Core health indicators in the WHO European Region 2022. Special focus: European Programme of Work Measurement Framework

Core health indicators in the WHO European Region Special focus: European Programme of Work Measurement Framework 2022 Document number: WHO/EURO:2022-6068-45833-65989 © World Health Organization 2022 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition: Core health indicators in the WHO European Region. Special focus: European Programme of Work Measurement Framework. Copenhagen: WHO Regional Office for Europe; 2022”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. (http://www.wipo.int/amc/en/ mediation/rules/). Suggested citation. Core health indicators in the WHO European Region. Special Focus: European Programme of Work Measurement Framework. Copenhagen: WHO Regional Office for Europe, 2022. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/ about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. 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 WHO 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 and dashed 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 WHO 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 WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Designed by: Pellegrini Abbreviations 2 ART antiretroviral therapy DPT3 third dose of the diphtheria–tetanus–pertussis vaccine EPW European Programme of Work 2020–2025 – “United Action for Better Health in Europe” HEP health emergencies protection HIS health information system HPOP promoting health and well-being IHR International Health Regulations (2005) MCV2 second dose of measles vaccine MDR multidrug-resistant NCD noncommunicable disease OECD Organisation for Economic Co-operation and Development PCV3 three doses of pneumococcal conjugate vaccine RR rifampicin-resistant SDG Sustainable Development Goal UHC universal health coverage WHO World Health Organization Data and health information are at the crux of evidence-based decision making Timely, credible, reliable, and actionable data are key to ensure that political decisions are data driven. Reliable data also facilitate the monitoring and forecasting of future health trends. One year ago, Member States in the WHO European Region adopted the European Programme of Work Measurement Framework. This year’s version of Core Health Indicators displays each of these indicators — as one framework, for the first time. Vigilance while staying the course in pandemic times The European Programme of Work, 2020–2025 – “United Action for Better Health in Europe” (EPW) cites the ability to collect and analyse data as being critical to WHO’s work to improve health throughout the life course. At no time has this been more important to the Region as we emerge from the COVID-19 pandemic. This publication includes information on the three Core Priorities of the EPW. Countries in our Region should be proud of some of the significant achievements observed, including the increase in antiretroviral therapy coverage and the reduction of premature mortality from major noncommunicable diseases. But we also need to be vigilant; the full health impact of the pandemic is not completely understood nor fully visible at this point in time. Preface Investing in data to measure progress in the midst and aftermath of COVID-19 It is clear that the health impacts of the pandemic will be substantial and have the potential to undo many of the achievements we have worked hard to accomplish, while adding challenges to our path reaching the health-related SDGs. Now, more than ever, is the time to invest in data and health information systems, so that we can understand and predict future health systems needs and enable the Region to be better prepared to withstand future health crises. Based on the most recent data available from our Member States, and organized by EPW Core Priorities, this new publication