Data sources for this report include demographic data from the United Nations World Population Prospects (2008 revision) and World Urbanization Prospects (2009 revision), and health-related data from the WHO European Health for All (January 2012 revision) and GLOBOCAN (2008) databases and from The global burden of disease:
2004 update (1–5).
The main source is the European Health for All database (3), which contains over 600 indicators from demographic, socioeconomic, mortality, morbidity and hospital discharge, lifestyle, environment, health care resources, health care utilization and expenditure, and maternal and child health categories, disaggregated by sex and age groups, where pertinent. Time series for some indicators span 1970 to 2011, but most data used extend from 1980/1990 to 2009/2010. Although the number of countries in the WHO European Region nearly doubled after 1990, the statistics used represent data annually reported by today’s 53 Member States to the WHO Regional Office for Europe, contributing to its health monitoring efforts.
European regional averages represent population-weighted averages, weighted by total population, population younger or older than 65 years, or number of live births – either for both sexes or solely for males or females, as appropriate. In most cases, mortality indicators represent the age- and sex-standardized mortality rate, calculated with the direct method using the European standard population (3). Some of the estimates and projections used were produced by WHO, the International Agency for Research on Cancer (IARC) and the United Nations Population Division.
The global burden of disease: 2004 update (5) divides the countries in the European Region into two groups:
○ high-income countries: Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, the Netherlands, Norway, Portugal, San Marino, Slovenia, Spain, Sweden, Switzerland and the United Kingdom;
○ low- and middle-income countries: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Poland, the Republic of Moldova, Romania, the Russian
Federation, Serbia and Montenegro (one country in 2004), Slovakia, Tajikistan, the former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine and Uzbekistan.
In contrast, Chapter 2 of this report illustrates target development using historical country subgroups, as used in the European Health for All database (3):
○ EU15: the 15 Member States belonging to the EU before 1 May 2004 – Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden and the United Kingdom;
○ EU12: the 12 new Member States joining the EU in May 2004 or in January 2007 – Bulgaria, Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Romania, Slovakia and Slovenia; and
○ CIS (Commonwealth of Independent States until 2006): Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan.
Countries in the European Region but not included in these groups are: Albania, Andorra, Bosnia and Herzegovina, Croatia, Iceland, Israel, Monaco, Montenegro, Norway, San Marino, Serbia, Switzerland, the former Yugoslav Republic of Macedonia and Turkey.
A challenge identified in this report is how to allocate all 53 countries to meaningful sub-European aggregations, for example, to illustrate subregional trends in a contemporary context.
References
1. World Population Prospects, the 2008 revision [online database]. New York, United Nations Department of Economic and Social Affairs, Population Division, 2008 (http://esa. un. org/unpd/wpp, accessed 1 September 2011).
2. World Urbanization Prospects, the 2009 revision [online database].
New York, United Nations Department of Economic and Social Affairs, Population Division, 2009 (http://esa. un. org/unpd/wup/
index.htm, accessed 27 June 2011).
3. European Health for All database [online database]. Copenhagen, WHO Regional Office for Europe, 2012 (http://data. euro. who. int/
hfadb, accessed 23 January 2012).
4. Ferlay J et al. GLOBOCAN 2008 v2. 0, Cancer Incidence and Mortality Worldwide: IARCCancerBase No. 10 [web site]. Lyon, International Agency for Research on Cancer, 2010 (http://globocan. iarc.fr, accessed 8 November 2012).
5. The global burden of disease: 2004 update. Geneva, World Health Organization, 2008 (http://www. who. int/healthinfo/global_burden_
disease/GBD_report_2004update_full.pdf, accessed 11 October 2012).
functions is to provide objective and reliable information and advice in the field of human health. It fulfils this responsibility in part through its publications programmes, seeking to help countries make policies that benefit public health and address their most pressing public health concerns.
The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces nearly 900 million people living in an area stretching from the Arctic Ocean in the north and the Mediterranean Sea in the south and from the Atlantic Ocean in the west to the Pacific Ocean in the east. The European programme of WHO supports all countries in the Region in developing and sustaining their own health policies, systems and programmes; preventing and overcoming threats to health; preparing for future health challenges; and advocating and implementing public health activities.
To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health.
distribution within and between countries.
It breaks new ground, however, by helping both to define well-being, a goal of Europe’s new health policy, and to map the way towards achieving it.
The report shows that, while decreases in certain causes of death and advances in tackling risk factors and socioeconomic and living conditions have led to better health, health inequalities and their determinants occur – and in some cases are widening – in many parts of the Region.
Avoidable inequalities that can be
addressed by current knowledge are in fact health inequities. In response to this situation, the countries in the Region adopted the new European health policy, Health 2020, in 2012; its aim is to improve the health and well-being of populations,
provides policy-makers and public health professionals with the epidemiological evidence base that underpins Health 2020 and its six overarching targets. Further, it works to incorporate well-being in Health 2020 by quantifying a European target and relevant indicators. The report describes the WHO Regional Office for Europe’s work with partners and experts to develop a common concept and approach to well-being that both allow for valid measurement and yield information useful to policy-makers and in programme evaluation. It sets out the agreed approach to monitoring progress towards Health 2020, outlines the collaborative agenda to address the challenges ahead and makes the case for measuring well-being as a marker of progress in health.
lth report 2012 | Charting the way to well-being