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Dutch Public Health Status and Forecast 2006

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www.rivm.nl/vtv/phsf2006

Appendices


29 May 2007
Appendices
Appendix 1: Acknowledgements

This report has been a joint effort of many. The Supervisory committee of the Ministry of Health Welfare and Sports and the National Scientific Advisory Committee for this PHSF have greatly contributed to the potential policy relevance and the scientific basis of this PHSF report, respectively. The finalization of the report was a joint effort by the PHSF projectteam.

Many others contributed as well.

PHSF supervisory committee of the Ministry of Health, Welfare and Sport

Chairman


H.H.P. Meijer

Secretary

Ir. S.I. Rutz (until February 2006)

I. Storm, MSc

Members

Represenatives from various Directorates of the Ministry of Health, Wellfare and Sport and from Public Health Inspectorates

Ir. J.A. Cornelese; Dr. J. Geelhoed; T.H. Halbertsma; Dr. J.W. Hartgerink; H.E.M. Hollenberg- van Pelt, MSc; M. Holling, MSc; J.R.C. Janse, MSc ; A.B.A. Kemper, MSc; L. Kootstra, MSc; M. van der Maten; J.K. van Wijngarden, MD; A.J.M Zengerink, MSc

Representatives from the RIVM:

Dr. A.E.M. de Hollander; Prof. dr. ing. J.A.M. van Oers; Dr. H. Verkleij

National Scientific Advisory Committee

Chairman

Dr. M.J.W. Sprenger

Members

Prof. dr. J.M. Bensing; Dr. D. Bakker; R.J. Beuse, MSc (until May 2005); Dr. A. Boer; Prof. Dr. M.C.H. Donker; Dr. A.J.J. Voorham; Prof. Dr. T.E.D. van der Grinten; Prof. Dr. N.S. Klazinga; Prof. Dr. J.A. Knottnerus; Prof. dr. J.P. Mackenbach; Dr. G.R.M. Molleman; W.M.L.C.M. Schellekens, MSc; Prof. dr. J.L. Severens; Prof. dr. P. Schnabel; Dr. R. Bijl; Prof. dr. S.P. Verloove-Vanhorick; Dr. S. Buitendijk

Observers on account of the PHSF project team:

A. van den Berg Jeths, MSc (until November 2005); Dr. N. Hoeymans; Dr. A.E.M de Hollander; Ir. J.M. Melse; Prof. dr. ing. J.A.M. van Oers; Dr. J.J. Polder

PHSF Project team

Project leader and final editor

Dr. A.E.M de Hollander

Editing team

Dr. N. Hoeymans; Ir. J.M. Melse; Prof. dr. ing. J.A.M. van Oers; Dr. J.J. Polder

Members project team and authors

Dr. P.W. Achterberg; A. van den Berg Jeths, MSc (until November 2005); Dr. P.G.N. Kramers; L.A.T.M. van Leest, MSc; Dr. F. van der Lucht; Ir. A.H.P. Luijben; Dr. ir. A.J. Schuit; Dr. H.F. Treurniet; Ir. K.E. Witte; S.L.N. Zwakhals, MSc

Project support

Ir. A.H.P. Luijben (project leader); C.L.C. Aarts MSc; A.J. Berends; S.W. Bongers, MSc; J. de Bruin, MSc; Ing. H. Giesbers, MSc; B. Kostalova, MSc; M.J.C. Middelburg; S. Rosbergen, MSc; Sanderse C; E. Slichter; Fidder & Löhr bv: K. van Daalen, W. van Hees

English translation

Taalcentrum-VU, Amsterdam; Dr. P. Bol

Others involved

Many other Dutch experts and institutions have contributed to the PHSF report. Their names and affiliations are provided on the website of this report (www.rivm.nl/vtv/phsf2006).


29 May 2007
Appendices
Appendix 3: Regional differences in indicators of health, determinants and prevention

Table A3.1: Regional differences in indicators of health, determinants and prevention