presents tables, graphs and infographics on each EPW Measurement Framework Indicator, disaggregated by sex wherever possible. I am delighted to present this publication. As always, I look forward to continued collaboration with all our Member States and international partners in support of the generation and use of health information, for monitoring the EPW, and ultimately, for people’s better health and well-being. Dr Hans Henri P. Kluge Director WHO Regional Office for Europe I am pleased to present this year’s edition of a key annual publication for the WHO Regional Office for Europe: Core health indicators in the WHO European Region 2022. 3 Core Priority 1. Moving towards universal health coverage (UHC) 1 2 3 4 5 6 7 8 9 Mid-year population (thousands) Estimated maternal mortality per 100000 live births Country 2017 2020 2018 2019 2019 2015 2018 2018 2020 Albania 2 862 15.0 47 75 11.4 3.7 29 12.46d 8.20d — Andorra 81 — — — — — 18.7 — — 91.81d Armenia 2 962 26.0 48 46 19.9 2.7 26 — — 82.85d Austria 8 878 5.0 — 83 10.4 10.4 21 3.22d 0.98d 171.3b Azerbaijan 9 854 26.0 57 57 27.2 4.0 24.5 — — 103.54d Belarus 9 466 2.0 66 73 23.8 16.5 27 — — 171.48d Belgium 11 503 5.0 — 83 10.6 13.9 17.5 3.82 0.86 292.42 Bosnia and Herzegovina 3 416 10.0 — 100d 18.7 8.3 30.8 — — 87.11d Bulgaria 6 976 10.0 — 61 24.2 6.5 28 19.23 7.96 107.33d Croatia 4 065 8.0 75 0 16.1 11.0 32.4 3.95d 2.51d 108.75d Cyprus 881 6.0 — 0d 8.2 3.2 19.8 5.00d 1.79d 80.59d Czechia 10 669 3.0 — 36 14.3 9.5 28 1.06d 0.50d 144.45b Denmark 5 825 4.0 90 50d 10.8 7.6 20.6 — — 160.29c Estonia 1 327 9.0 66 68 14.9 12.0 27.4 8.09d 2.79d 117.79b Finland 5 524 3.0 — 40d 9.6 13.4 19 3.82d 1.17d 299.48c France 64 668 8.0 — 4 10.6 9.7 22 2.07d 1.49d 167.7b Georgia 3 723 25.0 65 67 24.9 7.7 26.3 17.39 6.82 131.59b Germany 80 475 7.0 86 55 12.1 8.3 20 2.43 1.00 200.75b Greece 10 733 3.0 67 — 12.5 3.6 19.1 8.86b 2.57b 124.11b Hungary 9 771 12.0 — 60 22.1 11.8 30 11.63d 5.92d 120.22b Iceland 366 4.0 88 — 8.7 11.2 20 — — 227.4b Ireland 4 977 5.0 85 13 9.7 8.9 19.7 1.23d 0.85d 231.00b Israel 9 054 3.0 — 64 8.8 5.2 16.6 — — 177.77 Italy 59 729 2.0 91 — 9 4.3 21 9.44b 4.18b 122.79 Kazakhstan 18 514 10.0 57 81 22.4 18.1 27.1 — — 123.66d Kyrgyzstan 6 457 60.0 48 62 20.3 8.3 26.7 12.77d 3.61d 83.63d Latvia 1 914 19.0 — 66d 21.6 16.1 29 14.99d 4.21d 94.24 Lithuania 2 795 8.0 — 69 19.3 20.2 29.3 15.23d 5.61d 178.29 Luxembourg 576 5.0 — — 9.7 8.6 21.9 2.35d 1.37d 168.67d Malta 504 6.0 — 100 10.5 5.3 19 6.85d 2.17d 129.93d Monaco 38 — — — — — — — — 312.97d Montenegro 622 6.0 50 100 22.3 16.2 29.1 — — 83.89 Netherlands 17 441 5.0 88 80 10.3 9.3 19 — — 156.3b North Macedonia 2 081 7.0 — 50 22.7 7.2 29 6.51 3.93 — Norway 5 379 2.0 80 83 8.7 9.9 19.7 — — 252.48 Poland 38 354 2.0 — 23d 17 9.3 28.7 8.64d 3.76d 126.29 Portugal 10 286 8.0 87 64 11 7.2 24 10.64d 3.75d 144.67c Republic of Moldova 3 545 19.0 47 59 24.1 12.2 29.8 17.12d 6.64d 84.94b Romania 22 155 19.0 66 48 21 7.3 30 12.52d 5.64d 120.73d Russian Federation 146 460 17.0 — 51 24.2 21.6 27 — — 104.36b San Marino 34 — — — — — — — — 156.34d Serbia 6 945 12.0 65 67d 22 7.9 29.5 — — — Slovakia 5 454 5.0 — 67 15.5 9.3 29 5.09d 3.28d 109.59b Slovenia 2 100 7.0 87 — 11.4 14.0 30.5 0.82b 0.22b 151.91b Spain 47 352 4.0 85 23 9.6 5.3 19.2 1.59b 0.81b 126.59b Sweden 10 353 4.0 — 100 8.4 12.4 19 1.81d 1.03d 178.87c Switzerland 8 379 5.0 — 67 7.9 9.8 18 — — 236.78b Tajikistan 8 931 17.0 56 70 28.3 5.3 26.1 — — — Türkiye 83 385 17.0 — 55 15.6 2.3 20.3 4.26b 2.65 57.73b Turkmenistan 5 439 7.0 — 45 27.7 6.1 25.4 — — 69.36d Ukraine 44 624 19.0 57 50 25.5 17.7 27 16.68b 10.78b 102.84d United Kingdom 66 797 7.0 — 75 10.3 6.9 15.2 1.43d 0.82d 132.36b Uzbekistan 33 256 29.0 54 67 25.3 8.3 25.6 — — 138.45d WHO European Region 927 956 12.66 74.4 51.7 16.4 10.3 23 — — 130.3c *rifampicin-resistant and multidrug-resistant — = no data available **cardiovascular