(WHO) is a specialized agencyof the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Offi ce for Europe is one of six regional offi ces throughout the world, each with its own programme geared to the particular health conditions of the countries it serves.
Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium
Bosnia and Herzegovina Bulgaria
Croatia Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Netherlands Norway Poland Portugal
Republic of Moldova Romania
Russian Federation San Marino
Serbia and Montenegro Slovakia
Slovenia Spain Sweden Switzerland Tajikistan
The former Yugoslav Republic of Macedonia Turkey
This statistical atlas presents key health fi gures for the WHO European Region. They cover basic data on populations, births, deaths, life expectancy and diseases, lifestyle and environmental indicators such as drinking, smoking and traffi c accidents, and types and levels of health care.
All indicators are presented as a map to show overall regional variations, a bar chart to indicate country rankings and a time chart to show trends over time in three main country groupings.
Using the WHO Regional Offi ce for Europe’s unique health for all database, combined with the best alternative sources of data around the Region, this atlas offers the most comprehensive overview of health in Europe. In a handy size, this atlas is designed to be an easily accessible resource at all times, in the offi ce or on the road.
World Health Organization
Regional Offi ce for Europe
The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its publications programmes. Through its publications, the Organization seeks to support national health strategies and address the most pressing public health concerns.
The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces some 870 million people living in an area stretching from Greenland in the north and the Mediterranean in the south to the Pacific shores of the Russian Federation. The European programme of WHO therefore concentrates both on the problems associated with industrial and post-industrial society and on those faced by the emerging democracies of central and eastern Europe and the former USSR.
To ensure the widest possible availability of authoritative
information and guidance on health matters, WHO secures broad
international distribution of its publications and encourages their
translation and adaptation. By helping to promote and protect
health and prevent and control disease, WHO’s books contribute to
achieving the Organization’s principal objective – the attainment by
all people of the highest possible level of health.
Atlas of health
in Europe
WHO Library Cataloguing in Publication Data Atlas of health in Europe.
1. Health surveys – statistics – atlases 2. Health status
3. Morbidity – statistics 4. Mortality – statistics 5. Europe
ISBN 92 890 1370 2 (NLM Classification : WA 17)
Atlas of health
in Europe
ISBN 92 890 1370 2
Address requests for copies of publications of the WHO Regional Office to publicationrequests@euro.who.int; for permission to reproduce them to permissions@euro.who.int; and for per- mission to translate them to pubrights@euro.who.int; or contact Publications, WHO Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark (tel.: +45 3917 1717;
fax: +45 3917 1818; web site: http://www.euro.who.int).
© W
© W
© W
© W
© World Health Or orld Health Or orld Health Or orld Health Or orld Health Organization 2003 ganization 2003 ganization 2003 ganization 2003 ganization 2003
All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full.
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 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. Where the designation “country or area” appears in the headings of tables, it covers countries, territories, cities, or areas.
Dotted 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 the World Health Organization 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.
The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization.
P
RINTEDINI
TALYContents
Foreword ... 1
Technical notes ... 3
1. Demography 1. Demography 1. Demography 1. Demography 1. Demography ... ... ... ... ... 7
Notes ... 7
Population Mid-year population, 2002 ... 9
Natural population growth ... 10–11 Age pyramid, 2000 ... 11
Young population, 0–14 years ... 12
Old population, 65 years and over ... 13–14 Births Birth rate ... 15–16 Low-weight births, under 2500 g ... 16–17 Births to young mothers, under 20 years ... 18
Births to older mothers, 35 years and over ... 18
Abortions Abortions ... 19
2. Life and death 2. Life and death 2. Life and death 2. Life and death 2. Life and death ... ... ... ... ... 21
Notes ... 21
Life expectancy Conventional and estimated life expectancy ... 26
Life expectancy at birth and at 65 years ... 27
Estimated disability-adjusted life expectancy, 2001 ... 28
Life expectancy at birth ... 29
Deaths Deaths from all causes ... 29–31 Infant deaths ... 32–33 Perinatal deaths ... 34
Maternal deaths ... 35–36 Causes of death Main causes of death by age group ... 36 Deaths from:
diseases of the circulatory system ... 37–38
ischaemic heart diseases ... 39–40
cerebrovascular diseases ... 40–41 cancer ... 42–44 lung cancer ... 44–46 female breast cancer ... 47–48 cervical cancer ... 48–49 external causes of injury and poisoning ... 50–51 motor vehicle traffic accidents ... 52–53 suicide ... 53–54 diseases of the respiratory system ... 55–56 diseases of the digestive system ... 57–58 3. Diseases
3. Diseases 3. Diseases
3. Diseases 3. Diseases ... ... ... ... ... 59
Notes ... 59
Some infectious diseases New cases of: tuberculosis ... 61–62 viral hepatitis B ... 63–64 syphilis ... 65–66 clinically diagnosed AIDS ... 67–68 HIV infection ... 68–69 Selected outbreaks of infectious diseases, 2002 ... 70
Some noncommunicable diseases Prevalence of diabetes mellitus ... 71
Lung cancer incidence and deaths ... 72
Female breast cancer incidence and deaths ... 73
Cervical cancer incidence and deaths ... 74
Hospitalization
Hospital discharges for:
cancer ... 75–76
diseases of the circulatory system ... 76–77
diseases of the respiratory system ... 78–79
diseases of the digestive system ... 79–80
diseases of the musculoskeletal system ... 81–82
injury and poisoning ... 82–83
Teeth
Decayed, missing or filled teeth in 12-year-olds ... 84
4. Lifestyles and envir 4. Lifestyles and envir 4. Lifestyles and envir 4. Lifestyles and envir
4. Lifestyles and environment onment onment onment onment ... ... ... ... ... 85
Notes ... 85
Smoking Smokers among adults and 15-year-olds ... 87
Smokers among adult males ... 88
Cigarette consumption ... 88
Alcohol Total alcohol consumption ... 89–90 Consumption of spirits, 2000 ... 91
Foodborne disease Cases of microbiological foodborne disease ... 92
Work and traffic accidents Deaths from work-related accidents ... 93–94 Motor vehicle traffic accidents and deaths ... 95
5. Health car 5. Health car 5. Health car 5. Health car 5. Health care e e e e ... ... ... ... ... 97
Notes ... 97
Health personnel Number of: physicians ... 99–100 dentists ... 100–101 nurses ... 102
Hospitals Hospital beds ... 103
Length of stay in hospital ... 103
Number of beds and length of stay in hospital ... 104
Psychiatric hospital beds ... 105
Inpatient hospital admissions ... 106–107 Some procedures Caesarean sections ... 107–108 Children vaccinated against measles and diphtheria .... 109 Health expenditure
Total health expenditure as a percent of GDP ... 110–111
Total health expenditure per person ... 111–112
Foreword
Decisions in the area of public health are based on a profound understanding of a wide range of factors, health statistics among them. Policy-makers consider all the available data on the health status in their countries, and shape their policies and design their actions accordingly. The comparison of national with international health data is a major part of the complex picture of public health:
statistics backed up by in-depth analyses can be a powerful resource to help health authorities identify failures and successes, constraints and good practices.
The WHO Regional Office for Europe offers this atlas to a wide range of public health and medical professionals, as well as to a broader audience. Rich and elaborate data from various sources have been gathered, systematized, grouped and formatted to present readers with the most complete picture of the health of Europe that can be expressed through figures.
We hope this statistical atlas will be useful for those committed to the improvement of public health Europe-wide.
Mar Mar Mar Mar
Marc Danzon c Danzon c Danzon c Danzon c Danzon Regional Director
WHO Regional Office for Europe
Technical notes
This publication contains basic health-related statistics for the 51 Member States of the WHO European Region. The data cover the main aspects of health and its determinants, i.e. basic demographic data, health status in terms of mortality and morbidity, and some indicators on lifestyles and the environment, health care resources and their utilization. The period covered runs from 1980 at the earliest to 2001 at the latest, depending on the data available in the various countries. The only exception is the mid-year population graph, which shows data for 2002.
