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European Union state of health from 1990 to 2017: time trends and its enlargements’ effects

  • Original article
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International Journal of Public Health

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.

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Acknowledgements

The authors would like to thank José Valente for data acquisition. ML, RMN and CCD would like to acknowledge the Project NanoSTIMA (NORTE-01-0145-FEDER-000016), which is financed by the North Portugal Regional Operational Programme (NORTE 2020) under the PORTUGAL 2020 Partnership Agreement and through the European Regional Development Fund (ERDF). JV would like to acknowledge “Fundação para a Ciência e Tecnologia (FCT)”, Portugal, which funded his Grant (PD/BD/129833/2018).

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Authors and Affiliations

  1. MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal

    João Vasco Santos, Mariana Lobo, Rui Manuel Neiva, João Viana, Júlio Souza, Cláudia Camila Dias & Alberto Freitas

  2. CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal

    João Vasco Santos, Mariana Lobo, Rui Manuel Neiva, João Viana, Júlio Souza, Cláudia Camila Dias & Alberto Freitas

  3. Public Health Unit, ACES Grande Porto VIII – Espinho/Gaia, ARS Norte, Vila Nova de Gaia, Portugal

    João Vasco Santos

  4. Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, UK

    Jonathan Cylus

  5. Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy

    Walter Ricciardi

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  1. João Vasco Santos
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Correspondence to João Vasco Santos.

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As we used secondary publicly available data sets, with complete anonymized data (gathered estimates), there was no need for an ethical statement.

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Santos, J.V., Lobo, M., Neiva, R.M. et al. European Union state of health from 1990 to 2017: time trends and its enlargements’ effects. Int J Public Health 65, 175–186 (2020). https://doi.org/10.1007/s00038-020-01335-0

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