Municipal health service name

Life expectancy

Disabilities

MHI

Cancer

Cardiovascular disease

Asthma and COPD

Accidents

Diabetes

Smoking

Heavy drinking

Sufficient exercise

Obesity

Nitrogen

DTP-polio vaccination

Mammography

Influenza vaccination

Stopping smoking

Health score

Determinant score

Prevention score

Drenthe

15

15

5

35

21

25

9

7

17

15

18

36

4

3

17

16

26

18

14

11

IJssel-Vecht

12

12

17

14

9

10

13

16

24

14

17

30

6

29

15

20

28

6

13

24

Twente

36

27

20

31

36

33

19

22

21

33

6

31

5

11

14

23

36

30

15

19

Gelre-IJssel

17

13

9

25

17

36

26

20

10

18

3

17

9

6

11

26

23

24

5

12

Noordwest Veluwe

19

5

1

4

26

7

27

21

7

1

4

2

10

36

35

37

30

9

1

39

Gelderland Midden

25

16

18

19

23

20

7

10

27

10

25

23

14

34

25

29

18

12

16

33

Rivierenland

33

36

13

30

34

35

38

39

15

6

31

39

18

37

3

35

34

37

29

36

Regio Nijmegen

30

28

24

34

27

37

18

13

23

17

20

3

19

4

13

4

5

29

11

1

Flevoland

16

35

15

12

2

29

35

1

3

2

28

15

8

37

22

12

6

19

3

20

Eemland

22

18

23

3

24

28

10

14

30

27

26

6

23

24

38

15

7

14

23

30

Stad Utrecht

35

37

31

37

33

34

23

31

20

26

5

28

36

17

36

24

1

36

30

18

Kop van Noord-Holland

21

26

4

23

18

5

28

15

31

35

1

12

1

20

20

34

17

15

9

29

West-Friesland

10

34

7

16

10

4

17

5

12

36

2

1

7

19

10

31

24

7

4

22

Noord-Kennemerland

6

14

26

7

5

8

39

8

2

19

15

4

11

26

30

18

3

17

2

14

Zuid- en Midden-Kennemerland

14

20

35

29

8

27

20

25

26

20

30

9

20

14

21

17

4

28

22

7

Amsterdam

38

38

38

36

13

22

34

38

33

38

36

26

35

23

37

32

2

38

39

31

Amstelland en de Meerlanden

1

4

2

5

4

6

1

6

19

39

9

22

31

22

31

13

8

1

33

17

Gooi en Vechtstreek

4

3

25

17

11

9

11

9

36

24

13

7

25

33

24

9

27

4

27

25

Den Haag

37

31

33

38

35

38

36

32

35

30

34

19

37

28

32

14

15

39

36

27

Zuid-Holland West

2

10

6

9

1

14

21

36

1

7

7

21

34

15

18

22

19

13

7

16

Midden-Holland

3

1

21

2

6

31

16

3

4

13

12

14

27

25

4

33

25

3

10

26

Rotterdam

34

32

37

26

16

12

1

34

34

11

39

34

38

31

38

30

38

25

37

37

Nieuwe Waterweg Noord

24

9

14

38

32

3

29

4

29

22

38

38

39

10

33

36

22

21

38

34

Zuid-Holland Zuid

18

8

30

13

14

13

37

18

8

8

27

33

28

35

9

28

31

22

19

32

Zuidhollandse Eilanden

9

2

12

20

25

17

8

24

25

4

33

37

17

30

5

2

12

10

31

6

Zeeland

5

7

8

8

22

11

25

11

14

5

11

20

12

37

34

38

20

8

8

38

Eindhoven

29

17

32

32

31

38

33

37

37

21

21

10

32

18

19

21

11

35

32

15

Noord- en Midden-Limburg

28

33

16

1

12

18

24

19

6

34

29

25

24

5

8

19

33

16

26

10

Oostelijk Zuid-Limburg

39

38

34

22

39

30

30

12

38

3

32

35

30

16

6

6

39

34

35

13

Zuidelijk Zuid-Limburg

26

22

36

21

38

23

5

27

22

32

35

18

29

27

7

25

32

31

34

21

Westelijke Mijnstreek

32

19

38

11

37

26

6

35

13

12

37

5

33

21

27

10

37

33

24

28

Provincie Groningen

31

25

29

33

30

19

32

33

38

25

10

32

3

13

26

11

10

32

25

8

Fryslân

20

29

3

10

19

16

31

23

32

23

8

24

2

12

23

38

35

20

12

35

Midden-Nederland

7

11

10

24

7

15

22

2

5

9

16

8

26

32

12

27

16

5

6

23

Zaanstreek/Waterland

11

21

28

6

15

1

4

29

28

28

24

29

13

8

2

7

21

11

28

5

Zuid-Holland Noord

8

6

19

15

3

2

3

17

11

29

22

16

22

9

29

8

13

2

18

9

West-Brabant

23

24

22

28

29

21

12

30

18

16

19

27

21

7

28

1

14

26

21

4

Midden en Noordoost-Brabant

27

30

27

18

20

32

15

28

16

31

14

11

15

1

16

5

9

27

17

2

Zuidoost-Brabant

13

23

11

27

28

24

14

26

9

37

23

13

16

2

1

3

29

23

20

3


29 May 2007
Appendices
Appendix 4: Summary of key epidemiological data

Table A8.1 gives the annual incidences and annual prevalences for the diseases selected for the PHSF. The data originate from GPs’ records and other care data registration schemes. Use has been made of data for 2003 or an average for several years. Where no recent data were available, older figures have been used (see notes). The figures have been standardized for the population as it was in 2003.

The incidence data for acute illnesses relate to numbers of cases; therefore a given individual may feature several times. The incidence data for sub-acute and chronic disorders relate to numbers of individuals. Prevalence and incidence figures in excess of 2,500 have been rounded off to the nearest hundred; figures smaller than 2,500 to the nearest ten. For more detailed information concerning the tabulated data, please refer to the National Compass on Public Health (www.nationaalkompas.nl).

The statistics in the table are not directly comparable with those presented in the PHSF 2002. In a number of cases, different sources have been used, or different decisions made regarding the variable to be reported. For the cancers, for example, the ten-year prevalences are reported, whereas in the PHSF 2002, the lifetime prevalences were reported. With regard to trends over time, the reader is referred to the information on the individual illnesses in the Compass, or to subsection 2.1, where the most important incidence, prevalence and mortality trends are summarized. In contrast to the PHSF 2002, we have not on this occasion presented a separate table of epidemiological study data. This is partly because no such data are available for most of the PHSF diseases , and partly because those epidemiological study data that are available for individual illness are mostly somewhat dated.

