OECD has published “Health at a Glance 2009, OECD indicators”. The publication is based on OECD Health Data 2009, a database on health and health care systems in OECD countries. It comprises seven chapters discussed below. The publication includes number of diagrams and tables as well as explanatory texts.
Iceland compared with other OECD countries.
Health Status
Life expectancy at birth was 79.1 years on average in OECD countries in 2007 and had increased by over ten years since 1960. In 2007 life expectancy at birth for the total population was 81.2 years in Iceland or the fifth higest of OECD countries. Life expectancy of Icelandic men was 79.4 years just below Swiss men who were at the top. Life expectancy of women in Iceland, Norway and Austria was 81.2 years sharing 10th -12 place of OECD countries.Gender gap in life expectancy at birth was 5.6 years on average for OECD countries, narrowest in Iceland or 3.5. years.
Cardiovascular diseases are the main cause of mortality in almost all OECD countries with 36% of causes of death in 2006 (Iceland 38%). In this group fall ischemic heart disease (IHD) and stroke. Mortality rates of IHD which are much higher for men than women have decreased in almost all OECD countries since 1960 and is Iceland among 10 countries where death rates have decreased by at least 50%. In Iceland 121 men per 100.000 population (age-standardised) died in 2006 compared with 126 on average in OECD countries and 64 women compared with 66 per 100.000 in OCED countries. Mortality rates from stroke have been decreasing as well.
Cancer is the second most common cause of death in countries of OECD (27%) with a higher mortality rate of men than women. In Iceland the male mortality rate of cancer was the third lowest of OECD countries (174 per 100.000 population age-standardised) after Sweden and Mexico but 13 countries had lower female mortality rate of cancer than Iceland (124) which was close to OECD average (126).
Mortality from road accidents has decreased in Iceland by 28% since 1970 but by 58% on average in OECD countries. The rate was 8.2 per 100.000 population (age-standardised) in Iceland in 2006 compared with 9.6 in OECD on average.
In the year 2007 the rate of infant mortality was the second lowest in Iceland or 2.0 deaths of infants per 1,000 live births. At the same time the average of OECD countries was 3.9. The percentage of low birth weight infants (below 2500 grams) was lowest in Iceland or 3.8 of live births with OECD average at 6.8.
Estimated prevalence of diabetes of adults aged 20-79 is 1.6% in Iceland for the year 2010 or lowest of OECD countries where the average is estimated at 6.3%. The estimated prevalence is over 10% for United States and Mexico.
Non-medical determinants of health
The proportion of those who smoke has decreased in recent years, relatively more for men than women. In 2007 Iceland was one of seven OECD countries with daily smoking under 20%.
At the same time as the consumption of alcohol has decreased in the majority of OECD countries since 1980 it has increased by 74% in Iceland and was 7.5 litres of alcohol per inhabitant 15 years and over in 2007. OECD average was at 9.7 l..
Half or more of the adult population is considered being either overweight or obese in 13 OECD countries, Iceland included. In 2007 the proportion of obese people was lowest in Japan and Korea, 3% but highest 34% in the United States. At the same time the rate was 20% in Iceland compared with 12% in 2002 and 8% in 1990.
In the OECD publication the results from the latest Health Behaviour in School-aged Children (HBSC) survey in 2005-06 is discussed. Was Iceand included in the survey that revealed that 13-14% of 15 year old Icelandic children smoked at least once a week but the average of 24 OECD countries was 16-17%. The proportion of those who had experienced drunkenness at least twice in their lifetime was 31% for boys and 32% for girls in Iceland but 33% and 29% on average in OECD countries.
Eating at least one fruit per day is more common among girls than boys but for both the consumption decreased by higher age. The consumption fell by up to half between ages 11 and 15 in Iceland orf rom 51% to 28% for girls and 39% to 18% for boys. For OECD countries comparable proportion fell from 46% to 36% for girls and from 38% to 26% for boys.
One in every seven (13.8%) children 11–15 years old in OECD countries were considered overweight or obese but one in every five in Canada and almost one in every three in the United States where the rate was highest. In Iceland 14.5% of children were overweight or obese compared with 10% in Denmark, Norway and Sweden and 15.8% in Finland.
Health workforce
The number of practicing physicians per 1000 population was 3.7 in Iceland but 3.1 on average in OECD. It was 3.9 in Norway, 3.6 in Sweden, 3.2 in Denmark and 3.0 in Finland in 2007. The share of women of physicians has generally been increasing and in Iceland it was 29% compared with 40% on average in OECD countries. The share was highest in Slovak Republic or 57% and in Finland, 56% but lowest in Japan, 17%.