disease, cancer, diabetes, chronic respiratory disease ***= Medical doctors, nurses and midwives, dentists, pharmacists Note: a = 2021, b = 2019, c = 2018, d = 2017–2012 (% of households) Antiretroviral therapy (ART) coverage (%) Probability of dying from any of the four major NCDs** (age 30-70), (%), Total Estimated age standardized suicide rates (per 100 000 population), Total Raised blood pressure prevalence (%) RR and MDR* treatment success rate (%) Impoverishing health spending Catastrophic health spending 2020 Density of health workers (per 10000 population) *** 4 UHC HEP* HPOP 10 11 12 13 14 15 16 17 18 Hospital access (beds per 100000 population) Tobacco use prevalence, Total(%) Antibiotic consumption (%) International Health Regulations average of capacities Prevalence of children overweight(%) Prevalenceof children obese(%) Transfatty Acid Policy Implemented Country 2019 2020 2018 2020 2018 2018 2018 2018 2020 Albania 288.97d 22.4 39 76a 23.2d 16.5d 10.7d 5.3d Yes Andorra — 31.8 — 41 — — — — No Armenia — 25.5 63 84a — — — — Yes Austria 718.9 26.4 58 71a 30.3d 22.3d 12.4d 6.2d Yes Azerbaijan — 24 61 84a — — — — Yes Belarus — 30.5 57 94a — — — — Yes Belgium 556.72 23.4 66 67a — — — — Yes Bosnia and Herzegovina — 35 66 38a — — — — Yes Bulgaria 774.07 39 45 72a 30.2d 28.6d 15.7d 11.4d Yes Croatia 566.48 36.9 62 75a 37.1d 28.5d 16.2d 10.3d Yes Cyprus 311.47 35.1 49 64a 43d 43.1d 21.5d 19.2d Yes Czechia 658.04 30.7 60d 76a 22.9d 19.1d 10.9d 5.5d Yes Denmark 259.29 17.5 79 95a 17.6d 20.1d 4.9d 5.1d Yes Estonia 453.01 29.7 61 74a 28.6d 23.3d 11.4d 7.9d Yes Finland 334.59 21.6 72 85a 28.3d 26.7d 11.5d 9.0d Yes France 583.79 33.4 71 86a 24.6d 23.4d 8.9d 6.2d Yes Georgia — 31.7 43 63a 26.1d 22.2d 10.3d 7.2d Yes Germany 791.48 22 56 87a — — — — Yes Greece 418.01 33.5 47 71a 42d 37.8d 20.1d 14.3d Yes Hungary 690.75 31.8 49 70a 28d 27.8d 14.1d 11.2d Yes Iceland 279.84 12 84 76a — — — — Yes Ireland 288.04 20.8 68 66a 27.1d 19.8d 9.3d 5.3d Yes Israel — 21.2 — 87a — — — — Yes Italy 316.28 23.1 48 72a 41.9d 38.5d 21d 14d Yes Kazakhstan — 23.2 51 88a 17.5c 19.8c 4.8d 6.2d Yes Kyrgyzstan — 25.4 33 42a 10.9d 8.8d 3.5 1.6 Yes Latvia 542.32 37 64 69a 24.8d 20.6d 8.8d 6.5d Yes Lithuania 634.65 32 67 82a 28.5d 22.9d 12.2d 7.8d Yes Luxembourg 426.45 21.1 58 60a — — — — Yes Malta 410.27 24 46 73a 37d 34.6d 18d 14.9d Yes Monaco — — — 77a — — — — No Montenegro 385.67 31.4 57 53a 37.4d 28.8d 18.9d 8.7d No Netherlands 307.84 22.2 72 84a — — — — Yes North Macedonia 426.3 — 47 66a — — — — Yes Norway 346.96 16.2 61 95a 24d 22.4d 7.2d 4.7d Yes Poland 617.45 24 44 69a 31.7d 28.8d 14.3d 10.5d Yes Portugal 350.6 25.4 65 85a 29d 32.4d 12d 1.7d Yes Republic of Moldova — 29 51 60a — — — — Yes Romania 705.75 28 53 63a 30.6d 25.8d 15d 8.8d Yes Russian Federation — 26.8 47 100a 27d 22.4d 10.2d 6.5d Yes San Marino — — — 29a 39.1d 32.2d 19.5d 8.7d No Serbia 568.97 39.8 51 68a 32.6d 28.5d 15d 9.7d No Slovakia 576.11 31.5 39 64a 30.1d 23.3d 12.4d 10.5d Yes Slovenia 443.21 22 61 78a 24.3d 24.5d 10.5d 8.4d Yes Spain 294.6 27.7 63 80a 42.2d 40.4d 18.7d 16.8d Yes Sweden 207.1 24 71 88a 27.5d 28.2d 10.4d 7.1d Yes Switzerland 459.34 25.5 61 92a — — — — Yes Tajikistan — — 42 57a 9.4d 5.2d 1.8d 1.1d Yes Türkiye 287.61 30.7 50 88 27.3d 25.4d 12.7d 8.8d Yes Turkmenistan — 5.5 — 81a 11.5d 11.4d 3.6d 2.3d Yes Ukraine — 25.8 36 65a — — — — Yes United Kingdom 249.54c 15.4 67 93a — — — — Yes Uzbekistan — 17.6 30 65a — — — — Yes WHO European Region 464.7 25.6 53.6 74a — — — — — * Core Priority 2. Protecting against health emergencies — = no data available Note: a = 2021, b = 2019, c = 2018, d = 2017–2012 Core Priority 2. Public health emergency preparedness Male FemaleMale Female 5 Core Priority 3. Promoting health and well-being (HPOP) 19 20 21 22 23 24 25 26 27 Pure alcohol consumption, litres per capita, aged ≥15 Violence against women (%)* Urban air pollution (PM2.5 in urban areas) (µg/m³) Country 