Table A8.1: Annual incidence, annual prevalence (both on the basis of care records), mortality and lost life-years, standardized for the population of the Netherlands in 2003 (absolute numbers); sources as specified in the table

Disease / affliction ( ICD-9 order)

Incidence

Prevalence

Mortality

Lost life-years

Infectious diseases

men

873

13,114

women

1,019

12,324

·  infectious diseases of the gastrointestinal tract

men

152,600

a

34

423

women

174,800

a

60

646

·  tuberculosis 1

men

770

a

33

370

women

550

a

39

560

·  meningitis 2

men

370

a

40

1340

women

330

a

43

1090

·  septicaemia 3

men

1,380

a

444

5295

women

1,320

a

482

5727

·  aids 4

men

180

m+w: 2.370

69

2209

women

60

18

675

·  bacterial STDs 5

men

3,700

a

0

0

women

1,960

a

0

0

·  viral STDs 5

men

7,700

a

17

313

women

10,200

a

9

204

Neoplasms 6

men

21,614

276,284

women

18,253

284,014

·  oesophageal cancer

men

1,020

1,060

971

14,181

women

420

460

376

5,129

·  stomach cancer

men

1,270

2,700

977

12,199

women

700

1,760

629

8,000

·  colorectal cancer

men

5,200

20,200

2,256

28,075

women

4,700

19,700

2,195

28,306

·  lung cancer

men

6,100

10,100

6,156

77,057

women

2,900

4,400

2,706

50,460

·  skin cancer

- melanoma

men

1,170

7,500

308

6,046

women

1,700

11,300

240

5,195

- other skin cancers

men

2,210

10,300

41

410

women

1,680

7,200

27

233

·  breast cancer

men

30

362

women

11,700

77,600

3,361

61,163

·   cervical cancer

men

women

580

5,400

214

4,311

·   prostate cancer

men

7,900

36,900

2,349

19,652

women

·   non-Hodgkin's lymphomas

men

1,330

5,500

661

9,837

women

1,120

4,800

578

8,609

Endocrinal, digestive and metabolic disorders

men

1,774

21,698

women

2,790

26,791

·   diabetes mellitus

men

36,300

292,500

1,527

17,253

women

36,200

316,400

2,264

20,575

Diseases of the blood and the haematopoietic organs

men

172

2,031

women

317

2,627

Mental disorders

men

1,915

14,246

women

4,645

28,237

·   dementia

men

4,500

29,500

1,909

10,996

women

10,300

72,100

5,142

28,925

·   schizophrenia

men

950

17,600

5

76

women

900

13,500

9

106

·   depression

men

38,400

116,900

4

64

women

73,600

246,700

13

244

·   anxiety disorders

men

16,600

42,200

0

0

women

32,000

89,400

2

48

·   dependency on alcohol or drugs 7

- alcohol dependency

men

m+w: 6.700

20,200

568

12,413

women

6,700

232

5,862

- drug dependency

men

m+w: 5.100

24,200

64

2,475

women

5,700

17

717

·   mental disability

men

b

59,900

16

667

women

b

43,000

11

446

·   mental problems in children and young people

men

c

c

d

d

women

c

c

d

d

Nervous system and senses

men

1,623

22,415

women

2,055

25,070

·   Parkinson's disease 8

men

2,700

12,700

557

3,802

women

2,300

15,000

541

4,042

·   multiple sclerosis

men

330

4,200

75

1,470

women

1,220

10,800

131

3,142

·   epilepsy

men

4,700

34,800

126

3,668

women

4,500

34,100

123

2,968

·   visual impairments

- age-related macula degeneration

men

1,780

13,900

e

e

women

2,700

27,000

e

e

- diabetic retinopathy

men

3,500

30,400

e

e

women

3,000

31,100

e

e

- glaucoma

men

6,500

42,500

e

e

women

6,600

54,200

e

e

- cataracts

men

22,900

120,900

e

e

women

37,400

222,800

e

e

·   hearing impairments

- noise and old age-induced hearing impairment

men

25,800

281,700

e

e

women

25,000

251,900

e

e

- serious hearing impairments in children

b

b

e

e

Cardiovascular disease

men

22,634

241,170

women

24,308

208,459

·   coronary heart disease 9

men

38,900

409,300

8,897

102,881

women

28,600

266,200

6,639

61,635

·   heart failure

men

16,200

77,200

2,540

19,303

women

19,200

101,700

3,849

24,317

·   stroke 10

men

15,200

111,100

4,531

42,008

women

18,500

117,400

7,062

58,929

·   abdominal aortic aneurysm 3, 11

men

3,400

b

624

5,887

women

550

b

195

1,596

Respiratory disease

men

7,359

58,924

women

6,883

58,721

·   infections of the upper respiratory tract

- common cold

men

488,600

a

e

e

women

586,800

a

e

e

- sinusitis

men

131,800

a

e

e

women

273,000

a

e

e

- tonsillitis

men

113,500

a

e

e

women

141,600

a

e

e

·   lower respiratory tract infections

- pneumonia

men

66,400

a

2,686

20,289

women

68,500

a

3,257

22,807

- acute bronchitis / bronchiolitis

men

256,000

a

13

137

women

295,500

a

35

310

·   influenza 12

men

81,400

a

55

472

women

82,200

a

111

891

·   asthma

men

52,600

236,800

40

778

women

64,700

283,000

75

1,161

·   COPD

men

17,200

176,500

3,833

30,411

women

16,400

139,900

2,589

26,256

Digestive disorders

men

2,529

31,655

women

3,327

33,386

·   dental abnormalities

men

b

b

e

e

women

b

b

e

e

·   gastric and duodenal ulcers

men

4,300

23,700

148

1,522

women

3,600

17,200

205

1,819

·   inflammatory bowel diseases 13

men

2,210

43,100

20

221

women

3,500

46,600

42

539

Illnesses of urinary tract and reproductive organs

men

1,237

9,381

women

1,754

13,029

·   acute urinary tract infections

men

91,500

a

2

7

women

661,300

a

12

69