The sum of professional nurses and associate nurses was 14 per 1000 population in Iceland in 2007 or similar to the number in Denmark but it was 9.6 per 1000 population in OECD on average.
The number of dentists per 100.000 population was 61 on average in OECD countries but 94 in Iceland and only in Greece the number was higher or 127.
Health care activities
Average length of hospital stay (acute care) was 5.4 days in Iceland in 2007 compared with 6.5 in OECD on average while it was 3.5–5.0. in other Nordic countries. Average length of stay for normal delivery was 2.0 days in Iceland and New Zealand which was less than in other Nordic countries (2.3–3.4) and also less than for OECD on average (3.2).
In the year 2007 the number of coronary revascularisation procedures (angioplasty and bypass) conducted per 100.000 inhabitants in Iceland was 272 or slightly more than in OECD countries on average (267). As previous years Iceland was in 2007 one of the countries with relatively low caesarean section rate or 17 per 100 live births or similar to Finland and Norway (16) compared with 26 in OECD countries on average.
There are great variations across countries in the consumption of drugs. In 2007 the consumption of andtideabetics, was lowest in Iceland or 26 DDD (defined daily dose) per 1000 people per day compared with 52 in OECD on average. The consumption of antidepressants was on the other hand highest in Iceland or 95 DDD per 1000 people per day but 52 on average in OECD. In Iceland the consumption of anticholesterols was below OECD average while the consumption of antibiotics was the same.
Quality of care
In the OECD publication Health at a Glance 2009 there is a chapter for the second time on quality of care. On the bases of a conceptual framework a set of quality indicators have been developed that indicate quality of health care. The availablity of quality indicators for cross-national comparisons is limited and the indicators have to be used in the light of comparability limitations. The indicators that are now published cover all major health care services and most major disease areas.
In-hospital case fatalty rates within 30 days after admission for acute myocardial infarction was the lowest in Iceland of the OECD countries in 2007 and the same accounts for in-hospital case fatalty rates within 30 days after admission for ischemic stroke. The five-year relative survival rates for breast cancer (2002–2007 or nearest year available) was 88.3% in Iceland or in second place of the OECD countries where the average was 81.2% (age-standardised).
Access to care
In the OECD publication there is a comparison of 20 European countries regarding unmet needs for medical or dental examination for the last 12 months in 2007. The weight of treatment cost, waiting time or travelling distance varied by countries and income. A larger proportion of the population reported unmet needs for dental care than for medical care. Poland (7.5%), Italy (6.7%) and Iceland (6.5%) reported the highest rates in 2007. In Iceland and some other countries the rate was much higher for the low income group than the high income.
Health expenditure
In 2007, the average share of GDP that OECD countries devoted to health spending reached 8.9%. However, this share varied considerably across the OECD countries, ranging from around 5.7% in Turkey to 16.0% of GDP in the United States. In Iceland, the total expenditure on health reached 9.3% of GDP in 2007 compared with 9.1% in 2006. The Danes spent 9.8% of GDP on health in 2007, the Swedes 9.1% and the Norwegians 8.9, but Frenchmen 11.0% and the Swiss 10.8%. Measured in this way, Iceland is rated in the twelfth place of the OECD countries.
Around 82.5% of the total health expenditure in Iceland was financed by the public sector in 2007 or 7.7% of GDP. In other Nordic countries, this percentage was similar or 81.7 – 84.5% with the exception of Finland where it was 74.6% of GDP in that year. In this regard, Luxembourg ranks the highest with 90.9% financed by the public sector (in 2006) and Mexico ranks lowest with 45.2%. In 2007, the average spending on health per capita in the OECD countries was 2,984 USD PPP. The highest spending country was the United States, devoting 7,290 USD per capita to health in 2007, and Turkey was the lowest, devoting 618 USD per capita. In Iceland, the expenditure per capita was 3,319 USD in 2007, in Norway 4,763 USD, in Denmark 3,512 USD and in Sweden 3,323 USD. On this scale, Iceland was in the fourteenth place behind Germany, Denmark, Ireland, Sweden and Austria.
Public health expenditure per capita in Iceland was 2,739 USD PPP in 2007, which means that Iceland was in the tenth place of the OCED countries. Above Iceland was Norway with 4,005 USD in public spending per capita, Luxembourg with 3,782 USD (in 2006), and the United States with 3,307 USD per capita. Mexico ranked lowest, with 372 USD PPP per capita on public health expenditure.