Profile of Health and Well-being: Greece

Greece

Profile of Health

and Well-being

Greece

Profile of Health

and Well-being

Abstract

Profiles of health and well-being give an overview of a country's health status, describing data on mortality, morbidity and exposure to key risk factors together with trends over time. They are developed in collaboration with WHO European Member States. When possible, each report also compares a country to a reference group, which is in this report the whole WHO European Region and the European Union member countries prior to 1 May 2004. To make the comparisons as valid as possible, data are as a rule taken from one source to ensure that they have been harmonized in a reasonably consistent way. The data in the report are drawn from the European Health for All (HFA) database of the WHO Regional Office for Europe. The HFA data are collected from Member States on an annual basis and include metadata that specify the original source of data for specific indicators.

Keywords HEALTH STATUS, COST OF ILLNESS, LIFE EXPECTANCY, COMPARATIVE STUDY, HEALTH SYSTEMS PLANS, DELIVERY OF HEALTH CARE, GREECE

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ISBN 978 92 890 5143 9

? World Health Organization 2016

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.

Design: ref-.

Greece

Profile of Health

and Well-being

Contents

Acknowledgements ...................................................................................... vi Abbreviations and acronyms ................................................................... vii Summary of situation and trends in health and well-being in Greece ..................................................................................... ix Introduction ..................................................................................................... 1 Selected demographic and economic information ................................ 2 Health status and burden of disease ......................................................... 4

Life expectancy ........................................................................................................... 4 Healthy life expectancy and disability-adjusted life-years ................ 5 Morbidity ......................................................................................................................... 5 Infant and maternal mortality ........................................................................... 6 Leading causes of death .......................................................................................... 6 Other major causes of death ................................................................................ 8 Premature mortality .............................................................................................. 10 Risk factors and determinants of health ................................................ 14 Alcohol consumption ............................................................................................. 14 Tobacco smoking ...................................................................................................... 14 Diet, consumption of macronutrients and overweight ...................... 15 Comparative risk assessment ............................................................................ 16 Health system ................................................................................................ 17 Health 2020 .................................................................................................... 19 Reduce premature mortality by 2020 ........................................................... 19 Increase life expectancy ....................................................................................... 21 Reduce inequalities in health ............................................................................ 21 Enhance the well-being of the population ................................................. 21 Ensure universal coverage and the right to the highest attainable level of health .......................................................... 22 Set national goals and targets related to health .................................... 22 Conclusions.................................................................................................... 24 References ..................................................................................................... 28 Annex 1. ICD-10 codes for causes of death ............................................. 29 Annex 2. Selected mortality data ............................................................. 30

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Acknowledgements

The highlights on health and well-being and accompanying profiles of health and well-being are produced under the overall direction of Claudia Stein, Director, Division of Information, Evidence, Research and Innovation, WHO Regional Office for Europe. The principal authors of this publication were: ? Mika Gissler, Consultant, WHO Regional Office for Europe,

and Research Professor, National Institute for Health and Welfare, Finland; ? Ivo Rakovac, Programme Manager a.i., Health Information, Monitoring and Analysis, WHO Regional Office for Europe; ? Nadia Scott, Consultant, WHO Regional Office for Europe; ? Claudia Stein, Director, Division of Information, Evidence, Research and Innovation, WHO Regional Office for Europe. Other contributors included Charalampos Economou, Panteion University of Social and Political Sciences, Athens, Greece, and Jo?o Breda, Silviu Domente, and Sarah Thomson, WHO Regional Office for Europe.

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Abbreviations and acronyms

EU European Union EU15 countries belonging to the EU before 1 May 2004 GDP gross domestic product HFA Health for All (database) ICD International Classification of Diseases PPP purchasing power parity

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Summary of situation and trends in health and well-being in Greece

Historically, the health status of the Greek population was among the best in the WHO European Region. The improvement in health status, as measured by life expectancy and mortality, has continued, but more slowly than the average for the countries belonging to the European Union before 1 May 2004 (EU15). The most recent life expectancy at birth for males (79 years) equals the EU15 average, while women are expected to live one year less (83 years) than their counterparts in the EU15. Healthy life expectancy increased to 69 years for men and to 73 years for women by 2013.

The slow rise in life expectancy is mainly a function of the slow improvement in mortality from diseases of the circulatory system and malignant neoplasms (cancers) in comparison with the EU15. The mortality rate from diseases of the respiratory system has in fact increased, reflecting the high proportion of regular daily smokers. The already low mortality rates from infectious diseases and external causes of injuries and poisoning have continued to fall, apart from mortality from motor vehicle traffic accidents for which Greece has the highest rate in the EU. Premature mortality, particularly from cardiovascular diseases, is substantially higher in Greece than the EU15 average.

The incidence of infectious disease is in general low, excluding the rates for HIV and AIDS, which have rapidly increased during the last few years. Vaccination coverage is high.

The health system is curative-oriented. No referral system has been established and the network of public health services is underdeveloped. It is also characterized by a high density of physicians, low density of nurses and high hospitalization rates. Total health expenditure is in line with the EU15 average, but the share of out-of-pocket expenditure is very high.

Since 2009, the Greek economic crisis has negatively affected the health status of the population. Notably, the numbers of infant and maternal deaths have increased, as have suicides and homicides (for males only).

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