Most of the data used in this publication come from the Member States themselves, usually from statistical units of ministries of health or public health institutions, and national statistical institutions. These data are systematically collected by the technical units of WHO (at the Regional Office for Europe or in headquarters) or by WHO collaborating centres. All these data, and more, are available in databases accessible on the WHO/Europe web site (http://www.euro.who.int) Information sources > Data >
European health for all database; and on the WHO headquarters web site (http://www.who.int) Research tools > WHOSIS. For the sake of completeness, some publicly available data collected and published by other international organizations (such as the International Labour Office (ILO), the United Nations Economic Commission for Europe (UNECE), the Organisation for Economic Co-operation and Development (OECD), and the Food and Agriculture Organization of the United Nations (FAO)) have also been included when appropriate, with the information source acknowledged.
Data were compiled, validated and processed in a uniform way in order to improve the international comparability of statistics.
Nevertheless, many factors, such as variations in national
definitions, incomplete registration in some countries or other
national specificities in data recording and processing, may
influence the accuracy and comparability of the national statistics.
Therefore, statistics, particularly in international comparisons, should always be interpreted with caution. The same applies to statistics for countries with very small populations (figures tend to
“jump” up and down purely because of the small numbers registered). On the other hand, the “statistical noise” from possible data inaccuracies or random fluctuations due to small figures is usually not so high as to mask completely what the statistics show.
Most of the data in this publication are presented in three standard graphic forms.
The ranked bar The ranked bar The ranked bar
The ranked bar The ranked bar-char -char -char -char -charttttt shows the relative position of each country in relation to other countries. The data used are from 2001, or the latest available year. But as the timing of data reporting to WHO varies a lot, data from different years often have to be used. As more recent data are provided, rankings may change. Serbia and Montenegro is still referred to as Yugoslavia, because that was the name that pertained at the time the data apply.
The map The map The map
The map The map aims to reveal specific geographical patterns in the data, such as the east–west mortality gradient. Again, data from different years may have to be used, although 2001 is the most common year.
The line char The line char The line char
The line char The line charttttt shows health trends over the last 20 years, in
different parts of the Region. Technically, it is difficult to present
trends separately for each of the 51 countries on one line chart. On
the other hand, had only the average trends for the whole Region
been given, some important sub-regional differences in health
trends would not have been visible. Therefore, sub-regional
population-weighted averages for each indicator are calculated for
three groups of countries, representing the trends in the eastern,
central and western parts of the Region. The first (eastern) group
consists of the 12 countries of the former USSR that now
constitute the Commonwealth of Independent States (CIS). The
second (central) group is the 15 central and south-eastern
European countries (CSEC) in rapid transition, including the three
Baltic states. The third (western) group represents the western part
of the Region, consisting of the 15 member states of the European
Union (EU).
Unless otherwise stated, death rates are age-standardized death rates (SDR), i.e. the number of deaths per 100 000 people in a
“standard” population. This facilitates international comparability by removing differences in rates caused by different population age structures between countries. The European standard population (see the table below) was used to calculate the SDR.
The mortality rates used cover all age groups: those aged under 65 (so called premature mortality) or aged 25–64 (representing the working age). Readers interested in other or more detailed age groups may consult the European health for all database.
The European standard population structure
Age Percent of Age Percent of
(years) population (years) population
0 1.6 45–49 7
1–4 6.4 50–54 7
5–9 7 55–59 6
10–14 7 60–64 5
15–19 7 65–69 4
20–24 7 70–74 3
25–29 7 75–79 2
30–34 7 80–84 1
35–39 7 85+ 1
40–44 7 All ages 100
1. Demography
Notes
Population (p. 9)
In mid-2002, the population of the 51 countries of the WHO European Region totalled 874.6 million. The six largest countries (the Russian Federation, Germany, Turkey, France, United Kingdom, and Italy) make up more than half of the Region’s population. The data are estimates published by United Nations Statistical Division.
Natural population growth (pp.10–11)
In the 1990s, the decline in the number of births and the increase in the number of deaths reached a cross-over point for several countries, mostly in the central and eastern part of the Region.
Deaths now exceed births in the European Region as a whole.
Age structure (pp.11–14)
European countries generally have an ageing population. Every seventh person is aged 65 years or more and this proportion is growing while the proportion of children is declining. The ageing process is more advanced in the western part of the Region. The graphs are based on population data by age, as most recently reported by countries to WHO.
Births (pp.15–18)
Live birth rates are declining in European countries and this decline is particularly sharp in eastern, central and south-eastern parts of the Region. This is most likely due to the profound socioeconomic changes and economic crises in this group of European countries.
The proportion of infants with low birth weight (below 2500 g) is
growing throughout the entire Region. The worst situation seems to
be in the central and south-eastern parts of the Region, although
low-weight births may also be high but underreported in some countries of the eastern part of the Region.
While births to young mothers are most common in the eastern part of the Region, births to mothers over 35 years of age are most frequent in western countries.
Abortions (p. 19)
The legal requirements for abortion vary between countries. The
dramatic increase in the average rate of abortions in the central and
south-eastern part of the Region in 1990 was caused by a six-fold
increase in the number of abortions in Romania after a change in
the law.
aThe former Yugoslav Republic of Macedonia 27
30 64 283 394 447 1360 1984 2051 23923164 3681 3790 38784127 4273 4506 46574930 5047 5183 5213 5342 54086177 63037168 7790 8070 8147 88239867 10048 10106 10250 10275 10523 10631 1599016026
2233225618 3854339924
4865257450 59657 59670
6856981990
143752
0 50 000 100 000 150 000
San Marino Monaco Andorra Iceland Malta Luxembourg Estonia Slovenia TFYR Macedoniaa
Latvia Albania Lithuania Armenia Ireland Bosnia and Herzegovina Republic of Moldova Norway Croatia Turkmenistan Kyrgyzstan Finland Georgia Denmark Slovakia Tajikistan Israel Switzerland Bulgaria Austria Azerbaijan Sweden Hungary Portugal Belarus Czech Republic Belgium Yugoslavia Greece Netherlands Kazakhstan Romania Uzbekistan Poland Spain Ukraine Italy United Kingdom France Turkey Germany Russian Federation
Population (thousands)
Population
Mid-year population, 2002
-7.6 -6.6-5.7-5.6-4.9-4.3-3.5-2.5
-1.9-1.8 -1.7-1.0
-0.9 -0.8 -0.8 -0.6-0.3
0.10.2 0.30.5
0.71.21.21.21.41.41.5 2.22.52.73.23.53.84.04.2
