25/06/2001 - The number of smokers is still high in many OECD countries, and too many people are overweight. But despite the health risks these problems pose, growth of health expenditure as a percentage of GDP has stabilised across the OECD area and is actually falling in some countries. These are some of the conclusions to be found in OECD Health Data 2001, the latest edition of the OECD's annual interactive database comparing key aspects of health-care systems in the 30 OECD countries.
Health spending as a percentage of OECD GDP amounted to 8.3% in 1998, the latest year for which comparative figures are available, up only marginally from 8.2% of GDP in 1993. In 1980, health spending in OECD countries averaged 6.9% of GDP (see Table 1). But avoidable health risks in OECD countries remain high, suggesting that stronger efforts are needed to tackle them through preventive and early intervention measures.
Smoking is the most predominant avoidable health risk in OECD countries and a major factor in at least two leading causes of premature mortality, cancer and circulatory disease. The correlation between tobacco consumption and lung cancer is demonstrated by data relating deaths from lung cancer in the period 1995-97 with tobacco consumption levels 20 years earlier in 1975-77 (see Chart 1).
In most countries, there has been a sizeable reduction in the proportion of adults who smoke every day (see Chart 2). By the end of the 1990s, Portugal, Sweden and the United States had the lowest rates, with fewer than 20% of adults smoking daily. Japan, the Netherlands, Spain and Switzerland continue to have over one third of adults reporting that they are daily smokers.
On a less positive note, the past two decades have seen an increase in numbers of obese men and women in all age groups in all OECD countries for which data are available (see Chart 3). In the US, 22.6% of the population were classified as obese in the period 1988-1994, up from 14.5% in the period 1978-1980. In the U.K. the ratio of obese people to total population jumped from 7% in 1980 to 20% in 1999. Obesity leads to a greater propensity to diabetes and circulatory diseases, and so is another health risk that could be reduced by preventive measures such as improved nutrition and more regular exercise.
The United States is still, by far, the largest spender on health care, not only as a percentage of GDP but also on a per capita basis. Though health spending as a proportion of GDP in the United States slipped slightly in 1998 to 12.9% from 13.2% in 1993, on a per capita basis rose to $4,165 in 1998 from $3,383 in 1993. Switzerland was the second highest spender per capita on health care in 1998, followed by Norway, Germany, Canada and Luxembourg, each with more than $2,200 expenditure per capita. At the bottom end of the range, six countries -- the Czech Republic, Hungary, Korea, Mexico, Poland and Turkey -- each spent less than $1, 000 per capita on health care (see Chart 4).
OECD Health Data 2001 presents more detail than previous editions on the way health expenditure is financed in different countries. Public expenditure on health as a share of GDP in the United States is similar to that in other OECD countries but covers only part of the population (see Table 2). Private out-of-pocket payments in the US are greater than in other OECD countries on a per-capita basis (see Chart 4). However, the out-of-pocket share of health care funding has decreased in the United States over the past decade, while it has been rising in many other OECD countries, including Canada, Germany and several Nordic Countries.
OECD Health Data 2001 is a quadrilingual version in English, French, German and Spanish under Windows 95/98/NT/2000/Me, available on CD-ROM. Its fast, user-friendly content enables PC users to query OECD data-files and analyse them in the form of tables, charts and maps. The database brings together some 1,200 different series which are available as over 7,000 indicators. Key items span the period 1970-1998/1999. Several chapters show historical time series from 1960 onwards. Selected projections and preliminary data are available for the years 1999/2000, and an extensive documentation of variable definitions, national sources and estimation methods accompanies the database.
"OECD Health Data 2001: a Comparative Analysis of 30 OECD Countries""
CD-Rom, OECD, Paris 2001
Â€325; FF2,131.86; US$295; DM635.64
ISBN 92-64-06876-7 (81 01 07 3)