Inequalities in health and access to quality care persist in Europe, shows a new OECD/EC report


03/12/2014 - Today, Europeans enjoy a much longer life expectancy than the previous generation, but large inequalities in health remain across and within countries. These are largely due to disparities in access to and quality of care, as well as individual lifestyles and behaviours, according to a new joint OECD/European Commission report.


Health at a Glance: Europe 2014 shows that life expectancy in EU member states has increased by more than five years on average since 1990. But the gap between those countries with the highest life expectancies (Spain, Italy and France) and those with the lowest (Lithuania, Latvia, Bulgaria and Romania) remains around eight years.


Within all EU countries, highly educated people are likely to live several years longer and in better health than those with low level of education. This is particularly the case in Central and Eastern Europe.


This makes it all the more important that all European countries put in place effective public health strategies to prevent diseases and contribute to the reduction in health inequalities.


Inequalities in access to health care contribute to inequalities in health


In most EU countries, universal health coverage has ensured continued access to health care during the recent economic crisis. But in Bulgaria and Greece, many people lost their insurance coverage, at least temporarily. Several countries have seen their coverage for certain health services and goods reduced, and out-of-pocket payments by patients have risen.  The new OECD/EC report shows that, on average across EU countries, the proportion of low-income people reporting some unmet needs for medical care and dental care is two-times greater than among the population as a whole, and four-times greater than for high-income groups. Such unmet care needs may have long-term health and economic consequences.   


Quality of care continues to improve, but there remain large gaps 


Quality of care has generally continued to improve in recent years in most European countries, despite the crisis. For example, mortality rates for people suffering from a heart attack have decreased by 40% and strokes by 20%, on average across EU countries over the past decade. But large gaps remain in the chances of surviving these life-threatening diseases. For example, a person admitted to a hospital for a heart attack is twice more likely to die 30 days after the hospital admission in Hungary and Latvia than in Denmark and Sweden. Survival from different types of cancer also varies substantially across EU countries. Efforts are needed to improve the prevention, early diagnosis and treatment of cancer and other life-threatening diseases in countries that are lagging behind. 


Key other main findings of Health at a Glance: Europe 2014 include:


  • The crisis has had a mixed impact on population health and mortality: while suicide rates rose at the start of the crisis, they seem to have return to pre-crisis levels in most countries in recent years. Mortality from transport accidents has declined following the economic crisis, and so did the exposure to air pollution, although some air pollutants seem to have risen again in recent years.
  • Between 2009 and 2012, expenditure on health in real terms (adjusted for inflation) fell in half of the EU countries and significantly slowed in the rest. On average, health spending decreased by 0.6% each year, compared with annual growth of 4.7% between 2000 and 2009. This was due to cuts in health workforce and salaries, reductions in fees paid to health providers, lower pharmaceutical prices, and increased patient co-payments.
  • On average across EU countries, the number of doctors per capita increased from 2.9 doctors per 1 000 population in 2000 to 3.4 in 2012. This growth was particularly rapid in Greece (mostly before the economic crisis) and in the United Kingdom (an increase of 50% between 2000 and 2012). In all countries however, the density of doctors is greater in urban regions than in rural regions, resulting in growing shortages in certain areas.
  • There are wide variations across EU countries in waiting times for non-emergency surgical interventions. While some countries have been able to achieve progress in reducing waiting times for planned surgical interventions over the past few years, waiting times have started to rise following the crisis in other countries such as Portugal and Spain.


More information on Health at a Glance: Europe 2014 and country-specific notes for France (in French), Germany (in English and in German), Ireland, Italy (in English and in Italian), Norway, Poland (in English and in Polish) and the United Kingdom are available at:


For comment, journalists should contact Francesca Colombo (tel. +33 1 45 24 93 60) or Gaetan Lafortune (tel. + 33 1 45 24 92 67) of the OECD’s Health Division.


Journalists can download the report from the OECD’s protected site or contact the OECD Media Division (tel. + 33 1 45 24 97 00).


Note: the hashtag for Health at a Glance is #OECDhealth.


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