4.96.0 6.27.68.08.510.8
13.314.8 15.215.5
15.6 25.7
-15 -5 5 15 25
Ukraine (2000) Russian Federation (2001) Latvia (2001) Bulgaria (2001) Belarus (2001)Estonia (2001) Hungary (2001) Lithuania (2001) Croatia (2001) Romania (2001) Czech Republic (2001) Republic of Moldova (2001)Germany (1999)Sweden (1999)Italy (1999) Slovenia (2001)Greece (1999) Austria (2001)Poland (2000)Spain (1999) Slovakia (2000) Yugoslavia (2000) United Kingdom (2000)Georgia (2001)Belgium (1996) Portugal (2000) Denmark (1999) Finland (2001) Switzerland (1999)Armenia (2000)Norway (1999)Malta (2001) France (1999) San Marino (2000) Luxembourg (2001)Netherlands (2000) Kazakhstan (2001) TFYR Macedonia (2000)Ireland (2000) Bosnia and Herzegovina (1991)Azerbaijan (2001) Iceland (1997) Albania (2000) Kyrgyzstan (2001) Turkmenistan (1998) Uzbekistan (2001)Tajikistan (1999)Turkey (1998)Israel (1998)
Rate per 1000 population
Population
Natural population growth
Population
Natural population growth
-5 0 5 10 15
Rate per 1000 population
CIS CSEC EU
Year
1980 1985 1990 1995 2000
15 000 10 000 5000 0 5000 10 000 15 000
Population (thousands) 0–4
5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)
CIS CSEC EU
Males Females
15 000 10 000 5000 0 5000 10 000 15 000
Population (thousands) 0–4
5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)
15 000 10 000 5000 0 5000 10 000 15 000
Population (thousands)
15 000 10 000 5000 0 5000 10 000 15 000
Population (thousands) 0–4
5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)
0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+
Age group (years)
CIS CSEC EUEU
CIS CSEC
Males Females
Age pyramid, 2000
15 20 25 30
1980 1985 1990 1995 2000
Year
Percent of population
CIS CSEC EU
Population
Young population, 0–14 years
42 30 25 18 17
% of population –<
–<
–<
–<
–<
5 10 15 20
1980 1985 1990 1995 2000
Year
Percent of population
CIS CSEC EU
Population
Old population, 65 years and over
18 16 14 10 5
% of population –<
–<
–<
–<
–<
Population
Old population, 65 years and over
3.8 3.8 4.3
5.5 6.1 6.1 6.3 6.8
9.4 9.5 9.9
10.1 11.2
11.4 11.612.2
12.5 12.8
13.6 13.6 13.6 13.7 13.8 13.9 14.0 14.1 14.2 14.3 14.9
15.1 15.2 15.3 15.3 15.4 15.4 15.5 15.5 15.6 15.6 16.0 16.1 16.2 16.4 16.7
16.8 17.1
17.3 17.8
0 5 10 15 20
Tajikistan (2001) Turkmenistan (1998) Uzbekistan (2001) Kyrgyzstan (2001) Albania (2000) Azerbaijan (2001) Bosnia and Herzegovina (1991) Kazakhstan (2001) Armenia (2000) Republic of Moldova (2001)Israel (1998) TFYR Macedonia (2000) Ireland (2000) Slovakia (2000) Iceland (1998) Poland (2000) Malta (2001) Russian Federation (2001) Netherlands (2000) Belarus (2001) Romania (2001) Yugoslavia (2000) Czech Republic (2001) Ukraine (2000) Luxembourg (2001) Lithuania (2001) Georgia (2001) Slovenia (2001) Denmark (1999)Finland (2001) Hungary (2001) Switzerland (2000) Estonia (2001) Norway (1999) Latvia (2001) Portugal (2000) Austria (2001) United Kingdom (2000) Croatia (2001) France (1999) Germany (1999) San Marino (2000) Belgium (1997) Spain (1999) Bulgaria (2001) Greece (1999) Sweden (1999) Italy (1999)
Percent of population
7.88.48.68.78.89.09.19.19.2 9.29.3 9.3 9.39.49.59.69.89.810.010.0
10.010.110.210.210.410.810.8 10.911.411.411.5
11.811.812.4 12.712.713.013.3
13.614.514.514.9 15.416.1 19.9
20.621.121.521.7 27.2
0 5 10 15 20 25 30
Ukraine (2000)Latvia (2001) Bulgaria (2001) Slovenia (2001) Czech Republic (2001) Armenia (2000) Lithuania (2001) Russian Federation (2001)Belarus (2001) Croatia (2001) Estonia (2001)Austria (2001) Germany (2000)Hungary (2001)Greece (1999)Italy (2000) Poland (2000) Romania (2001)Spain (2000)Malta (2001) Republic of Moldova (2001)Georgia (2001)Sweden (2000) Slovakia (2000) Bosnia and Herzegovina (2000)San Marino (2000)Finland (2001) Switzerland (2000) United Kingdom (2000)Luxembourg (2001)Yugoslavia (2000)Portugal (2000)Andorra (2000)Belgium (2000) Denmark (2000)France (1999) Netherlands (2000)Azerbaijan (2001)Norway (2000) TFYR Macedonia (2000)Kazakhstan (2001)Kyrgyzstan (2001)Iceland (2000)Albania (2000)Ireland (2000) Uzbekistan (2001) Turkmenistan (1998)Tajikistan (2001)Turkey (2000)Israel (2000)
Live births per 1000 population
Births
Birth rate
5 10 15 20 25
1980 1985 1990 1995 2000
Year
Per 1000 population
CIS CSEC EU
Births
Birth rate
4 5 6 7 8
1980 1985 1990 1995 2000
Year
Percent of live births
CIS CSEC EU
Low-weight births, under 2500 g
3.84.3 4.3 4.4 4.5
4.7 4.9 4.9 5.05.1
5.2 5.2 5.3 5.4 5.55.5
5.7 5.7 5.9
6.0 6.06.1 6.16.1 6.2 6.3
6.5 6.6 6.7 6.7 6.7 6.9 6.9 7.0 7.3 7.3 7.5 7.5 7.9 7.9 8.1
8.2 8.5
8.8 9.1
0 1 2 3 4 5 6 7 8 9 10
Iceland (2001) Estonia (2001) Finland (2001) Sweden (1999) Lithuania (2001) Uzbekistan (2001) Norway (2000) Turkmenistan (1997) Yugoslavia (1999) Latvia (2001) Belarus (2001) Republic of Moldova (2001) Kazakhstan (2001)Ukraine (2001) Kyrgyzstan (2001)Denmark (2000) Slovenia (2001) Ireland (1999) Italy (1998) Spain (1997) Czech Republic (2001)Poland (2000) Russian Federation (2001) Malta (2001) Croatia (2001) Switzerland (1999) Germany (1999) Azerbaijan (2001) Austria (2001) France (1998) Tajikistan (2001) Albania (1990) Georgia (2001) Slovakia (2001) United Kingdom (1997)Andorra (2001) Belgium (1997) Luxembourg (2000) Armenia (2001) Portugal (2001) Greece (1999)Israel (2001) Hungary (2001) Romania (2001)Bulgaria (2001)
Percent of live births
Births
Low-weight births, under 2500 g
Births
Births to young mothers, under 20 years
22 17 14 10 6 No data
% of all births –<
–<
–<
–<
–<
Births to older mothers, 35 years and over
18 12 9 5 2
No data
% of all births –<
–<
–<
–<
–<
0 500 1000 1500
1980 1985 1990 1995 2000
Year
Per 1000 live births
CIS CSEC EU
Abortions
Abortions
1500 1000 700 400 200 No data Per 1000 live births
–<
–<
–<
–<
–<
2. Life and death
Notes
Life expectancy (pp. 26–29)
Life expectancy, or the average number of years that a newborn baby can expect to live if mortality patterns remain unchanged, is one of the most common measurements of the health status of a population. As it is calculated using mortality statistics, its accuracy depends on the accuracy and completeness of official national mortality data. The table on p.26 shows two different estimates of life expectancy. One is the conventional life expectancy based on reported official mortality statistics. The other estimate is calculated using special demographic techniques to counteract possible underreporting of deaths (see The world health report 2000
1for details on methodology). Countries with the largest differences between these two estimates most probably have life expectancies well below the level calculated from official statistics. This problem occurs mainly in central Asia, the Caucasus and the Balkans, which were affected by armed conflicts and severe socioeconomic difficulties during the 1990s. Many countries’ national vital statistics systems (registration of marriages, births and deaths) were damaged. This should be kept in mind when comparing the life expectancy in these areas with other countries.
The trends in life expectancy show a dramatic increase in the gap between the western and eastern parts of the Region. The average trend for the CIS is particularly complex, as it reflects the effects of both the anti-alcohol campaign introduced in the USSR in 1985 and the deep socioeconomic crisis of the 1990s. The same pattern can be seen in the cause-specific mortality trends: a relatively sharp improvement in 1985–1986, a sharp deterioration in the first half of the 1990s, a gradual improvement in 1995–1998 and a
1
The world health report 2000. Health systems: improving performance. Geneva,
World Health Organization, 2000.
deterioration again in 1999–2000. The latest deterioration may have some association with the financial crisis that hit the Russian Federation and other CIS countries in the autumn of 1998.
