State of Health in the EU Denmark Country Health Profile 2017 European on Health Systems and Policies a partnership hosted by WHO The Country Health Profile series Contents The State of Health in the EU profiles provide a concise and 1 • HIGHLIGHTS 1 policy-relevant overview of health and health systems in the EU 2 • HEALTH IN DENMARK 2 Member States, emphasising the particular characteristics and 3 • RISK FACTORS 4 challenges in each country. They are designed to support the efforts of Member States in their evidence-based policy making. 4 • THE HEALTH SYSTEM 6 5 • PERFORMANCE OF THE HEALTH SYSTEM 9 The Country Health Profiles are the joint work of the OECD and 5.1 Effectiveness 9 the European Observatory on Health Systems and Policies, in 5.2 Accessibility 11 cooperation with the European Commission. The team is grateful for the valuable comments and suggestions provided by Member 5.3 Resilience 13 States and the Health Systems and Policy Monitor network. 6 • KEY FINDINGS 16 Data and information sources The data and information in these Country Health Profiles are The calculated EU averages are weighted averages of the based mainly on national official statistics provided to Eurostat 28 Member States unless otherwise noted. and the OECD, which were validated in June 2017 to ensure the highest standards of data comparability. The sources and To download the Excel spreadsheet matching all the methods underlying these data are available in the Eurostat tables and graphs in this profile, just type the following Database and the OECD health database. Some additional data StatLinks into your Internet browser: also come from the Institute for Health Metrics and Evaluation http://dx.doi.org/10.1787/888933593475 (IHME), the European Centre for Disease Prevention and Control (ECDC), the Health Behaviour in School-Aged Children (HBSC) surveys and the World Health Organization (WHO), as well as other national sources. Demographic and socioeconomic context in Denmark, 2015 Denmark EU Demographic factors Population size (thousands) 5 683 509 394 Share of population over age 65 (%) 18.6 18.9 Fertility rate¹ 1.7 1.6 Socioeconomic factors GDP per capita (EUR PPP2) 36 600 28 900 Relative poverty rate3 (%) 7.1 10.8 Unemployment rate (%) 6.2 9.4 1. Number of children born per woman aged 15–49. 2. Purchasing power parity (PPP) is defined as the rate of currency conversion that equalises the purchasing power of different currencies by eliminating the differences in price levels between countries. 3. Percentage of persons living with less than 50 % of median equivalised disposable income. Source: Eurostat Database. Disclaimer: The opinions expressed and arguments employed herein are solely those of the authors any territory, to the delimitation of international frontiers and boundaries and to the name of any and do not necessarily reflect the official views of the OECD or of its member countries, or of the territory, city or area. European Observatory on Health Systems and Policies or any of its Partners. The views expressed Additional disclaimers for WHO are visible at http://www.who.int/bulletin/disclaimer/en/ herein can in no way be taken to reflect the official opinion of the European Union. This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty over © OECD and World Health Organization (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies) Highlights . 1 1 Highlights Denmark The Danish population is living longer than a decade ago, but not all of these additional years are spent in good health. The Danish health system generally provides good access to high-quality care, with comparatively low levels of unmet need for medical care. Challenges remain to tackle important risk factors to health, such as excessive alcohol consumption and rising obesity rates and to improve care coordination for the growing number of people living with chronic conditions. Health status Healthy life years Life expectancy At age 65, Danish women can expect to live almost another 20.7 years, and men another 18.0 years (up from 18.3 and 15.2 years, respectively, in 2000). Danes can expect to Men at 65 11.0 18.0 spend about 60% of this time beyond 65 in good health and free from disability (12 years for women and 11 years for men). Women at 65 11.9 20.7 Years 0 10 20 Risk factors % of adults in 2014 DK EU Smoking rates in Denmark have declined sharply since 2000 and are now among the lowest in the EU. On the other hand, 37% of Danish adults report regular heavy alcohol Smoking 17% consumption, the highest in the EU. Almost 40% of Danish adolescents report having