2019 2017 2020 2019 2020 2018 2020 2020 2016 Albania 4.4 63.38 99b 96 96b 13 71 48 19.32 Andorra 11.0 — 99 95 96 — 91 100 9.47 Armenia 3.8 75.0 92b 96 92b 10 87 69 45.5 Austria 11.9 38.74 85 84 — 15 99 100 12.95 Azerbaijan 1.38 48.32 79 97 79 14 88 21b 23.21 Belarus 10.6 104.4 97 98 — 21 95 74 18.1 Belgium 9.15 39.36 98b 85 94b 22 100 89 12.78 Bosnia and Herzegovina 5.5 86.8 73b 76 — 12 89 40c 30.69 Bulgaria 11.2 120.8 91 87 85 19 98 72 21.1 Croatia 9.6 69.7 94b 95 — 13 — 68 17.75 Cyprus 9.59 32.65 96b 88 81b 16 100 77 15.59 Czechia 12.7 59.0 97b 84 — 22 98 85 15.8 Denmark 9.16 30.37 97 90 96 23 97 92 10.11 Estonia 11.7 43.05 91 90 — 21 96 93 6.73 Finland 8.2 18.7 91 93 89 23 100 84 6.5 France 11.4 25.18 96b 83 92b 22 99 79 12.21 Georgia 7.45 118.8 88 97 82 10 66 34 26.95 Germany 10.6 45.3 93b 93 84b 21 100 97 11.8 Greece 6.33 62.19 99 83 96 18 100 92 14.99 Hungary 10.8 82.7 99b 99 99b 19 93 88 16.66 Iceland 7.7 16.9 92b 95 92b 21 100 84 5.8 Ireland 10.9 20.2 94 — 86 16 97 83 8.49 Israel 3.07 23.25 98 96 94 — 99 95 18.59 Italy 7.7 48.7 94 88 91 16 96 96 15.3 Kazakhstan 3.73 48.01 88 98 89 16 89 — 25.6 Kyrgyzstan 4.0 49.0 87 98 90 23 70 92 28.24 Latvia 12.9 83.2 99 96 91 25 96 83 14.4 Lithuania 11.9 82.1 91 93 83 22 95 94 11.7 Luxembourg 11 22.64 99 90 96 20 99 97 10.2 Malta 8.1 43.5 98 95 — 17 100 92 13.2 Monaco — — 99b 79 — 16 100 100 11.52 Montenegro 9.9 77.36 84 86 — — 85 45 19.41 Netherlands 8.2 31.3 94b 90 93b 21 100 97 12 North Macedonia 3.9 69.7 92b 94 — 13 77 12 33.6 Norway 6.1 18.67 97 95 96 20 99 65 7.64 Poland 10.96 76.3 95b 92 60b 13 98 91 21.9 Portugal 10.4 28.3 99b 96 98b 18 95 85 8.4 Republic of Moldova 7.45 86.06 86 95 72 27 74 — 14.09 Romania 11.0 84.2 87 76 85 18 82 83 15.74 Russian Federation 7.3 80.5 97 97 87 — 76 61 11.2 San Marino — — 89 79 82 — 100 70 10.06 Serbia 7.45 74.73 97b 91 99b 17 75 18 25.15 Slovakia 10.3 54.6 97 98 96 18 99 82 18.3 Slovenia 11.05 47.82 95 94 70 18 98 72 16.77 Spain 10.7 27.13 98 94 88 15 100 96 9.51 Sweden 7.1 18.5 97 95 97 21 100 95 6.0 Switzerland 9.4 25.24 96 90 86 12 94 100 10.32 Tajikistan 0.85 50.14 97 97 — 24 55 — 46.47 Türkiye 1.18 46.15 98 88 95 32 — 78 36.88 Turkmenistan 2.9 50.2 98 99 23 — 95 — 33.26 Ukraine 5.7 123.6 81 92 — 18 89 72 14.9 United Kingdom 9.8 32.13 93 87 91 24 100 98 10.45 Uzbekistan 2.45 45.84 95 99 93 — 59 — 33.86 WHO European Region 7.8 55.6 94.4 91.4 88.1 20.4 90.4 81.3 16.98 *Proportion of women aged ≥ 15 years and subjected to physical and/or sexual violence by a current or former intimate partner in the past 12 months (or in their lifetime - since 15 years old) (%) — = no data available Note: a = 2021, b = 2019, c = 2018, d = 2017–2012 Proportion of population covered by vaccines (%) DTP3 MCV2 PCV3 Safe drinking water (%) Safe sanitation (%) Proportion of the population using Mortality rate attributed to air pollution, (per 100 000 population), Total 6 0 100 200 300 400 Tajikistan Türkiye Turkmenistan Cyprus Armenia Kyrgyzstan Montenegro Moldova Bosnia and Herzegovina Andorra Latvia Ukraine Azerbaijan Russian Federation Bulgaria Croatia Slovakia Estonia Hungary Romania Italy Kazakhstan Greece Poland Spain Malta WHO European Region Georgia United Kingdom Uzbekistan Czechia Portugal Slovenia San Marino Netherlands Denmark France Luxembourg Austria Belarus Israel Lithuania Sweden Germany Iceland Ireland Switzerland Norway Belgium Finland Monaco Catastrophic health spending, all households Health workforce density by health profession Medical Doctors Nurses Midwives Dentists Pharmacists Core Priority 1. Moving towards universal health coverage (UHC) 100 20 300 4 0 Tajikistan Türkiye Turkmenistan Cyprus Armenia Kyrgyzstan Montenegro Moldova Bosnia and Herzegovina Andorra Latvia Ukraine Azerbaijan Russian Federation Bulgaria Croatia Slovakia Estonia Hungary Romania Italy Kazakhstan Greece Poland Spain Malta WHO Europ an Region Georgia United Kingdom