Disability-adjusted life expectancy (often also called healthy life expectancy) shows the estimated number of years of life expected to be lived in full health. These estimates were calculated by WHO using special techniques (see The world health report 2000
2for details on methodology).
Deaths from all causes (pp. 29–31)
Mortality is gradually increasing from the western to the eastern part of the Region. The level of premature mortality (i.e. below 65 years of age) varies particularly dramatically. East–west differences in the mortality of the elderly population (i.e. those aged 65 years or over) are relatively less pronounced. Excess male mortality is presented as the ratio of male death rates to female death rates on the left side of the bar charts on pp. 30–31. Particularly high premature male mortality in eastern countries makes the largest contribution proportionally to the east–west gap in total mortality.
Infant deaths (pp. 32–33)
Infant mortality shows the number of deaths of children under 1 year of age per 1000 live births. Unfortunately, some countries cannot ensure the complete registration of infant deaths and live births, in accordance with the WHO definition of live births. The infant mortality rates they report are therefore lower than they actually are and intercountry comparisons should be treated with caution.
As mentioned above, particularly high levels of under-registration occur in central Asia and the Caucasus, and possibly in countries of the former Yugoslavia and Albania.
Special household surveys carried out in the 1990s by the United States Agency for International Development (USAID) and the United Nations Children’s Fund (UNICEF) in some of these countries produced much higher estimates of infant mortality rates
2
The world health report 2000. Health systems: improving performance. Geneva,
World Health Organization, 2000.
than the official figures based on national vital statistics systems.
For example, differences between reported infant mortality and survey-based estimates were: for Azerbaijan 19.9 vs. 79.0, Kazakhstan 25.2 vs. 61.9, Tajikistan 47.0 vs. 89.0, Uzbekistan 30.7 vs. 43.5, Kyrgyzstan 29.1 vs. 66.2.
3Although, for methodological reasons, survey-based estimates are not directly comparable with registration-based data, these differences indicate the possible size of under-registration.
Infant mortality is higher in the eastern part of the Region, with the highest levels in some south-eastern countries. Given the likely under-registration, the real infant mortality in these countries is probably even higher.
Perinatal deaths (p. 34)
The rate shows the number of deaths of fetuses weighing 1000 g or more and of newborn babies aged 0–6 full days per 1000 births (live and stillborn). Where weight-specific data were not available, calculations were based on the data provided by countries whatever the national criteria.
Maternal deaths (pp. 35–36)
A maternal death is the death of a woman while pregnant or within 42 days of the end of a pregnancy, from any cause related to or aggravated by the pregnancy or its management. Maternal mortality (deaths per 100 000 live births) was calculated using mortality data from routine vital statistics reported to WHO and hospital data reported by ministries of health, taking the larger figure where they differed. Even in countries with good vital statistics systems, however, maternal mortality is believed to be higher than reported. WHO, UNICEF and the United Nations Population Fund (UNFPA) have estimated that maternal mortality in these countries may actually be some 50% higher.
4The drop in the average rate in the central and south-eastern part of the Region in 1990 is attributable to the sharp reduction in
3
A decade of transition. New York, UNICEF, 2002 (Regional Monitoring Report, No.8).
4
WHO, UNICEF, UNFPA. Maternal mortality in 1995: estimates developed by WHO,
UNICEF, UNFPA. Geneva, World Health Organization, 2001 (WHO/RHR/01.9).
maternal mortality in Romania after the change in the anti-abortion law.
Deaths by cause and age (p. 36)
The importance of specific causes of death differs significantly in the different phases of the life span. Respiratory and some other diseases are leading causes of death in childhood, replaced by accidents and other external causes of death among adolescents and young adults. Cancer and diseases of the circulatory system become leading causes of death in older age groups.
Deaths from diseases of the circulatory system (pp. 37–41) The average trends in mortality from these diseases show a decline in the western and central parts of the Region. The average for the CIS shows the specific trend pattern noted under life expectancy during the 1990s. A clear east–west gradient contributes a large part of the east–west difference in total mortality and life expectancy.
The patterns of trends and differences in death rates from ischaemic heart diseases and cerebrovascular diseases are similar to those for all diseases of the circulatory system.
Deaths from cancer (pp. 42–49)
Trends in cancer death rates show some general improvement in the EU and the CIS, while in the central part of the Region the overall situation is deteriorating. The average cancer mortality in western countries is relatively low in younger age groups and relatively high among the older population. The opposite is true in the CIS while, in the central part of the Region, mortality is high in both younger and older age groups.
Female mortality from lung cancer is steadily increasing in the western and central parts of the Region.
Deaths from external causes of injury and poisoning (pp.50–54)
External causes of death from injury and poisoning include
accidents, homicide, suicide and other causes that are not
diseases. A remarkable increase in mortality in the eastern part of
the Region, in the first half of the 1990s, is attributable to the
combined effect of the end of the anti-alcohol campaign that started in the USSR in 1985 and the socioeconomic crisis of the 1990s.
Deaths from diseases of the respiratory system (pp. 55–56) Generally, there is a downward trend in all parts of the Region. The average for the CIS follows the specific trend pattern described above for diseases of the circulatory system and for life expectancy.
Deaths from diseases of the digestive system (pp. 57–58)
Deaths from chronic liver disease and cirrhosis are responsible for
about half of all deaths from this group of diseases. Mortality is
steadily declining in the western part of the Region and is stable or
slightly increasing in the central part. The average for the CIS
follows the specific trend pattern as described above for diseases
of the respiratory and circulatory systems, and for life expectancy.