Pregnancy, delivery and confinement

men

0

0

women

8

375

Diseases of the skin and subcutis

men

109

1,135

women

304

2,118

·   constitutional eczema

men

44,400

122,200

e

e

women

51,200

137,900

e

e

·   contact eczema 14

men

157,300

323,800

e

e

women

245,800

478,400

e

e

·   bed sores

men

b

b

62

437

women

b

b

217

1,306

Disorders of the musculoskeletal system and connective tissues

men

247

2,577

women

625

5,738

·   rheumatoid arthritis

men

5,300

57,100

32

263

women

11,500

90,400

126

1,114

·   arthritis 15

men

25,900

223,000

14

71

women

66,600

459,100

71

451

·   neck and back problems

men

445,700

687,000

18

157

women

594,300

925,800

29

283

·   osteoporosis

men

2,150

17,500

12

64

women

20,200

138,600

71

358

Congenital abnormalities 16

men

301

18,723

women

256

15,635

·   congenital abnormalities of the central nervous system

men

m+w: 670

19,100

36

2,488

women

16,700

25

1,908

·   congenital abnormalities of the cardiovascular system

men

m+w: 1.100

23,400

103

6,783

women

23,500

65

4,169

·   Down's syndroom

men

m+w: 320

b

49

1,452

women

b

56

1,808

Perinatal disorders

men

282

21,409

women

195

15,742

·   premature birth 17

men

m+w:14.200

f

63

4,795

women

f

58

4,682

·   health problems following full-term pregnancies

men

b

f

79

6,013

women

b

f

59

4,763

Symptoms, signs and ill-defined disorders

men

3,230

47,347

women

3,894

41,645

Accidental injury and poisoning

men

3,113

87,798

women

2,291

42,871

·   hip fracture 3

men

4,800

a

g

g

women

12,600

a

g

g

·  injuries sustained in:

- road traffic accidents 18

men

130,000

a

761

27,591

women

130,000

a

272

9,867

- occupational accidents 18

men

110,000

a

80

2,910

women

50,000

a

3

187

- non-occupational accidents 18

men

310,000

a

1,022

17,415

women

420,000

a

1,403

14,406

- sports injuries 18

men

540,000

a

e

e

women

240,000

a

e

e

- suicide, attempted suicide, and self-mutilation 19

men

5,000

a

1,016

31,797

women

9,100

a

484

14,954

- violence 19

men

27,000

a

129

4,943

women

10,000

a

73

3,068

Used data sources:

  • Tuberculosis: KNCV National Tuberculosis Register
  • Meningitis: AMC/RIVM Dutch Reference Laboratory for Bacterial Meningitis
  • Septicaemia, abdominal aortic aneurysms and hip fractures: Prismant LMR
  • Bacterial STDs (gonorrhoea, syphilis and infection with Chlamydia trachomatis): RIVM STD Monitoring Station
  • Viral STDs (herpes genitalis, hepatitis B and condylomata acuminata): RIVM STD Monitoring Station, NIVEL National General Practice Information Network (LINH) for 2004, IGZ/RIVM Osiris
  • AIDS: HIV Monitoring Foundation
  • Neoplasms: incidence data from the Association of Comprehensive Cancer Centres (VIKC) Dutch Cancer Register (NKR) ten-year prevalence at January 2002 (Amsterdam Integrated Cancer Centre and Southern Integrated Cancer Centre)
  • Dependency on alcohol or drugs: IVZ Foundation LADIS
  • SCP, point prevalence (SCP analysis of data from article: Maas JMAG, Serail S, Janssen AJM. Frequency study of mental disability 1986. Tilburg: IVA, 1988)
  • Influenza: NIVEL Dutch CMR Survey Stations
  • Congenital abnormalities: Foundation for Perinatal Data Registration in the Netherlands LVR/LNR
  • Premature births: Foundation for Perinatal Data Registration in the Netherlands
  • Accidental injuries: number of medical treatment recipients from SCV OBiN; mortality: Statistics Netherlands unnatural death statistics
  • Suicide, attempted suicide and self-mutilation, and violence: number of treatment cases in A&E departments, from SCV LIS
  • Other disorders: GP records. Sources used were NIVEL National General Practice Information Network (LINH) for 2004, St. Radboud UMC Nijmegen CMR for 2000-2004, Transition Project Foundation project data for 2000-2004, the UM RNH for 2001-2004 and the LUMC RUNH-LEO for 2001-2004. Available data sources were investigated for each disease. Where use was made of two or more data sources, the average incidence or prevalence was calculated.
  • For schizophrenia: prevalence as determined from GP records plus number of patients admitted to mental hospital. The latter figure was estimated by dividing the number of mental hospital care-days in 2003 where schizophrenia was the primary diagnosis by 365 (source ZORGIS).
  • For diseases associated with prolonged nursing home care for a relatively large number of patients, the number of such patients was estimated and added to the number recorded in GP records. On the basis of 2003 data from the National Nursing Home Care Register (LZV) and from the Central Record Office for Exceptional Medical Expenses (CAK), an estimate was made of the number of days that people suffering dementia, Parkinson’s disease, multiple sclerosis (MS) or stroke spent in nursing homes. This was done by applying the age and gender-specific diagnosis distributions from the LZV to the CAK data, that did not include any diagnosis information. The number of people involved was estimated by dividing the total number of care-days in 2003 by 365.
  • Mortality rates and lost life-years: Statistics Netherlands Mortality Statistics, analysed by the RIVM.

