UK Among Unhealthiest Countries in Europe, Despite Free Medical Care

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Main Category: Public Health
Article Date: 06 Mar 2013 - 0:00 PST


The United Kingdom has fared badly in health when compared to its Western European neighbors and Australia, in spite of sixty years of free universal health care, considerable increases in health care spending, and the introduction of several nationwide health initiatives, researchers reported in The Lancet.

Over the last twenty years, the UK's ranking regarding health outcomes or longevity have not improved, when compared to 15 European nations (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden), Australia, Canada and the USA.

The findings of this study, which startled some of the researchers, showed that despite life expectancy rising by 4.2 years in the UK over the last twenty years, the rate at which premature mortality has fallen is well below that achieved by the 15 European countries.

The only country the UK appears to fare well against over the last twenty years is the USA. In 2011, the United States slipped to 37th place in life expectancy.

The authors said "concerted action is urgently needed" in the UK.

Lead author, Chris Murray, from the Institute for Health Metrics and Evaluation, University of Washington, USA, and team gathered data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010). They analysed patterns of ill health and death in the United Kingdom, took into account preventable risk factors, and ranked the country against a group of competitor nations (high-income countries) whose levels of health expenditure were similar in 1990 and 2010.

Only males aged 55+ years in the UK have experience considerably faster reductions in death rates compared to the other countries over the last two decades.

As far as mortality rates for people aged from 20 to 54 years are concerned, the UK's ranking has dropped considerably. Over the past twenty years, there have been a significant rise in alcohol and drug disorders - which in 1990 were the 43rd and 32nd causes of death in the country respectively, and the 18th and 6th causes in 2010.



The United Kingdom is "unhealthy" compared to most of its Western European neighbors


Of the eight leading causes of death, five were the same in 2010 as in 1990; they were:

• chronic obstructive pulmonary disease (COPD)
• ischemic heart disease
• lower respiratory infections
• lung cancer
• stroke

Alzheimer's disease rose to 10th place as a cause of premature death in 2010, from 24th in 1990. Drug disorders rose to 21st place from 64th in the same years.

Premature mortality from the following diseases, situation or conditions was lower than the 15 European nations' average:

• diabetes
• liver cancer
• automobile accidents (including all road injuries)
• chronic kidney disease

However, as far as the these diseases and conditions are concerned, the UK has slipped and is today well below the Western European average:

• aortic aneurysm
• breast cancer
• congenital abnormalities
• COPD
• esophageal cancer
• ischemic heart disease
• lower respiratory tract infections
• other heart and circulatory disorders
• preterm birth complications

Disability is becoming a considerably greater burden of disease today in the United Kingdom, mainly because people are living longer than they used to 20 years ago. However, people are spending their later years in worse health than they did in 1990.

Over half of all years lived with disability in the UK were because of two types of disorders:

• Mental and behavioural disorders - including bipolar disorder, schizophrenia, alcohol use, drug use, anxiety, and depression


• Musculoskeletal disorders - mainly lower back pain and falls

Below are data on how much the following conditions, illnesses or situations contributed to the UK's disease burden in 2010:

• The harmful effects of tobacco smoking - 11.8%
• Hypertension (high blood pressure) - 9%
• Obesity - 8.6%
• Poor diet plus physical inactivity - 14.3%

The authors added that the effects of alcohol are contributing more and more each year to the UK's disease burden.

Murray said:

"Further progress in premature mortality from several major causes, such as cardiovascular diseases and cancers, will probably require improved public health, prevention, early intervention, and treatment activities. The growing burden of disability, particularly from mental disorders, substance use, musculoskeletal disorders, and falls deserves an integrated and strategic response."

In a linked Comment in the same issue of The Lancet

Edmund Jessop, from the UK Faculty of Public Health in London, UK wrote:

"The UK has done very well in the past 20 years in many areas. As Murray and colleagues show, mortality has reduced and several aspects of diet have improved, with drops in disability-adjusted life-years for all dietary risk factors examined.

The UK has stronger tobacco control than does any other country in Europe, and we continue to enjoy some of the safest roads in Europe."

Jessop cautioned:

"There is still plenty of room for bold action by politicians and the body politic: plain packaging for cigarettes, minimum pricing for alcohol, banning of trans fats, improved control of hypertension, and attention to psychiatric disorders. Alternatively, the UK can continue to languish at the bottom of European league tables."

In an accompanying Editorial

Editor in Chief of The Lancet, Dr Richard Horton, wrote of the study:

"(it is) an independent scientific report card on decades of NHS reorganisations that have often had more to do with political ideology than sound evidence. The GBD results do not by themselves offer definitive prescriptions for the predicaments they describe. And they do not provide a simple verdict on the performance of the UK health system. But they do offer a quantitative means to monitor measures of health and disease and to enable more rational review and discussion of health priorities. This work is an important step forward for health policy."

UK Health Secretary, Jeremy Hunt, in a response to the news that the United Kingdom is behind many Western countries in managing cardiovascular health, said that the UK is developing a new plan to tackle cardiovascular disease that could save up to 30,000 lives over the next several years. He says that he hopes to make life expectancy in England one of the top in Europe.

Written by Joseph Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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