Life expectancy
Conventional and estimated life expectancy
Estimated life expectancy, 2001 (years) Males Conventional life expectancy
(years)
Albania (2000) 72.03 66.3 78.04 73.2
Andorra 76.2 82.9
Armenia (2000) 73.46 66.2 78.11 73.0
Austria (2001) 76.10 75.9 81.95 81.8
Azerbaijan (2001) 69.66 60.7 75.01 66.6
Belarus (2001) 62.79 62.9 74.55 74.2
Belgium (1996) 73.97 74.8 80.76 81.2
Bosnia and Herzegovina (1991) 69.49 69.3 75.98 76.4
Bulgaria (2001) 68.55 68.4 75.44 74.8
Croatia (2001) 71.03 68.9 78.17 77.1
Czech Republic (2001) 72.18 71.9 78.71 78.8
Denmark (1999) 74.13 74.8 78.87 79.5
Estonia (2001) 64.91 65.7 76.44 76.5
Finland (2001) 74.72 74.5 81.81 81.2
France (1999) 75.17 75.6 82.83 82.9
Georgia (2001) 72.44 65.4 78.48 72.4
Germany (1999) 74.89 75.1 81.02 81.1
Greece (1999) 75.82 75.5 81.03 80.8
Hungary (2001) 68.32 67.3 76.76 76.1
Iceland (1997) 76.41 78.2 81.61 81.3
Ireland (2000) 74.01 73.8 79.31 79.2
Israel (1998) 76.21 76.1 80.59 80.9
Italy (1999) 76.28 76.2 82.62 82.2
Kazakhstan (2001) 60.57 58.8 71.40 67.2
Kyrgyzstan (2001) 64.53 60.1 72.97 68.2
Latvia (2001) 64.48 65.2 75.68 76.0
Lithuania (2001) 65.89 67.7 77.49 77.9
Luxembourg (2001) 75.48 74.9 81.13 81.8
Malta (2001) 76.37 75.8 81.19 80.3
Monaco 76.5 84.0
Netherlands (2000) 75.65 75.8 80.76 80.7
Norway (1999) 75.71 76.1 81.32 81.4
Poland (2000) 69.80 69.9 78.09 78.1
Portugal (2000) 72.63 72.7 79.67 80.1
Republic of Moldova (2001) 64.54 64.2 71.94 71.7
Romania (2001) 67.69 67.8 75.01 74.5
Russian Federation (2001) 59.08 58.9 72.28 72.3
San Marino (2000) 77.93 77.6 86.58 83.9
Slovakia (2000) 69.26 69.3 77.64 77.4
Slovenia (2001) 72.32 72.1 80.52 79.5
Spain (1999) 75.24 75.3 82.35 82.6
Sweden (1999) 77.13 77.7 82.08 82.3
Switzerland (1999) 76.97 77.3 82.80 82.8
Tajikistan (1999) 69.99 59.9 73.98 66.9
TFYR Macedonia (2000) 71.18 68.9 75.74 74.9
Turkey 67.0 71.2
Turkmenistan (1998) 62.48 58.9 69.84 66.5
Ukraine (2000) 62.30 62.2 73.62 73.3
United Kingdom (2000) 75.69 75.1 80.51 79.9
Uzbekistan (2001) 67.57 62.7 72.64 68.5
Yugoslavia (2000) 70.36 69.7 75.18 74.8
Estimated life expectancy, 2001 (years) Females Conventional life expectancy
(years)
Bosnia and Herzegovina (1991)
13.6 13.2 13.8 13.8 13.1 13.9 14.6 14.4 15.2 15.5 14.9 16.0 14.5 15.3 15.5 15.5 14.7 15.0 14.5 15.2 15.9 15.6 15.3 17.4
16.0 17.3 16.7 17.2 16.8 16.5 17.5 17.9 17.7 17.6 18.2 18.3 18.0 17.9 17.8 18.4 17.4 18.3 19.2 18.8 18.7 18.4 19.1 21.3
65.3 65.9 66.1 67.9 68.3 68.5 68.7 70.1 70.1 70.7 71.3 71.7 71.9 72.0 72.4 72.6 72.7 72.7 73.4 73.5 74.0 74.7 74.9 75.4 75.5 75.7 76.2 76.5 76.5 76.6 77.4 78.1 78.2 78.3 78.4 78.4 78.4 78.5 78.5 78.8 78.9 79.0 79.0 79.2 79.5 79.6 80.0 82.3
40 30 20 10 0 10 20 30 40 50 60 70 80 90 Russian Federation (2001)
Kazakhstan (2001) Turkmenistan (1998) Ukraine (2000) Republic of Moldova (2001) Belarus (2001) Kyrgyzstan (2001) Uzbekistan (2001) Latvia (2001) Estonia (2001) Romania (2001) Lithuania (2001) Bulgaria (2001) Tajikistan (1999) Azerbaijan (2001) Hungary (2001) Yugoslavia (2000) TFYR Macedonia (2000) Slovakia (2000) Poland (2000) Croatia (2001) Albania (2000) Georgia (2001) Czech Republic (2001) Armenia (2000) Portugal (2000) Slovenia (2001) Denmark (1999) Ireland (2000) Belgium (1996) Germany (1999) United Kingdom (2000) Netherlands (2000) Finland (2001) Luxembourg (2001) Greece (1999) Israel (1998) Norway (1999) Spain (1999) Malta (2001) Iceland (1997) France (1999) Austria (2001) Italy (1999) Sweden (1999) Switzerland (1999) San Marino (2000)
Years at birth Years at 65
Life expectancy
Life expectancy at birth and at 65 years
50.1 50.351.5
52.452.8 53.5
56.757.4 57.558.3
58.4 58.759.8
59.8 60.961.161.8
62.162.2 62.5
63.3 64.164.3
66.666.8 67.7
69.269.469.6 69.7 69.970.1
70.170.2 70.4 70.670.8
70.9 70.9 71.2 71.3 71.3 71.872.2
72.8
50 55 60 65 70 75
Tajikistan Turkmenistan Kyrgyzstan Kazakhstan Azerbaijan Uzbekistan Russian Federation Ukraine Republic of Moldova Armenia Belarus Albania Georgia Turkey Latvia Romania Lithuania Hungary Estonia Yugoslavia TFYR Macedonia Bosnia and HerzegovinaBulgaria Croatia Slovakia Poland Czech Republic Portugal Slovenia Ireland Malta Israel United Kingdom Belgium Netherlands Denmark Finland Germany Greece Luxembourg Norway Andorra Spain Austria Italy Iceland France Monaco Sweden San Marino Switzerland
Years
71.0 71.0
69.0
63.0
62.0
60.0
Life expectancy
Estimated disability-adjusted life expectancy, 2001
65 70 75 80
1980 1985 1990 1995 2000
Year
Years
CIS CSEC EU
Life expectancy
Life expectancy at birth
1500 1300 1100 800 650 No data Per 100 000 population
–<
–<
–<
–<
–<
Deaths from all causes
Deaths
302176 164 188 204 162 173 179 155 222 248200
160 186 232
201 231
172 186 196 229
154 246
225203 247 245 175 255 271
188 230
181 230146 243
222165 309297288
216 199 308
292 183 250 303
152.5163.3 173.2 178.4182.4 195.5 196.2 200.3 201.4 203.5 204.7 205.4 210.7218.7
222.5 223.3229.1 230.8 234.7 236.7 254.3 262.2283.1
285.2299.4305.2 319.4 320.7360.2
361.7 371.4376.4
391.8 400.5 406.5 433.6
443.9474.9 476.6523.0539.4
570.9 571.6604.2
621.5 629.7703.9
600 400 200 0 200 400 600 800
San Marino (2000) Malta (2001) Sweden (1999) Switzerland (1999) Italy (1999) Iceland (1997) Norway (1999) Israel (1998) Netherlands (2000)Greece (1999) Spain (1999) Austria (2001) United Kingdom (2000) Luxembourg (2001) Finland (2001) Germany (1999) France (1999) Ireland (2000) Albania (2000) Belgium (1996) Portugal (2000) Denmark (1999) Slovenia (2001) Czech Republic (2001)Armenia (2000)Croatia (2001) Georgia (2001) TFYR Macedonia (2000) Poland (2000) Slovakia (2000) Yugoslavia (2000) Bosnia and Herzegovina (1991) Azerbaijan (2001)Bulgaria (2001) Tajikistan (1999) Hungary (2001) Romania (2001) Uzbekistan (2001) Lithuania (2001)Estonia (2001)Latvia (2001) Kyrgyzstan (2001) Republic of Moldova (2001) Belarus (2001) Ukraine (2000) Turkmenistan (1998) Kazakhstan (2001) Russian Federation (2001)
Per 100 000 population 771.2
Ratio males / females (%)
1000
Deaths
Deaths from all causes, 0–64 years
174 170 159 148 163
152 162 152 152 161 129 154 129 159
145 159 168 114 140
114 169
140 147 156 163 151 147 125 147 152 171 122 159 151 119 112 132 136 120 128 134 134 161
