Good health brings many benefits, including enhanced access to education and the job market, an increase in productivity and wealth, reduced health care costs, good social relations, and of course, a longer life.
Life expectancy is the most widely used measure of health, although it only takes into account the length of people’s life and not their quality of life. There have been remarkable gains in life expectancy over the past 50 years in OECD countries. On average, life expectancy at birth reaches 80 years across OECD countries, a gain of more than 10 years since 1960. Women live almost six years longer than men, averaging 83 years versus 77 years for men. The OECD countries with the highest life expectancy are Italy, Japan, and Switzerland with an average life expectancy of 83 years. At the other end of the scale, life expectancy among OECD countries is the lowest in Mexico, at 74 years. Life expectancy in the Russian Federation is 70 years, and it is 74 years in Brazil.
Recent OECD analysis suggests that health care spending growth has contributed to the improvement in life expectancy, but other determinants such as rising living standards, environmental improvements, lifestyle changes and education are also important drivers. Taken together, these explain much of the cross-country differences in life expectancy, as well as changes over time. Further progress in population health status and life expectancy can be achieved by putting greater emphasis on public health and disease prevention especially among disadvantaged groups, and improving the quality and performance of health care systems.
Chronic (non-communicable) diseases including cancer, cardiovascular diseases, chronic respiratory conditions and diabetes, are now the main causes of disability and death in OECD countries. Chronic diseases cause around three-quarters of all deaths in OECD countries. Many of these diseases are preventable, since they are linked to modifiable lifestyles. People who do not smoke, drink alcohol in moderate quantities, are physically active, eat a balanced diet, and who are not overweight or obese have a much lower risk of early death than those who have unhealthy habits.
A number of OECD countries have achieved remarkable progress in reducing tobacco consumption over the past few decades. However, it is still a leading cause of early death and it remains the largest avoidable risk to health. Much of the decline in tobacco consumption can be attributed to public awareness campaigns, advertising bans and increased taxation. Less than 20% of adults in 15 OECD countries now smoke daily, down from over 30% in 1980. Only 13% of adults in Mexico, and 14% of adults in Sweden and Iceland smoke daily. Tobacco consumption remains high in certain countries such as Greece where 32% of adults continue to smoke on a daily basis.
Overweight and obesity is another important risk factor for many chronic diseases. In 21 of the 34 OECD countries, more than 50% of the adult population is now defined as being overweight or obese. The prevalence of obesity, which presents more health risks than being overweight, varies from around 4% in Japan and Korea to 30% or over in Mexico and the United States. The rate of obesity has more than doubled over the past 20 years in a number of OECD countries and the average is 17.8%. Governments in many OECD countries have introduced policies to combat obesity through promoting more balanced diets and physical activity. Often these initiatives are aimed at school-age children, by changing the school environment and canteen menus, as well as including health and lifestyle education in the curriculum. Other initiatives include encouraging physicians to provide appropriate counselling for at-risk patients, strengthening food labelling and advertising regulations, and fiscal measures to tax unhealthy foods and reduce taxes on healthy foods.
Most OECD countries conduct regular health surveys which allow respondents to report on different aspects of their health. The commonly-asked question, “How is your health?” is one way of collecting data on self-perceived health status. Despite the subjective nature of this question, the answers received have been found to be a good predictor of people’s future health care use. Across the OECD, about 69% of the adult population say their health is ‘good’ or ‘very good. In the United States, 90% of adults report being in good health; while in Japan, Korea and Portugal less than 50% of people rate their health as ‘good’ or ‘very good’. Cultural factors may affect responses to this broad question on health status.
Men are more likely to report good health than women, with an OECD average of 71% of men saying their health is ‘good’ or ‘very good’ compared with 66% for women. The gap is largest in Chile, Portugal and Turkey. In Australia, Canada, Ireland, New Zealand and the United States, male and female rates are similar. Age and social status also have an impact on answers. Not surprisingly, older people report poorer health, as do those who are unemployed, or who have less education or income. About 79% of the top 20% of the adult population across OECD countries rate their health as ‘good’ or ‘very good’, compared to about 61% for the bottom 20%.