Global Health Spending at All-Time High

June 23, 2003
By Emily Hayes

LONDON (Reuters Health) - Health care spending is on the rise throughout the industrialized world, but cancer deaths are on the decline, according to global health statistics released Monday. And U.S. residents are still the fattest in the world, according to statistics gathered by the Organization for Economic Co-operation and Development (OECD).  

These statistics are just a few of the items that provide a window into health and habits in the 30 countries in the OECD, a group dedicated to helping governments meet the challenges of globalization.

The data show, among other things, where people buy the most alcohol (Luxembourg and Ireland), live the longest (Japan) and grow the fattest (the United States).

In terms of national health spending, including private and public sources, there were few surprises.

Once again, the U.S. topped the spending charts, with 13.9 percent of gross domestic product (GDP), or $4,887 per capita (adjusted to account for purchasing power) going to health care. Switzerland was the second biggest spender at about $3,160 per person, followed by Norway ($3,012) and Germany ($2,808).

At the bottom end were Mexico ($586) and Poland ($629).

On average, OECD countries spent 8.4 percent of GDP on health in 2001, representing a small increase of 0.3 percent from 2000, according to Health Data 2003, a sweeping statistical database updated by the OECD annually. The latest version is based on figures from 2000 and 2001.

"Health spending as a proportion of GDP continues to go up -- this is driven by a rise in health spending in combination with economic slow-down," said Gaetan Lafortune, an economist at the OECD's health policy unit.

In particular, countries are spending more on pharmaceuticals, with the U.S. and France at the high end relative to national purchasing power.

"What lies behind this (increase in spending) is the introduction of new and more expensive drugs," Lafortune told Reuters Health.

Increases in spending do not necessarily correspond to higher life expectancy. In the U.S., for example, life expectancy was just under the OECD average.

Many factors affect life expectancy rates. The U.S., for example, tends to have a higher rate of "premature deaths" -- deaths due to homicide, suicide or accidents -- than other OECD countries. This could bring overall life expectancy rates down. Other contributing factors include nutrition and lifestyle habits.

Japan boasted the highest life expectancy, having increased its average rate from 72 years in 1970 to 81 years in 2001.

"This (increase in life expectancy) has been driven by two things -- huge progress in reducing infant mortality and huge progress in reducing mortality rates from heart disease and stroke," Lafortune said.

The report also indicates that obesity rates in 2001 were highest in the U.S. (30.9 percent), followed by Mexico (24.2 percent) and the United Kingdom (22 percent).

The database also shows that deaths from cancer, the second leading cause of death in the OECD after heart disease, declined over the last decade in the major industrialized countries.

Cancer death rates were lowest in Sweden, Finland and Japan and highest in Poland, the Czech Republic and Hungary. The U.S. is in the middle of the OECD pack with respect to cancer mortality, Lafortune said.

Factors behind the general decline include expansion of screening programs, improvements in lifestyle, such as smoking cessation and better access to treatment programs.

There has also been a drop in alcohol consumption, which the OECD measures in terms of sales. According to the group, alcohol consumption was lowest in Sweden and highest in Luxembourg.

The Luxembourg rates cannot be taken at face value, however, because a good part of sales in the tiny nation derive from foreigners from neighboring countries, Lafortune said.

After Luxembourg, Ireland had the highest level of alcohol consumption in 2001, having doubled its rate between 1970 and 2001.

"The trend in OECD countries is declining consumption -- and it is declining particularly quickly in countries where traditionally there has been heavy alcohol consumption, such as France, Italy and Spain. Ireland does not fit the pattern in OECD countries. We need to explore this further," Lafortune said.

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