced daily or weekly healthcare datasets, but 23 out of 24 countries surveyed by the OECD reported improved data timeliness as a result of the pandemic.
Mortality data was particularly important. Until 2020, most countries produced mortality statistics on an annual basis. Only two countries, Latvia and Denmark, reported having mortality data available in real time prior to 2021. COVID-19 transformed this, hitting countries in drastic waves that evolved significantly on a week-by-week basis. In many cases, mortality data are now generated on a daily basis—and sometimes even multiple times daily.
Not only did more countries start producing health data regularly and rapidly, but the quality of their data improved as well. The accuracy, coverage and completeness of the datasets increased during the pandemic in 19 out of the 24 surveyed countries.
These major improvements in health data show how health systems adapted to the crisis, and are continuing to forge a path towards greater resilience.
The pandemic caused massive disruptions in the treatment and preventative care of many unrelated health problems. With hospitals and medical professionals at capacity treating COVID-19 patients, elective surgeries like knee and hip replacements needed to be delayed.
But the disruption also affected routine yet crucial check-ups, with potentially serious consequences down the line. The proportion of women screened for breast cancer within the last two years fell by an average of 5 percentage points in 2020, compared with 2019.
Screening for cancer can have a large impact on survival, as it is often imperative to begin medical interventions as early as possible. Diagnostic delays have been shown to increase the mortality for multiple types of cancer.
As demand for health services increases in the coming decades, governments need to be able to ensure adequate continuity of care through crises.
Young people have reported much higher levels of anxiety and depression since the onset of the COVID-19 pandemic compared with the general adult population, widening existing differences.
Data from July 2021 point to 44.8% of young people reporting symptoms of anxiety in the United States, compared to 27% for all adults, while 38.6% reported depression compared with 22.1% of adults. Earlier OECD data (from March 2021) showed that young people were 30% to 80% more likely to report symptoms of either depression or anxiety in Belgium, France and the United States.
Reduced social contact and school disruptions have interrupted recent progress in integrating mental health support for young people into education systems and employment services.
More data and analysis to identify sub-groups needing more support – women, LGBTI+ and those from lower socio-economic backgrounds – will be needed to better target extra mental health resources.
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With reduced mobility during containment measures, the use of remote health consultations did help relieve the impact of some medical disruptions. This had the added benefit of helping to reach populations in already-underserved areas before the pandemic hit.
Pharmacies, often serving as a first point of contact between people and health systems, also expanded their services and remain key actors in testing and vaccination campaigns.
Although today 1 in 10 workers are employed in the health and social care sectors in OECD countries, the disruptions in medical studies due to the pandemic could compromise the capacity of health systems to face future needs. Notwithstanding the fact that the share of the population aged 80 and older in OECD countries is projected to increase from 4.6% in 2019 to 9.6% by 2050.
Increasing the capacity to train the future workforce will be essential to building resilient health systems and cope with the increasing demand for health and social care services.
> Number of medical doctors and nurses | Data insights
Governments need to move beyond crisis measures to build a more resilient health system capable of responding to future needs:
Vaccinate more people by building trust with hesitant population groups and deploy booster shots to protect against emerging COVID-19 variants and long-COVID symptoms.
Assure continuity of access to screenings and medical procedures to avoid compounding the health effects of the crisis.
Integrate mental health support into workplaces, public employment services and education systems, while targeting support to struggling groups.
Reduce territorial inequalities in access to care as demographic shifts occur and expand its reach through advancements, such as telehealth consultations.
Further increase the number of medical professionals to meet emerging healthcare demands and avoid overstretching doctors, nurses and long-term care workers.
Plan for population ageing and the associated increases in demand for health services when designing policies to be resilient in the long run.
The demand for health services is expected to increase in the OECD area due to population ageing, while labour forces are projected to shrink, posing a significant challenge for the resilience of health systems.
An integrated health information system enables the secure flow of data to advance policy objectives. This report looks at the current situation in Korea and recommends policy changes to overcome barriers.
In the face of COVID-19, the number of cancer-related procedures declined significantly across the world, but many countries attempted to mitigate this through innovative policy.
While COVID-19 has exacerbated medicine shortages, the problem was pre-existing and largely the result of manufacturing and quality issues. Nevertheless, policy solutions exist.
This guidebook outlines and discusses the steps involved in selecting, implementing and evaluating policy actions and interventions to improve public health.
How do countries compare on the number of medical graduates in a given year?
COVID‑19 hit the long-term care sector hard. The brief assesses the emergency preparedness of the sector and highlights the lessons learned in the pandemic.
Countries have unevenly progressed towards achieving an integrated approach to mental health policy, but COVID has helped raise awareness of the importance of good mental health for all life domains.
Vaccines continue to be our best tool in the fight against COVID-19. Not only does vaccination reduce the likelihood of dying or hospitalisation, but it also is effective at preventing ‘long COVID’.
However, while some populations have had multiple booster doses, large parts of the world remain without basic protection due to access and hesitancy.
International cooperation can boost access in rural and developing countries- a necessity not only for international solidarity and economic flow, but also for slowing the outbreak of future variants of the virus.
This inventory pulls together OECD analysis and data on healthcare systems and workers. It covers topics both directly and indirectly related to many of the issues arising in the context of the global coronavirus (COVID-19) crisis, from the resilience of health systems to the public health threats caused by pandemics or fake pharmaceuticals,
Explore key topics and broaden your knowledge of the Sustainable Development Goals (SDGs)