147 169 157 156 139
3085 3872 3910 4089 4100 4243 4276 4294 4304 4360 4428 4495 4502 4547 4580 4666 4696 4749 4762 4819 4850 5042
5297 5469 5589 5640 5677 5821 5903 5906 5914 6009 6067 6070 6122 6355 6383 6468 6562 6628 6810 7005
7117 7239 7242 7267 7695
8014
200 0 2000 4000 6000 8000 San Marino (2000)
France (1999) Switzerland (1999) Austria (2001) Italy (1999) Sweden (1999) Spain (1999) Luxembourg (2001) Iceland (1997) Finland (2001) Greece (1999) Germany (1999) Israel (1998) Norway (1999) United Kingdom (2000) Netherlands (2000) Belgium (1996) Georgia (2001) Malta (2001) Armenia (2000) Slovenia (2001) Denmark (1999) Ireland (2000) Portugal (2000) Lithuania (2001) Poland (2000) Czech Republic (2001) Azerbaijan (2001) Croatia (2001) Hungary (2001) Estonia (2001) Tajikistan (1999) Latvia (2001) Slovakia (2000) Bosnia and Herzegovina (1991) Yugoslavia (2000) Romania (2001) Kyrgyzstan (2001) Uzbekistan (2001) TFYR Macedonia (2000) Bulgaria (2001) Turkmenistan (1998) Belarus (2001) Ukraine (2000) Albania (2000) Russian Federation (2001) Kazakhstan (2001) Republic of Moldova (2001)
Per 100 000 population Ratio males / females (%)
10 000 400
Deaths
Deaths from all causes, 65 years and over
0 5 10 15 20 25 30
1980 1985 1990 1995 2000
Year
Per 1000 live births
CIS CSEC EU
Deaths
Infant deaths
40 20 15 10 5 Per 1000 live births
–<
–<
–<
–<
–<
3.23.44.0 4.0 4.2 4.3 4.3 4.34.54.54.6 4.85.05.05.1
5.25.35.55.55.66.06.06.2 6.27.77.98.18.1
8.68.89.210.4 11.011.611.812.0
12.513.314.414.6 15.015.816.418.4
18.419.221.6 27.9
32.8 40.0
0 10 20 30 40
Finland (2001) Sweden (1999) Czech Republic (2001)Denmark (1999)Slovenia (2001)Norway (1999) France (1999)Spain (1999)Malta (2001) Germany (1999) Switzerland (1999)Austria (2001) Luxembourg (2001)Netherlands (2000)Monaco (1999) Italy (1999) Belgium (1996)Iceland (1997) Portugal (2000) United Kingdom (2000)Andorra (1999)Greece (1999)Israel (1998) Ireland (2000) Croatia (2001) Lithuania (2001)Poland (2000) Hungary (2001)Slovakia (2000)Belarus (2001)Estonia (2001) Georgia (2001)Albania (2000)Latvia (2001) TFYR Macedonia (2000) Ukraine (2000) Azerbaijan (2001) Yugoslavia (2000)Bulgaria (2001) Russian Federation (2001) Bosnia and Herzegovina (1999)Republic of Moldova (2001)Uzbekistan (2001)Armenia (2000) Romania (2001) Kazakhstan (2001)Kyrgyzstan (2001)Tajikistan (2001) Turkmenistan (1998)Turkey (1999)
Per 1000 live births
Deaths
Infant deaths
Deaths
Perinatal deaths
1.3 3.4
3.63.7 3.8 4.5 4.5 5.1 5.2 5.2 5.4 5.6 5.6 5.7 5.8 5.9 6.1 6.2 6.4 6.5 6.57.0
7.0 7.3 7.4 7.9
8.2 8.8 8.89.0 9.5 9.7 10.0
11.3 11.5 11.7 11.8
12.313.2 13.6
14.7 15.5
16.4 16.4 17.1
20.721.2
0 5 10 15 20 25
Andorra (2001) Finland (2001)Austria (2001) Iceland (2001) Czech Republic (2001) Norway (2000) Slovenia (2001) Malta (2001) Israel (1998) Portugal (2000) Denmark (1999)Spain (1999) Sweden (2000) Lithuania (2001) Estonia (2001) Ireland (1999) Germany (2000) Luxembourg (2001) Italy (1998) Switzerland (1999)Slovakia (2001) Belgium (1995) France (1998) Croatia (2001) Belarus (2001) Netherlands (2001) United Kingdom (2000) Ukraine (2001) Greece (1999) Latvia (2001) Hungary (2001) Poland (2000) Uzbekistan (2001) Azerbaijan (2001) Albania (1992) Russian Federation (2001) Romania (2001) Bulgaria (2001) Kyrgyzstan (2001) Yugoslavia (1998) Republic of Moldova (2001) Kazakhstan (2001) TFYR Macedonia (2001) Armenia (2001) Turkmenistan (1997) Georgia (2001) Tajikistan (2001)
Per 1000 births
0.0 1.22.93.43.5
3.54.3 4.75.1 5.25.3 5.5 5.5 5.7 6.2 6.3 6.5 6.8 6.97.8 7.88.69.19.4
9.911.9 13.615.2
19.1 19.2 19.6 19.7 20.8 24.424.6 24.730.5
33.2 33.3 35.5 35.940.242.6
43.145.5 47.553.0
55.0 130.0
0 50 100 150
Andorra (2000) Ireland (2000)Spain (1998) Sweden (1999)Austria (2000) Italy (1998) Greece (1998) Finland (2000) Switzerland (1998)Portugal (1999) Germany (1999)Denmark (1998) Israel (2000) Norway (1998) Luxembourg (1997) United Kingdom (1999) Hungary (2000)Croatia (2000) Yugoslavia (1999)Belgium (1996) Czech Republic (2000)Slovakia (2000)France (1998)Poland (1995) Netherlands (1999) Lithuania (2000) Slovenia (2000)Bulgaria (2000) Albania (2000) Belarus (2000)Estonia (2000) Iceland (2000) Ukraine (2000) Malta (2000) Latvia (2000) Uzbekistan (2000) Azerbaijan (2000)Romania (2000) Armenia (2000) Kazakhstan (2000) Turkmenistan (1995)Kyrgyzstan (2000) Georgia (2000) Tajikistan (1999) Turkey (1998)
Per 100 000 live births Russian Federation (2000)
Republic of Moldova (2000)
Bosnia and Herzegovina (1990)
TFYR Macedonia (2000)
Deaths
Maternal deaths, three-year average
Causes of death
Main causes of death by age group
0 20 40 60 80 100
0 1–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85+
Infectious and parasitic diseases Cancer
Diseases of the circulatory system Diseases of the respiratory system Other diseases External causes of injury and poisoning
Age group (years)
Percent of all deaths in each group
Deaths
Maternal deaths
0 10 20 30 40 50 60
1980 1985 1990 1995 2000
Year
Per 100 000 live births
CIS CSEC EU
200 300 400 500 600 700 800
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Causes of death
Deaths from diseases of the circulatory system
900 750 600 400 250 No data Per 100 000 population
–<
–<
–<
–<
–<
Causes of death
Deaths from diseases of the circulatory system, 25–64 years
55.2 56.8 63.6 65.0 67.6 69.9 70.1 71.3 72.0 74.7 76.0 76.6 79.383.7
84.1 85.6 87.791.0 91.2 97.5 98.0 102.9
115.9 135.9
153.1 172.8 175.5188.1
189.9 209.7
215.3 217.5 220.1 233.3
250.2 254.1 254.9272.6288.8
290.5 293.9 320.4
344.0 361.4
378.1 419.8
441.9 442.7
0 100 200 300 400 500
France (1999) Switzerland (1999) Spain (1999) Italy (1999) Iceland (1997) Norway (1999) Sweden (1999) Israel (1998) San Marino (2000) Portugal (2000) Malta (2001) Netherlands (2000) Belgium (1996) Denmark (1999) Austria (2001) Luxembourg (2001)Germany (1999) Finland (2001) United Kingdom (2000) Greece (1999) Slovenia (2001) Ireland (2000) Albania (2000) Czech Republic (2001)Croatia (2001) Armenia (2000) Poland (2000) Slovakia (2000) TFYR Macedonia (2000) Hungary (2001) Bosnia and Herzegovina (1991) Lithuania (2001) Yugoslavia (2000) Georgia (2001) Romania (2001) Estonia (2001) Tajikistan (1999) Azerbaijan (2001) Bulgaria (2001) Latvia (2001) Republic of Moldova (2001) Uzbekistan (2001) Kyrgyzstan (2001) Ukraine (2000) Belarus (2001) Kazakhstan (2001) Turkmenistan (1998) Russian Federation (2001)