Notes:

  1. Transient diseases and acute injuries for which no prevalence figure is given.
  2. No (definite) data available.
  3. No care record data available. On the basis of other sources, the six-month prevalence of a number of mental problems in children has been estimated. ADHD (young people aged thirteen to seventeen): 12,800; autistic disorders (children and young people up to the age of twenty): 5,000; behavioural disorders (young people aged thirteen to seventeen): 55,000 young people with antisocial behavioural disorder and 6,900 young people with oppositional-defiant behavioural disorder. For more information and sources, see the National Compass on Public Health (www. nationaalkompas.nl).
  4. No definite data available; also included in other illness groups.
  5. Mortality rate and number of lost life-years are very low or zero.
  6. Not relevant.
  7. Mortality rate unreliable.
  1. Of the incident cases in 2003 4.3% were recidivist.
  2. Incidence relates only to the bacterial form and has been corrected for underreporting.
  3. Incidence reflects the number of hospital admissions where one of the specified diseases is the primary discharge diagnosis.
  4. Annual prevalence in 2003 is the number of cases reported between the start of the AIDS epidemic and the end of 2003, minus the number of fatalities up to the end of 2002.
  5. The viral STDs included are herpes genitalis, hepatitis B and condylomata acuminate; the bacterial STDs are infection with Chlamydia trachomatis, syphilis and gonorrhoea. Where bacterial STDs are concerned, cases recorded in the LINH have not been counted.
  6. The prevalence estimated on the basis of the IKA and IKZ data is the ten-year prevalence and reflects the number of people alive on 1 January 2002, in whom the illness was diagnosed in the preceding ten years. In other words, people who have been cured and are no longer under medical supervision are included.
  7. The prevalence relates to the number of clients in (outpatient) addiction care in 2003. The incidence is the number of new clients, i.e. people who were not previously registered as addicts. The data on drug dependency relate to opiates, cocaine, cannabis, amphetamine and Ecstasy. Mortality due to alcohol dependency relates to the ICD categories liver disease and -cirrhosis, heart disease, gastric inflammation and pancreatic inflammation, all resulting from excessive alcohol consumption, as well as mental disorders and behavioural disorders resulting from excessive alcohol consumption.
  8. Including secondary Parkinsonism.
  9. Prevalence relates to people receiving treatment for angina pectoris or (the consequences of) an acute myocardial infarction.
  10. Prevalence is lifetime prevalence, i.e. the number of people that have ever suffered a stroke.
  11. Incidence relates to the number of hospital admissions and thus primarily reflects the number of aneurysms requiring surgery. The actual number of newly diagnosed cases of aneurysm is not known.
  12. Relates to the average annual incidence in the period of week 27 of 2002 to week 26 of 2004 (two seasons).
  13. Relates to colitis ulcerosa and Crohn’s disease.
  14. Relates to irritation eczema and contact-allergic eczema.
  15. Relates only to arthrosis of the limbs (neck and back arthritis are included under neck and back problems).
  16. Incidence relates to prevalence at birth in living neonates (of both sexes). The figures quoted relate to 2002 and have not been standardized for 2003.
  17. Premature birth: birth in the period between the twenty-fourth and thirty-sixth week of pregnancy. The figures quoted relate to 2002 and have not been standardized for 2003.
  18. Average annual incidence for the period 2000 to 2003.
  19. Average annual incidence for the period 1999 to 2003.

30 January 2008
Appendices
Appendix 5: Detailed international comparisons

For each indicator, a table is presented below listing the five EU member states with the best scores for the indicator in question and the five with the worst scores; where available, the averages for the fifteen old member states (EU-15) and the twenty-five current member states (EU-25) are given in the middle of the table. In cases where the Netherlands is neither in the five best-scoring member states, nor in the five worst scoring member states, the Dutch average is also given in the centre group of figures. In some cases, the figure given for the Netherlands differs from that quoted elsewhere in the PHSF. This is because the international comparisons have sometimes been made on the basis of other data sources, or because the (mortality) statistics have been standardized.


Health Status

Table 1: Incidence of lung cancer (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Incidence per 100,000

Hungary

114.1

Denmark

68.2

United Kingdom

63.4

Czech Republic

57.9

Italy (2000)

56.8

.

Netherlands

55.6

EU-25

53.7

EU-15 (2000)

53.0

.

Ireland

31.1

Portugal (2000)

30.5

Luxemburg

28.5

Malta

28.2

Cyprus (2000)

20.8

Table 2: Mortality attributable to lung cancer (per 100,000), 2002 (Source: WHO-HFA, 2006)

Country

Mortality per 100,000

Hungary

64.9

Poland

53.2

Denmark (2001)

51.0

Netherlands

47.0

Czech Republic

46.1

.

EU-25

39.2

EU-15

36.9

.

Austria

33.4

Malta

30.8

Finland

26.9

Sweden

25.0

Portugal

23.0

Table 3: Incidence of breast cancer (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Incidence per 100,000

Denmark

147.9

Sweden

145.4

Netherlands

144.7

Luxemburg

139.7

France (2000)

138.2

.

Estonia (2000)

72.9

Latvia

70.2

Lithuania

66.3

Slovakia

66.0

Poland

61.0

Table 4: Mortality attributable to breast cancer (per 100,000), 2002 (Source: WHO-HFA, 2006)

Country

Mortality per 100,000

Denmark (2001)

36.1

Netherlands

33.3

Slovenia

30.8

Hungary

30.6

United Kingdom

30.1

.

EU-15

26.7

EU-25

26.3

.

Portugal

22.0

Sweden

21.5

Poland

21.4

Finland

21.0

Spain

20.1

Table 5: Incidence of cervical cancer (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Incidence per 100,000

Hungary

26.6

Lithuania

26.1

Estonia (2000)

22.0

Czech Republic

19.9

Slovenia

19.7

.