Uzbekistan Czechia Portugal Slovenia S n Marino Netherlands Denmark France Luxembourg Austria Belarus Israel Lithuania Sw den Germany Iceland Ireland Switzerland Norway Belgium Fi land Monaco Hepatitis C treatment coverage WHO European Region average 35.1 0 5 10 15 20 25 30 Pe rc en ta ge (% ) o f a ll ho us ho ld s 1 15 20 8% WHO European Regional Average Sl ov en ia C ze ch ia Ir el an d U ni te d Ki ng do m Sp ai n Sw ed en Fr an ce G er m an y Lu xe m bo ur g A us tr ia Be lg iu m Fi nl an d C ro at ia Tü rk iy e C yp ru s Sl ov ak ia N or th M ac ed on ia M al ta Es to ni a Po la nd G re ec e Ita ly Po rt ug al H un ga ry A lb an ia Ro m an ia Ky rg yz st an La tv ia Li th ua ni a U kr ai ne M ol do va G eo rg ia Bu lg ar ia Catastrophic health spendingImpoverishing health spending 80.8 4.3 5.8 6.1 Health workforce per 10 000 population 25 Medical Doctors Nurses Midwives Dentists Pharmacists 1 2 0 3 0 00 7 0 25 50 75 100 Moldova Albania Kyrgyzstan Armenia Montenegro Uzbekistan Tajikistan Ukraine Kazakhstan Azerbaijan Serbia Georgia Romania Estonia Belarus Greece WHO European Region Croatia Norway Spain Ireland Germany Slovenia Portugal Netherlands Iceland Denmark Italy 0%–23% 23.1%–51% 51.1%–62% 62.1%–75% Data not available 75.1%–100% Rifampicin-resistant (RR) and multidrug-resistant tuberculosis (MDR-TB) treatment success rate (%) Antiretroviral therapy coverage (%) 74.4% WHO European Regional Average Coverage (%) km 0 450 900 1800 2700 3600 The boundaries and names shown and the designations used on this map 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 and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Data source and map production: WHO Regional Office for Europe ©WHO 2021. All rights reserved. Core Priority 1. Moving towards universal health coverage (UHC) 8 Prevalence of raised blood pressure and premature NCD mortality Hospital beds per 100 000 population, WHO European Region average and range of values, 2008–2019 Range Estimated age standardized suicide rates (per 100 000 population) 0 100 200 300 400 500 600 700 800 900 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Range WHO European Region Average Be ds p er 10 0 00 0 po pu la tio n WHO European Region Average WHO European Regional Average 5 10 15 20 25 30 35 5 10 15 20 25 30 35 Pr ob ab ilit y of d yi ng fr om a ny o f c ar di ov as cu la r d is ea se , c an ce r, di ab et es , c hr on ic r es pi ra to ry d is ea se ( ag ed 3 0- 70 ) % Prevalence of raised blood pressure in adults aged≥18 (%) Prevalence of raised blood pressure in adults aged ≥18 (%) Pr ob ab ili ty o f d yi ng fr om a ny o f c ar di ov as cu la r di se as e, c an ce r, di ab et es , c hr on ic re sp ira to ry d is ea se (a ge d 30 –7 0) % 5 1 2 3 35 5 10 15 20 2 1 25 30 35 0 10 20 30 40 50 60 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Su ic id e ra te s (p er 1 00 0 00 p op ul at io n) Range Both Sexes Male Female Core Priority 1. Moving towards universal health coverage (UHC) 9 IHR Core capacities are those required to detect, assess, notify and report events and to respond to public health risks and emergencies of national and international concern. The average IHR core capacity score (average percentage of attributes of 15 capacities) was 74% in 2021, the highest score across the WHO regions. IHR capacity across Member States is the highest for surveillance (85%) and laboratory capacity (80%), and lowest for policy, legal and normative instruments to implement IHR (62%) and points of entry (64%). 