Per 100 000 population
Causes of death
Deaths from ischaemic heart diseases, 25–64 years
13.1 20.7
27.2 27.5 29.130.3
34.3 35.4 36.1 36.9 37.8 40.4 41.142.5 43.8 44.0 44.8 46.5 50.7 52.2 54.2 57.0
61.1 66.5
69.6 74.7
76.3 76.9 79.5
85.795.7 103.0
106.2 110.2
113.5 119.4
127.1133.6 139.4
141.8 147.0
156.8 175.6
199.3 204.7
214.4 221.9
225.6
0 50 100 150 200 250
San Marino (2000) France (1999) Portugal (2000) Italy (1999) Switzerland (1999) Spain (1999) Luxembourg (2001) Israel (1998) Netherlands (2000) Denmark (1999) Belgium (1996) Sweden (1999) Slovenia (2001)Norway (1999) Austria (2001) Germany (1999) Iceland (1997) Albania (2000) Malta (2001) Finland (2001) Greece (1999) United Kingdom (2000) Ireland (2000) Croatia (2001) Czech Republic (2001) Yugoslavia (2000) Poland (2000) TFYR Macedonia (2000) Bosnia and Herzegovina (1991) Bulgaria (2001) Slovakia (2000) Hungary (2001) Romania (2001) Tajikistan (1999) Armenia (2000) Lithuania (2001) Estonia (2001) Georgia (2001) Kyrgyzstan (2001) Uzbekistan (2001) Republic of Moldova (2001) Latvia (2001) Azerbaijan (2001) Turkmenistan (1998) Kazakhstan (2001)Ukraine (2000) Belarus (2001) Russian Federation (2001)
Per 100 000 population
0 50 100 150 200 250
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Causes of death
Deaths from ischaemic heart diseases, 25–64 years
0 25 50 75 100 125
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Deaths from cerebrovascular diseases, 25–64 years
7.9 11.8 11.8 11.9 12.5 13.2 13.3 13.5 13.5 13.8 14.4 14.615.0 15.2 16.6 18.1 18.3 20.2 20.5 21.1 24.0
25.5 25.5 30.4 31.8 32.9 39.6 40.1 41.2 41.6 42.151.7
53.6 56.3 57.1 60.3
65.1 71.2 71.4 72.8
80.982.7 91.0
99.0 106.4
116.4 120.5
149.5
0 30 60 90 120 150 180
Switzerland (1999) Israel (1998) France (1999) Norway (1999) Italy (1999) Sweden (1999) Germany (1999) Spain (1999) Netherlands (2000) Malta (2001) Iceland (1997) Austria (2001) Belgium (1996) United Kingdom (2000) Ireland (2000) Finland (2001) San Marino (2000) Denmark (1999) Greece (1999) Luxembourg (2001) Slovenia (2001) Czech Republic (2001) Slovakia (2000) Portugal (2000) Tajikistan (1999) Albania (2000) Poland (2000) Armenia (2000) Croatia (2001) Turkmenistan (1998) Lithuania (2001) Azerbaijan (2001) Hungary (2001) Estonia (2001) Bosnia and Herzegovina (1991) TFYR Macedonia (2000) Yugoslavia (2000) Bulgaria (2001) Latvia (2001) Georgia (2001) Uzbekistan (2001)Romania (2001) Ukraine (2000) Belarus (2001) Kazakhstan (2001) Republic of Moldova (2001) Russian Federation (2001) Kyrgyzstan (2001)
Per 100 000 population
Causes of death
Deaths from cerebrovascular diseases, 25–64 years
65.3 81.9
84.5 85.7 93.5
95.8 96.7 98.8
102.9107.1 107.5 109.8 111.6 111.8 112.1 114.0 115.9 118.6 120.4123.6
124.3 127.2 127.7 128.8 133.4
138.8 141.9 142.0144.1 145.0 145.6 149.4
152.4 157.7
159.4 162.9
165.3166.1 166.8 167.3 169.8 169.9 172.0 174.6
178.3 178.6 180.3 230.1
0 50 100 150 200 250
Tajikistan (1999) Uzbekistan (2001) Georgia (2001) Albania (2000) Finland (2001) Malta (2001) Turkmenistan (1998) Sweden (1999) Switzerland (1999) Luxembourg (2001) Azerbaijan (2001) Israel (1998) San Marino (2000) Greece (1999) Kyrgyzstan (2001) Norway (1999) Austria (2001) Italy (1999) Portugal (2000) United Kingdom (2000) Armenia (2000) Germany (1999) Spain (1999) Netherlands (2000) Ireland (2000) Iceland (1997) Bulgaria (2001)Belgium (1996) TFYR Macedonia (2000) France (1999) Bosnia and Herzegovina (1991) Slovenia (2001) Denmark (1999) Yugoslavia (2000) Republic of Moldova (2001) Estonia (2001) Kazakhstan (2001)Croatia (2001) Lithuania (2001) Romania (2001) Czech Republic (2001) Belarus (2001) Latvia (2001) Poland (2000) Russian Federation (2001) Ukraine (2000) Slovakia (2000) Hungary (2001)
Per 100 000 population
Causes of death
Deaths from cancer, 25–64 years
Causes of death
Deaths from cancer, 0–64 years
140 105 95 80 70 No data Per 100 000 population
–<
–<
–<
–<
–<
1300 1100 900 800 600 No data Per 100 000 population
–<
–<
–<
–<
–<
Deaths from cancer, 65 years and over
Causes of death
Deaths from cancer
160 170 180 190 200 210
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
40 50 60 70 80 90
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Deaths from lung cancer, males, 25–64 years
6 8 10 12 14 16
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Causes of death
Deaths from lung cancer, females, 25–64 years
100 125 150 175 200 225
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Deaths from lung cancer, 65 years and over
6.3 9.811.7
15.5 16.6 16.8 17.7 18.1 18.5 18.7 19.9 20.320.5 23.3
24.3 25.7 26.0 26.5 26.9 27.5 27.828.2 30.0 30.6 31.131.5
32.2 32.8 32.9 33.8 34.1 34.2 34.2 34.6 34.7 35.3 35.5 37.1 37.4 37.5 37.8 40.040.8
40.9 41.9 42.3
46.9
67.0
0 10 20 30 40 50 60 70 80
Tajikistan (1999) Uzbekistan (2001) Turkmenistan (1998) Kyrgyzstan (2001) Georgia (2001) Finland (2001) Azerbaijan (2001) Sweden (1999) Israel (1998) Malta (2001) Portugal (2000) San Marino (2000)Albania (2000) Switzerland (1999) Norway (1999) United Kingdom (2000) Ireland (2000) Austria (2001) Italy (1999) Luxembourg (2001) Germany (1999)Armenia (2000) Republic of Moldova (2001) Spain (1999) Greece (1999) Netherlands (2000) Bulgaria (2001) Lithuania (2001) TFYR Macedonia (2000) France (1999) Iceland (1997) Estonia (2001) Belarus (2001) Kazakhstan (2001) Slovenia (2001) Ukraine (2000) Denmark (1999) Russian Federation (2001) Latvia (2001) Belgium (1996) Slovakia (2000) Romania (2001) Yugoslavia (2000) Czech Republic (2001) Bosnia and Herzegovina (1991) Croatia (2001) Poland (2000) Hungary (2001)
Per 100 000 population
Causes of death
Deaths from lung cancer, 25–64 years
8.8 11.3
14.214.5 17.2
19.0 19.9
21.422.5 22.9 23.5 23.523.623.7 23.8 23.9 24.4 24.4 24.6 24.7 24.7 25.2 25.2 25.2
25.625.828.2 28.7 28.8 28.9 28.929.1 29.9 30.0 30.2 30.431.7
32.132.3 32.432.8 33.2 34.5
35.3 38.238.4 38.4
0 10 20 30 40