Ireland

7.6

Netherlands

7.5

Malta

6.1

Finland

5.9

Cyprus (2000)

4.3

Table 6: Mortality attributable to cancer (per 100,000), 2001 (Source: Eurostat, 2006)

Country

Mortality per 100,000

Hungary

265.6

Czech Republic

233.2

Slovakia

225.6

Denmark

218.8

Poland

216.5

.

Netherlands

194.7

EU-25

187.7

EU-15

180.5

Greece

164.8

Malta

162.1

Portugal

161.7

Sweden

157.9

Finland

149.6

Table 7: Healthy life expectancy, 2003 (Source: WHO, 2005a)

Country

Years

Latvia

62.8

Lithuania

63.3

Estonia

64.1

Hungary

64.9

Poland

65.8

.

Netherlands

71.2

.

Germany

71.8

France

72.0

Spain

72.6

Italy

72.7

Sweden

73.3

Table 8a: Life expectancy at birth (women), 2003 (Source: Eurostat, 2006)

Country

Years

Latvia

75.9

Hungary

76.7

Estonia

76.9

Lithuania

77.7

Slovakia

77.8

.

Netherlands

80.9

EU-25

81.2

EU-15

81.7

.

Finland

81.8

Italy

82.5

Sweden

82.5

France

82.9

Spain

83.6

Table 8b: Life expectancy at birth (men), 2003 (Source: Eurostat, 2006)

Country

Years

Latvia

65.7

Estonia

66.0

Lithuania

66.5

Hungary

68.4

Slovakia

69.9

.

EU-25

75.1

EU-15

76.0

Netherlands

76.2

.

Malta

76.7

Italy

76.8

Spain

76.9

Cyprus

77.0

Sweden

77.9

Table 9: Total mortality (per 100,000), 2001(Source: Eurostat, 2006)

Country

Mortality per 100,000

Latvia

1,148.3

Estonia

1,116.6

Lithuania

1,037.9

Hungary

1,035.4

Slovakia

990.6

.

EU-25

685.4

Netherlands

680.5

EU-15

640.7

.

Austria

632.4

France

621.8

Spain

606.6

Sweden

599.5

Italy

585.0

Table 10: Infant mortality (per 1,000), 2003 (Source: Eurostat, 2006)

Erratum: Per 100,000 in PHSF 2006 (p 315) should be per 1,000 infants.

Country

Mortality per 1,000 infants (< 1 year)

Latvia

9.4

Slovakia

7.9

Hungary

7.3

Estonia

7.0

Poland

7.0

.

Netherlands

4.8

EU-25

4.6

EU-15

4.3

.

Greece

4.0

Czech Republic

3.9

Spain

3.6

Finland

3.1

Sweden

3.1

Table 11: Mortality attributable to coronary heart disease (per 100,000), 2001 (Source: Eurostat, 2006)

Country

Mortality per 100,000

Lithuania

343.5

Estonia

330.7

Latvia

306.4

Slovakia

290.0

Hungary

225.5

.

EU-25

106.1

EU-15

93.4

Netherlands

79.5

.

Luxemburg

77.2

Italy

72.2

Spain

63.6

Portugal

61.3

France

48.4

Table 12: Mortality attributable to stroke (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Mortality per 100,000

Latvia

217.0

Estonia

157.2

Hungary

138.7

Czech Republic

133.4

Portugal

130.6

.

EU-25

68.6

EU-15

59.4

.

Germany

56.3

Sweden

56.0

Spain

54.5

Netherlands

53.9

France

38.0

Table 13: Mortality attributable to suicide (per 100,000), 2001 (Source: Eurostat, 2006)

Country

Mortality per 100,000

Lithuania

43.7

Latvia

28.6

Estonia

28.1

Hungary

26.6

Slovenia

26.5

.

EU-25

11.5

EU-15

10.1

Netherlands

8.6

.

Spain

6.8

United Kingdom (2000)

6.8

Portugal

6.3

Italy

5.9

Greece (2002)

2.6

Table 14: Mortality attributable to road traffic accidents (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Mortality per 100.000

Latvia

22.9

Lithuania

21.0

Portugal

19.0

Estonia

15.2

Greece

15.0

.

EU-25

10.4

EU-15

9.7

.

Finland

7.5

Netherlands

5.8

Sweden

5.3

United Kingdom

5.3

Malta

3.8

Table 15: Mortality attributable to chronic liver disease (per 100,000), 2001 (Source: WHO-HFA, 2006)

Country

Mortality per 100,000

Hungary

56.7

Slovenia

34.1

Slovakia

25.3

Estonia

22.1

Lithuania

19.1

.

EU-25

14.1

EU-15

12.7

.

Ireland

5.8

Sweden

5.4

Greece

5.0

Netherlands

4.5

Malta

4.1

Table 16: Incidence of AIDS (per million), 2004 (Source: EuroHIV, 2005)

Country

Incidence per million

Portugal

79.6

Spain

43.0

Latvia

39.8

Italy

29.2

Luxemburg

26.1

.

Netherlands

12.1

.

Finland

3.7

Slovenia

3.5

Hungary

2.3

Czech Republic

1.2

Slovakia

0.4

Table 17: Percentage of people with serious ADL disabilities, 2001 (Source: Eurostat, 2006 )

Country

%

United Kingdom

16.4

France

10.4

Germany

10.2

Finland

9.5

.

EU-15

9.3

Portugal

8.9

Netherlands

8.6

.