85% 80% 64% 74% Core Priority 2. Public health emergency preparedness IHR core capacity score in the WHO European Region and average global capacity, 2021 0 10 20 30 40 50 60 70 80 90 Score (%) 0 10 2 3 4 5 6 7 8 9 Radiation emergency Chemical events Food safety Zoonotic diseases Points of entry (PoEs) and border health Infection prevention and control (IPC) Health services provision Health emergency management Human resources Surveillance Laboratory Financing IHR Coordination, National IHR Focal Point functions and advocacy Risk communication and community engagement (RCCE) Policy, Legal and normative Instruments to implement IHR Average Capacity WHO European Region Capacity Average Global Capacity 10 Core priority 3. Promoting health and well-being Estimated road traffic mortality rate (per 100 000 population), Total, male, female and range, 2000–2019 Ambient air pollution vs. Mortality attributed to air pollution *Data are from 2016 and do not include Andorra, Monaco, or San Marino. Males are more than 3 times more likely to die in a road traffic accident than females. This gender gap has remained unchanged for more than 20 years. 0 5 10 15 20 25 30 35 40 45 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Range Female Male Total 0 20 40 60 80 100 120 140 0 5 10 15 20 25 30 35 40 45 50 WHO European Regional Average Annual mean concentrations of fine particulate matter (PM2.5) in urban areas (µg/m³) M or ta lit y ra te a tt rib ut ed to a ir po llu tio n (p er 1 00 0 00 p op ul at io n) , T ot al 40 10 12 0 5 20 38 40 140 80 60 20 10 15 25 30 45 50 M or ta lit y ra te p er 1 00 0 00 p op ul at io n 11 Proportion of women ≥ 15 subjected to violence by a current or former intimate partner in the past 12 months (%) WHO European Region Average 1/10 PEOPLE across the European Region lacks sufficient access to safe drinking water. 2/10 PEOPLE Nearly 2 in 10 people across the European Region lack sufficient access to safe sanitation. Percentage of children vaccinated with DTP3, MCV2, and PCV3 in the WHO European Region, 2010–2020 60 65 70 75 80 85 90 95 100 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Pe rc en ta ge (% ) DTP3 MCV2 PCV3 Pe rc en t ( % ) 0 10 20 30 40 Tü rk iy e M ol do va La tv ia Ta jik is ta n U ni te d Ki ng do m De nm ar k Fi nl an d Ky rg yz st an Be lg iu m Cz ec hi a Fr an ce Li th ua ni a B el ar us Es to ni a G er m an y Ic el an d N et he rla nd s Sw ed en Lu xe m bo ur g N or w ay B ul ga ria H un ga ry G re ec e Po rt ug al Ro m an ia Sl ov ak ia Sl ov en ia U kr ai ne M al ta Se rb ia C yp ru s Ire la nd Ita ly Ka za kh st an M on ac o A us tr ia Sp ai n Az er ba ija n Al ba ni a Cr oa tia N or th M ac ed on ia Po la nd Bo sn ia a nd H er ze go vi na Sw itz er la nd A rm en ia G eo rg ia Core priority 3. Promoting health and well-being 12 Core priority 3. Promoting health and well-being About 5.8 out of 10 adults are overweight or obese Men are slightly more likely to be overweight than women but women are slightly more likely to be obese than men. About 2.8 out of 10 children are overweight or obese of the Region has implemented policies for industrially produced Trans Fatty Acids 91% OR OR 20 litres of spirits 65 litres of wine 150 litres of beer = 7.8 litres pure alcohol Adults drink on average 7.8 litres of pure alcohol per year In the WHO European Region, the highest rate is times higher than the lowest rate 16 × About 2.6 out of 10 adults smoke tobacco Men are twice as likely to smoke as women RISK FACTORS 13 We hope you enjoyed this first look at all the indicators of the EPW Measurement Framework together, in one place, for the first time. As promised, no new data collections were implemented to gather these indicators. In the coming months and years ahead, we look forward to working with Member States to further enhance data systems and health information systems. Here is a brief look at what’s to come! Deep dive with data availability and the development list. The Development List is a part of the EPW Measurement Framework that contains 20 topics (see next page) highly important to the Region, but that have either limited data availability or are not yet well-defined with concrete indicators available to measure progress. With the support of our Member