been drunk at least twice in their life. Obesity rates are below the EU average but on the Binge drinking 37% rise: 14.0% of Danish adults were obese in 2014, up from 9.5% in 2000. Obesity 14% Health system Per capita spending (EUR PPP) DK EU In 2015, Denmark spent EUR 3 776 per capita on health care, much higher than the €4 000 EU average of EUR 2 797. This equates to 10.3% of GDP – up from 9.1% in 2005 and €3 000 above the EU average of 9.9%. Public financing made up 84% of the expenditure, the €2 000 second highest proportion in the EU, with the remainder mainly funded by out-of-pocket €1 000 payments concentrated heavily on prescription drugs and dental care. €0 2005 2007 2009 2011 2013 2015 Health system performance Effectiveness Access Resilience Amenable mortality in Denmark is among Danish residents enjoy good access to The Danish health the lowest in the EU. This suggests that health care. Relatively few report unmet care system functions the health care system is effective in needs for medical care. The gap between efficiently and boasts treating life-threatening conditions. low- and high-income groups is small a first-rate information compared to most other EU countries. infrastructure, even though Amenable mortality per 100 000 population DK EU the suspension of the Danish General 200 % reporting unmet medical needs, 2015 Practitioners (GP) database in 2014 was 175 High income All Low income 150 153 a setback. One important challenge is 126 to improve care coordination for chronic 100 99 DK conditions. 50 EU 0 2005 2014 0% 3% 6% STATE OF HEALTH IN THE EU: COUNTRY HEALTH PROFILE 2017 – DENMARK 2 . Health in Denmark 2 Health in Denmark Denmark Life expectancy is increasing and slightly Most of the life expectancy gains in Denmark since 2000 were above the EU average driven by reduced mortality rates after the age of 65. Danish women of this age could expect to live another 20.7 years in 2015 Life expectancy in Denmark increased by almost four years between (up from 18.3 years in 2000), whereas Danish men could expect 2000 and 2015 to reach 80.8 years, slightly above the EU average to live another 18.0 years (up from 15.2 years in 2000). However, and the second lowest among the earliest 15 Member States of at age 65, Danish women and men can expect to live about 60% the EU (Figure 1). As in other EU countries, a gender gap in life of their remaining years of life free from disability (11.9 years for expectancy persists, with 2015 data suggesting that life expectancy women and 11.0 years for men).2 at birth for Danish men (78.8 years) is about four years less than for women (82.7 years). This gap is slightly lower than the EU 1. Lower education levels refer to people with less than primary, primary or lower average of 5.6 years. A gap in longevity is also observed between secondary education (ISCED levels 0–2) while higher education levels refer to people with tertiary education (ISCED levels 5–8). socioeconomic groups: Danish men with a high level of education 2. These are based on the indicator of ‘healthy life years’, which measures the number of can expect to live six years longer than those with a low level of years that people can expect to live free of disability at different ages. education.1 For women, this gap is just over four years. Figure 1. Life expectancy in Denmark is increasing and slightly above the EU average. Denmark Years 2015 2000 90 80.8years of age 85 EU Average 80.6 years of age 83.0 82.7 82.4 82.4 82.2 81.9 81.8 81.6 81.6 81.5 81.3 81.3 81.1 81.1 81.0 80.9 80.8 80.7 80.6 80 78.7 78.0 77.5 77.5 76.7 75.7 75.0 74.8 74.7 75 74.6 70 65 60 EU Italy Spain Malta Latvia France Cyprus Poland Ireland Greece Austria Croatia Finland Estonia Sweden Belgium Bulgaria Portugal Hungary Slovenia Romania Germany Lithuania Denmark Netherlands Luxembourg Czech Republic Slovak Republic United Kingdom Source: Eurostat Database. Cancer and cardiovascular diseases are the The leading causes of death in Denmark have remained the largest contributors to mortality same since 2000 but their relative positions changed (Figure 3). Ischaemic heart diseases remain the most frequent cause of Cancer and cardiovascular diseases are the two leading causes of death even though incidence has more than halved since 2000. death in Denmark (Figure 2). The mortality rate due to cancer is Lung cancer is the second main cause of death, most likely the fourth highest in the EU, and in 2014, cancer accounted for 29% legacy of historically high smoking rates, previously among the of all deaths among women and 32% of all deaths among men.