João Vasco Santos1,2,3, Mariana Lobo4,5, Rui Manuel Neiva4,5, João Viana4,5, Júlio Souza4,5, Cláudia Camila Dias4,5, Jonathan Cylus6, Walter Ricciardi7, Alberto Freitas4,5. 1. MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. jvasco.santos@gmail.com. 2. CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal. jvasco.santos@gmail.com. 3. Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Vila Nova de Gaia, Portugal. jvasco.santos@gmail.com. 4. MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. 5. CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal. 6. Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, UK. 7. Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico "A. Gemelli" IRCCS, Rome, Italy.
Abstract
OBJECTIVES: We aimed to study health status' time trends in the European Union (EU) during 1990-2017 and its enlargements' impact. METHODS: Using estimates from the Global Burden of Disease 2017 study and calculating age-sex-standardized rates, we have described time trends and analysed the differences between EU groups regarding the state of health. Interrupted time-series analyses were also performed in order to assess the enlargement impact in the EU state of health. RESULTS: All age-sex-standardized rates (mortality, years of life lost, years lived with disability and disability-adjusted life years) declined (annualized rates of change of - 1.7%, - 1.52%, - 0.06% and - 1.01%, respectively) between 1990 and 2017 (except between 2014 and 2015). For EU-28, life expectancy and healthy life expectancy increased 5.9 and 4.6 years, respectively. With the EU-25 and EU-27 enlargements, all age-sex-standardized rates and life expectancies worsened (with statistical significance). The EU-28 enlargement revealed the same tendency, contrasting with the EU-15 one. CONCLUSIONS: Overall, the EU health status is improving, despite changes in its composition over the years. However, the average EU state of health declined with the 2004, 2007 and 2013 EU enlargements.
OBJECTIVES: We aimed to study health status' time trends in the European Union (EU) during 1990-2017 and its enlargements' impact. METHODS: Using estimates from the Global Burden of Disease 2017 study and calculating age-sex-standardized rates, we have described time trends and analysed the differences between EU groups regarding the state of health. Interrupted time-series analyses were also performed in order to assess the enlargement impact in the EU state of health. RESULTS: All age-sex-standardized rates (mortality, years of life lost, years lived with disability and disability-adjusted life years) declined (annualized rates of change of - 1.7%, - 1.52%, - 0.06% and - 1.01%, respectively) between 1990 and 2017 (except between 2014 and 2015). For EU-28, life expectancy and healthy life expectancy increased 5.9 and 4.6 years, respectively. With the EU-25 and EU-27 enlargements, all age-sex-standardized rates and life expectancies worsened (with statistical significance). The EU-28 enlargement revealed the same tendency, contrasting with the EU-15 one. CONCLUSIONS: Overall, the EU health status is improving, despite changes in its composition over the years. However, the average EU state of health declined with the 2004, 2007 and 2013 EU enlargements.
Entities:
Keywords:
Burden of disease; European Union; Health status; Public health
Authors: João Vasco Santos; Júlio Souza; José Valente; Vera Alonso; André Ramalho; João Viana; Walter Ricciardi; Alberto Freitas Journal: Eur J Public Health Date: 2020-06-01 Impact factor: 3.367