States and international partners, work is ongoing to create a common methodology to develop the indicator areas, with the hope of creating indicators to measure progress in each of these areas. This work has already commenced with mental health and digital health, two of our flagship initiatives; the other areas will start after the Regional Committee. An improved visualization platform for health indicators. The European Health Information Gateway has long been a one-stop, bilingual shop for all the Region’s data and health information needs. With new and consistent updates, the frequent integration of new datasets (including the EPW Measurement Framework), and a mobile-friendly explorer page for data needs on-the-go, the Gateway has exciting additions forthcoming. Health Information Systems (HIS) Assessments across the Region. We are proud to have conducted HIS Assessments in four Member States since the last Regional Committee. Following our first ever in-person training on the Health Information System Support Tool in early June, we look forward to leading further work to strengthen HIS through supporting countries in the establishment, enhancement, and evaluation of integrated and effective HIS. Complementing traditional data collections in innovative ways. Data collections are immensely useful to understand past and current trends, but what about the future? Using new and exciting alternative digital data sources – such as geospatial technology, social media streams, and electronic health records, among others – to complement classic data collection add to the wealth of information we have at our fingertips. We can harness this information and use the predictive power of data to improve the health and well-being of the European Region, forecasting and making predictions that will enable us to better prepare our health systems. For more information on any of these initiatives, please reach out to the data and digital health team at EUHIUData@who.int. What’s Next? Data and health information now and in years to come 14 Coverage of treatment interventions for substance use disorders (%) Proportion of women aged 15–49 years who have their need for family planning satisfied with modern methods Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis Intersectoral action for health Proportion of children who have experienced any physical punishment and/or psychological aggression Ageing populations: dementia (burden of dementia, dementia policies) Ageing populations: healthy ageing Ageing populations: long-term care and rehabilitation Unmet needs in health care Mental health Data and health information now and in years to come Digital health Specific primary health care (PHC) aspects such as quality of care, integrative care, multisectorality and multidisciplinarity Health inequalities Minimum package of health services in emergencies Burden of non-fatal injuries (for example, road traffic injuries, falls, burns) Self-perceived health and well-being Proportion of children under 5 years who are developmentally on track Availability of preparedness plans and guidelines to mitigate risk of high-threat or emerging pathogens Behavioural insights Health effects of climate change Proportion of work has already commenced with mental health and digital health, two of our flagship initiatives; the other areas will start after the Regional Committee. 