Spain

5.8

Belgium

5.6

Austria

5.3

Italy

4.5

Ireland

4.4

Table 18: Percentage of people in ‘good’ perceived health, 2004 (Source: Eurostat, 2006)

Country

%

Slovenia

26.6

Portugal

28.2

Latvia

36.7

Estonia

41.9

Poland

43.9

.

Netherlands

77.7

Denmark

77.9

Cyprus

80.8

Germany

82.1

Ireland

87.1


Determinants and prevention

Table 19: Percentage of infants still exclusively or partially breastfed at six months (Source: WHO-HFA, 2006)

Country

%

United Kingdom (2000)

21.0

Netherlands (2002)

27.0

Lithuania (2004)

31.0

Czech Republic (2004)

35.8

Slovakia (2004)

37.7

.

Spain (2001)

44.9

Estonia (2004)

47.8

Finland (2000)

51.0

Hungary (2004)

53.3

Sweden (2003)

70.6

Table 20: Percentage of the population (>15 years) who are daily smokers (Source: WHO-HFA, 2006)

Country

%

Greece (2000)

37.6

Germany (2003)

33.9

Hungary (2003)

33.8

Poland (2004)

32.0

Luxemburg (2004)

31.0

.

Netherlands (2004)

30.8

EU-25 (2003)

28.8

EU-15 (2003)

28.4

.

Slovenia (2001)

23.7

Malta (2002)

23.4

Finland (2004)

23.0

Belgium (2003)

20.0

Sweden (2004)

16.2

Table 21: Percentage of fifteen and sixteen-year-olds who have smoked in the last thirty days, 2003 (Source: Hibell et al., 2004; ESPAD study)

Country

%

Austria

49

Germany (6 States)

45

Czech Republic

43

Lithuania

41

Latvia

40

.

Netherlands

31

.

Portugal

28

Malta

27

Spain

27

Cyprus

25

Sweden

23

Table 22: Alcohol consumption (litres of pure alcohol per person), 2003 (Source: WHO-HFA, 2006)

Country

Litres per head

Luxemburg

14.6

Czech Republic

13.7

Hungary

11.6

Ireland (2001)

11.4

Germany

10.7

.

EU-15

9.4

EU-25

9.3

Netherlands

7.8

.

Greece

7.7

Italy

7.6

Poland

6.7

Sweden

5.6

Malta

5.4

Table 23: Percentage of fifteen and sixteen-year-olds who have had three or more ‘drinking binges’ in the last months, 2003 (Source: Hibell et al., 2004; ESPAD study)

Country

%

Ireland

32

Netherlands

28

United Kingdom

27

Malta

25

Sweden

25

.

Greece

11

Poland

11

Cyprus

10

France

9

Hungary

8

Table 24: Number of problem drug users a per 1,000 people aged fifteen to sixty-four (Source: EMCDDA, 2005b)

Country

Number per 1,000 people

United Kingdom (2001)

9.4

Luxemburg (2000)

9.3

Italy (2003)

7.5

Denmark (2001)

7.2

Portugal (2000)

7.1

.

Czech Republic (2003)

3.6

Netherlands (2001)

3.0

Germany (2003)

2.5

Greece (2003)

2.4

Poland (2002)

1.9

a EMCDDA definition of problem use: intravenous drug use or prolonged/regular use of opiates, cocaine and/or amphetamines. Age band: fifteen to sixty-four. Methods may differ from country to country. Where more than one estimate was available for a country, the average was taken.

Table 25: Percentage of fifteen-year-olds who used contraception when they last had sexual intercourse; unweighted average for boys and girls, 2001/2002 (Source: Currie et al., 2004; HBSC)

Country

%

Poland

73.0

Estonia

78.3

Hungary

78.5

Portugal

78.8

Great-Britain

83.4

.

Germany

91.4

Sweden

91.4

Austria

91.6

France

92.3

Netherlands

94.7

Table 26: Percentage of people who engage in moderate physical activity four to seven days per week, 2002 (Source: EORG, 2003a)

Country

%

France

19

Italy

22

Sweden

25

Spain

27

Austria

28

.

EU-15

31

.

Greece

39

Germany

39

Denmark

42

Portugal

49

Netherlands

72

Table 27: Percentage of people who are overweight (BMI 25.0-29.9); unweighted average for men and women (Source: IOTF Prevalence Data, 2005)a

Country

%

Germany (2002)

44.3

Greece (1994-98)

43.9

Slovakia (1992-1999)

40.9

Finland (2003)

40.5

Slovenia (2001)

40.5

.

Netherlands (1998-2002)

36.0

.

Austria (1999)

33.5

Italy (1999)

33.4

Denmark (2003)

32.9

France (2003)

30.6

Estonia (1997)

28.0

a The Netherlands has not been given a 'traffic light' colour, because it is on the boundary of amber and green.

Table 28: Percentage of people who are obese (BMI ≥ 30.0); unweighted average for men and women (Source: IOTF Prevalence Data, 2005)

Country

%

Greece (1994-1998)

32.8

Czech Republic (1997-1998)

25.5

Cyprus (1999-2000)

25.2

Germany (2002)

22.9

UK (England) (2003)

22.6

.

France (2003)

11.4

Sweden (1996-1997)

11.0

Netherlands (1998-2002)

10.3

Italy (1999)

9.7

Estonia (1997)

8.0

Table 29: Percentage of children who are overweight or obese; unweighted average for boys and girls (Source: IOTF Prevalence Data, 2005)

Country

Percentage of boys and girls

Malta (1992)

35.6

Portugal (2002-2003)

31.9

Belgium (1998-1999)

27.3

Italy (1993-2001)

25.7

Spain (1998-2000)

25.2

.