Tajikistan (1999) Turkmenistan (1998) Albania (2000) Uzbekistan (2001) Kyrgyzstan (2001) Azerbaijan (2001) Greece (1999) Sweden (1999)Spain (1999) Poland (2000) Norway (1999)Finland (2001) Belarus (2001) Switzerland (1999) Bulgaria (2001) Georgia (2001) Czech Republic (2001) Malta (2001) Luxembourg (2001) Portugal (2000) Kazakhstan (2001) Austria (2001) Slovakia (2000)Italy (1999) Romania (2001) Croatia (2001) Lithuania (2001) Republic of Moldova (2001) Slovenia (2001) Russian Federation (2001) Germany (1999) TFYR Macedonia (2000)France (1999) Latvia (2001) Israel (1998) United Kingdom (2000)Ukraine (2000)Estonia (2001) Hungary (2001) Yugoslavia (2000) Netherlands (2000)Armenia (2000) Denmark (1999) Iceland (1997) Ireland (2000) Belgium (1996)
Per 100 000 females Bosnia and Herzegovina (1991)
Causes of death
Deaths from female breast cancer, 25–64 years
10 15 20 25 30
1980 1985 1990 1995 2000
Year
Per 100 000 females
CIS CSEC EU
Causes of death
Deaths from female breast cancer
2 3 4 5 6 7 8 9 10
1980 1985 1990 1995 2000
Year
Per 100 000 females
CIS CSEC EU
Deaths from cervical cancer
1.0 1.2 1.7 1.9 2.3
2.5 2.5 2.6 2.7 2.9 3.1 3.23.3 3.5 3.5 3.8 3.9 4.0 4.1 4.2 4.3 4.6
4.8 5.1 5.2 5.7
6.0 6.6 6.8 6.8 7.1
7.5 8.0
8.5 8.5 8.79.4
9.6 9.9
10.2 10.6 10.7 10.9
11.914.6 15.1
20.0
0 5 10 15 20 25
Malta (2001) Italy (1999) Finland (2001) Switzerland (1999)Albania (2000) Austria (2001) Greece (1999) France (1999) Spain (1999) Netherlands (2000) Belgium (1996) Israel (1998) Sweden (1999) Azerbaijan (2001) Croatia (2001) Iceland (1997) Bosnia and Herzegovina (1991) United Kingdom (2000) Slovenia (2001) Turkmenistan (1998) Germany (1999) Luxembourg (2001) Portugal (2000) Norway (1999) Ireland (2000) Tajikistan (1999) Armenia (2000) Uzbekistan (2001)Denmark (1999) Belarus (2001) Georgia (2001) TFYR Macedonia (2000) Estonia (2001) Czech Republic (2001) Russian Federation (2001) Latvia (2001) Slovakia (2000) Kazakhstan (2001) Ukraine (2000) Bulgaria (2001) Hungary (2001) Kyrgyzstan (2001) Yugoslavia (2000) Poland (2000) Lithuania (2001) Republic of Moldova (2001) Romania (2001)
Per 100 000 females
Causes of death
Deaths from cervical cancer, 25–64 years
0 50 100 150 200
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Causes of death
Deaths from external causes of injury and poisoning
250 150 80 60 40 No data Per 100 000 population
–<
–<
–<
–<
–<
Per 100 000 population, females
Per 100 000 population, males 11.710.9
11.710.19.9 15.3 11.3 13.8 14.69.17.9 15.211.712.5 14.8 13.6 13.7 13.2 15.4 16.813.6 21.4 23.617.516.4 25.1
16.8 17.9 23.717.1 17.8 24.9 29.418.5 23.7 22.1 32.7 41.7 52.649.4 61.052.1 57.356.0 82.0
28.8 30.0 35.937.539.940.1
40.3 41.543.643.944.244.645.448.0
51.6 52.052.452.9 53.1 54.455.257.1 62.9 63.068.869.569.9 70.2 70.378.286.6
87.1 91.792.392.5 94.0 94.2134.2162.2
246.3 246.8263.8264.7
270.3278.5 369.6
200 100 0 100 200 300 400 500
Netherlands (2000)Malta (2001) United Kingdom (2000)Sweden (1999)Israel (1998)Italy (1999) Azerbaijan (2001)Germany (1999)Armenia (2000)Georgia (2001)Norway (1999) Switzerland (1999) TFYR Macedonia (2000)Yugoslavia (2000)Spain (1999) Denmark (1999)Portugal (2000)Iceland (1997)Ireland (2000) Greece (1999)Austria (2001) Tajikistan (1999)France (1999) Belgium (1996)Croatia (2001)Albania (2000) Luxembourg (2001) Bulgaria (2001) Czech Republic (2001)Uzbekistan (2001)Slovakia (2000) Slovenia (2001)Finland (2001) Turkmenistan (1998)Romania (2001)Poland (2000) Hungary (2001) Kyrgyzstan (2001) Republic of Moldova (2001)Latvia (2001) Ukraine (2000) Kazakhstan (2001)Lithuania (2001)Estonia (2001) Belarus (2001) Russian Federation (2001)
19.2
Causes of death
Deaths from external causes
of injury and poisoning, 0–64 years
2.14 3.82
3.99 4.33
4.63 5.37 5.37 5.57 5.67 6.47 6.64 6.75 7.31
7.77 8.45 8.47 8.93
9.19 9.22 9.34 9.72
10.67 10.96 11.48 11.64 12.14 12.39 12.47 12.96 12.99 13.31 13.49 13.51 13.75 13.92 14.18
14.7515.67 17.62
19.71 21.52
23.48
0 5 10 15 20 25 30
Albania (2000) Tajikistan (1999) Georgia (2001) Malta (2001) Iceland (1997) Sweden (1999) TFYR Macedonia (2000) United Kingdom (2000) Armenia (2000) Azerbaijan (2000) Netherlands (2000) Switzerland (1999) Yugoslavia (2000) Norway (1999) Finland (2001) San Marino (2000) Turkmenistan (1998) Germany (1999) Uzbekistan (2001) Denmark (1999) Israel (1998) Ireland (2000) Austria (2001) Bulgaria (2001) Ukraine (2000) Kazakhstan (2001) Czech Republic (2001) Italy (1999) Kyrgyzstan (2001) Hungary (2001) Portugal (2000) Slovakia (2000)France (1999) Romania (2001) Estonia (2001) Croatia (2001) Slovenia (2001) Belgium (1996) Spain (1999) Belarus (2001) Poland (2000) Luxembourg (2001) Greece (1999) Russian Federation (1998) Lithuania (2001) Latvia (2001)
Per 100 000 population Republic of Moldova (2001)
19.30
14.20
12.30
9.70
5.50
Causes of death
Deaths from motor vehicle traffic accidents
10 15 20 25
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
10 15 20 25 30 35
1980 1985 1990 1995 2000
Year
Per 100 000 population
CIS CSEC EU
Deaths from suicide
Causes of death
Deaths from motor vehicle traffic accidents
1.8 2.1 2.33.33.6
4.4 4.4 4.5 5.9 6.0 7.0 7.0 7.4 7.6 8.99.2
9.9 10.911.9
11.9 12.1 12.7
13.0 13.2 13.313.4 14.2 14.3 14.4 14.8 15.116.0
16.1 16.3 16.3 17.8
18.3 18.322.026.5
26.6 28.1 28.2 28.6
32.432.6 37.9
43.7
0 10 20 30 40 50
Armenia (2000) Georgia (2001) Albania (2000) Greece (1999) San Marino (2000) Azerbaijan (2001) Portugal (2000) Tajikistan (1999) Israel (1998) Italy (1999) Spain (1999) United Kingdom (2000) Malta (2001) TFYR Macedonia (2000)Netherlands (2000)Uzbekistan (2001) Bosnia and Herzegovina (1991) Turkmenistan (1998) Germany (1999) Romania (2001) Ireland (2000) Sweden (1999) Norway (1999) Iceland (1997) Denmark (1999) Slovakia (2000) Kyrgyzstan (2001)Bulgaria (2001) Czech Republic (2001) Poland (2000) Yugoslavia (2000) Luxembourg (2001) France (1999) Austria (2001) Switzerland (1999) Croatia (2001) Belgium (1996) Republic of Moldova (2001)Finland (2001) Slovenia (2001) Hungary (2001)Estonia (2001) Ukraine (2000) Latvia (2001) Belarus (2001) Kazakhstan (2001) Russian Federation (2001) Lithuania (2001)
Per 100 000 population