15 The data for the core health indicators were compiled, validated and processed in a standard way by EUROSTAT, OECD, WHO and other United Nations agencies and international networks, to improve the international comparability of the statistics. Nevertheless, many factors may influence the accuracy and comparability of national statistics, such as variations in definition, incomplete registration and other national specificities in data recording and processing. The international comparison of indicators should, therefore, always be interpreted with caution. Data Quality and comparability WHO databases are updated several times each year; therefore, the data presented in this version of the Core Health Indicators are a snapshot of the most recent data available at the time this was compiled. Regional averages, along with specific indicator values for Member States in the Region, may change after publication since Member States can provide data retrospectively. Similarly, minimum and maximum values in the Region presented for some indicators should be interpreted with caution, particularly for recent years, as there can be the most gaps in data coverage. Since the EPW Measurement Framework is a new framework for the Region, data availability for many of the indicators are lacking. As part of the EPW Measurement Framework, our goal is to obtain the most up-to-date data for these indicators in the coming years. We hope to fill in more and more of this table as the years go on. For some indicators (1, 5, obesity and overweight infographics), estimates have been used. These represent the best estimates of WHO using methodologies for specific indicators that aim for comparability across countries and time. They are updated as more recent or revised data become available, or when significant changes occur in the methodology being used. Consequently, they are not necessarily the same as official national estimates, although WHO whenever possible will provide Member States with the opportunity to review and comment on data and estimates as part of a thorough country consultation process. Mortality-based indicators (4, 20) are presented, based on official mortality data from countries. Cause-specific mortality rates Cause-specific mortality rates (indicator 20) are calculated using the European standard population structure.1 Technical background information and sources 1 See the European mortality database [online database], technical notes. Copenhagen: WHO Regional Office for Europe; 2021 (http://data.euro.who.int/hfamdb/help/mTechnical.html, accessed 5 July 2022). 16 INDICATOR DATA SOURCE 12 The data in this publication pertaining to EU/EEA Member States have been provided by ECDC. ECDC makes these data available ‘as they are’ without warranties of any kind. 13 WHO e-SPAR, State Parties Annual Reporting. Available at: https://extranet.who.int/e-spar 14–17 Data gathered from the Childhood Obesity Surveillance Initiative. 2 European Health Information Gateway [website]. Copenhagen: WHO Regional Office for Europe; 2021 (https://gateway.euro.who.int, accessed 5 July 2022) 3 News and top stories [website]. Geneva: World Health Organization; 2016 (http://www.who.int, accessed 5 July 2022.) Age-standardized indicators obtained through the Global Health Observatory (indicators 1 and 5) are standardized to the world population. Age standardization improves international comparability by removing the effects of differences in population age structure between countries. The bottom row in the data tables (the WHO European Region) gives the population- weighted average for all countries in the Region for which data are available. The exception is midyear population, where the value is the sum of the countries’ populations. Data were retrieved from the WHO European Health for All Database or the European mortality indicator database, unless specified otherwise in the table below. The data presented were limited to the years 2012–2021 for the sake of actuality and comparability. Additional indicators and more detailed data can be found on the WHO European Health Information Gateway2 and WHO headquarters websites.3 World Health Organization Regional Office for Europe UN City, Marmorvej 51, DK-2100, Copenhagen Ø, Denmark Tel.: +45 45337000; Fax: +45 45337001 Email: eurocontact@who.int Web site: www.who.int/europe WHO/EURO:2022-6068-45833-65989