Denmark (1996-1997)

14.7

Czech Republic (2001)

14.1

Germany (1995)

14.0

Netherlands (1997)

10.3

Slovakia (1995-1999)

9.0

Table 30: Percentage of people with ample social support, 2002 (Source: EORG, 2003b)

Country

%

Finland

8.5

Italy

9.1

Greece

10.1

Portugal

10.8

France

13.5

.

Great-Britain

24.4

Ireland

28.2

Sweden

28.4

Denmark

31.1

Netherlands

34.4

Table 31: Relative five-year survival rate for cancer (all forms, collectively), diagnosis 1990-1994 (Source: Sant et al., 2003a)

Country

%

Poland

29.0

Estonia

32.0

Slovakia

33.6

Slovenia

35.0

Czech Republic

36.1

.

Netherlands

47.6

.

Spain

49.0

Duitland

49.8

France

50.7

Sweden

53.2

Austria

56.6

Table 32: Relative five-year survival rate for breast cancer, diagnosis 1990-1994 (Source: Sant et al., 2003a)

Country

%

Slovakia

59.5

Estonia

61.9

Poland

63.1

Czech Republic

64.0

Slovenia

67.4

.

Netherlands

78.2

Italy

80.6

France

81.3

Finland

81.4

Sweden

82.6

Table 33: Relative five-year survival rate for lung cancer, diagnosis 1990-1994 (Source: Sant et al., 2003a)

Country

%

Denmark

6.0

Poland

6.3

Czech Republic

6.6

Groot-Brittanië

7.5

Slovakia

7.5

.

Germany

10.7

Netherlands

11.8

Spain

12.4

France

13.4

Austria

14.0

Table 34: Relative five-year survival rate for cervical cancer, diagnosis 1990-1994 (Source: Sant et al., 2003a)

Country

%

Poland

48.2

Estonia

53.2

Portugal

55.6

Slovakia

57.1

Slovenia

59.9

.

Denmark

66.7

France

67.8

Spain

68.7

Netherlands

69.4

Sweden

69.6

Table 35: Antibiotic resistance (MRSA percentage), 2004 (Source: EARSS, 2006)

Country

MRSA percentage

Malta

56.4

Cyprus

48.7

Portugal

46.1

Greece

44.3

United Kingdom

43.7

.

Estonia

4.8

Finland

3.1

Denmark

1.3

Netherlands

1.1

Sweden

0.7

Table 36: Percentage of children vaccinated against measles, 2004 (Source: WHO-HFA, 2006)

Country

%

Austria

73.5

United Kingdom

81.0

Ireland

81.1

Belgium

82.2

Italy

84.0

.

Netherlands

96.3

.

Poland

97.4

Lithuania

97.7

Slovakia

98.0

Latvia

98.7

Hungary

99.9

Table 37: Breast cancer screening (percentage women attending for mammography in a given year), 2002 (Source: EORG, 2003c)

Country

%

Ireland

9.4

Denmark

10.7

United Kingdom

12.5

Greece

12.6

Germany

17.3

.

EU-15

20.2

.

Italy

25.1

Netherlands

25.4

Luxemburg

31.3

Portugal

32.2

Austria

35.8


30 January 2008
Appendices
Appendix 6: References to websites providing background information

Achtergrondinformatie op websites

All the background information used in the compilation of this report can be found on the following websites (in Dutch:)


Literature and data sources

Literature and data sources

Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O. Young people’s health in context. Health Behaviour in School-aged Children (HBSC) study: international report from the 2001/2002 survey.  Kopenhagen: WHO Regional Office for Europe, 2004.
EMCDDA, European Monitoring Centre for Drugs and Drug Addiction. Statistical Bulletin 2005.  Luxemburg: EMCDDA, 2005b.
EORG, European Opinion Research Group. Physical Activity. Special Eurobarometer 183-6/ Wave 58.2.  Brussel: Europese Commissie, 2003a.
EORG, European Opinion Research Group. The mental health status of the European population (Eurobarometer 58,2).  Brussel: Europese Commissie, 2003b.
EORG, European Opinion Research Group. Health, food and alcohol and safety. Special Eurobarometer 186/ Wave 59.0.  Brussel: Europese Commissie, 2003c.
EuroHIV, European Centre for the Epidemiological Monitoring of AIDS. HIV/AIDS surveillance in Europe: End-year report 2004.  Saint-Maurice: IVS, 2005.
Hibell B, Andersson B, Bjarnason T, Ahlström S, Balakireva O, Kokkevi A, et al. The ESPAD Report 2003; Alcohol and Other Drug use Among Students in 35 European Countries.  Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN) and the Pompidou Group at the Council of Europe, 2004.
Sant M, Aareleid T, Berrino F, Bielska Lasota M, Carli PM, Faivre J, et al. EUROCARE-3: survival of cancer patients diagnosed 1990-94. Results and commentary.  Ann Oncol, 2003a; 14(Suppl 5): v61-118.
WHO, World Health Organization. The European health report 2005: public health action for healthier children and populations.  Kopenhagen: WHO-Europe, 2005a.

Data sources

EARSS. European Antimicrobial Resistance Surveillance System
ESPAD. The European School Survey Project on Alcohol and Other Drugs.
Eurostat. Statistische Database van de Europese Unie
HBSC. Health Behaviour in School-aged Children study (WHO Regional Office for Europe, 2004).
IOTF Prevalence Data. International Obesity TaskForce Prevalence Data
WHO-HFA. WHO - Health For All database