Ensuring universal access to quality care demands greater efforts to improve the effectiveness, accessibility and resilience of health systems in all EU countries. This new edition of Health at a Glance: Europe stresses that more should be done to improve the health of populations in EU countries and, in particular, to reduce inequalities in access and quality of services. This is necessary to achieve more inclusive economic growth and to deliver on the Sustainable Development Goals (SDGs), in particular SDG 3 to ensure healthy lives and promote well-being for all at all ages.

Life expectancy across EU member states has increased by more than six years since 1990, rising from 74.2 years in 1990 to 80.9 years in 2014, yet inequalities persist both across and within countries. People in Western European countries with the highest life expectancy continue to live over eight years longer, on average, than people in Central and Eastern European countries with the lowest life expectancy. Within countries, large inequalities in health and life expectancy also persist between people with higher levels of education and income and the more disadvantaged. This is largely due to different exposure to health risks, but also to disparities in access to high-quality care.

Health at a Glance: Europe 2016 presents key indicators of health and health systems in 36 European countries, including the 28 European Union member states, five candidate countries and three European Free Trade Association countries.

This chapter looks at the labour market impacts of chronic diseases and related behavioural risk factors, including obesity, smoking, and harmful alcohol consumption. Chronic diseases lead to the premature death of more than 550 000 people aged 25 to 64 each year across EU countries, resulting in the loss of some 3.4 million potential productive life years. Chronic diseases such as cardiovascular diseases, respiratory problems, diabetes, and serious mental health problems also have important labour market impacts for people living with these conditions: reduced employment, earlier retirement, and lower income. Using the latest data from the SHARE survey (Survey of Health, Ageing and Retirement in Europe), this chapter shows that the employment rate of people aged 50-59 who have one or more chronic diseases is lower than that of people who do not suffer from any disease. The same is true for people who are obese, smokers, or heavy alcohol drinkers. The labour market impacts of mental health problems such as depression are also large: across European countries, people aged 50-59 suffering from severe depression are more than two times more likely to leave the labour market early. The burden of ill‑health on social benefit expenditures is huge: 1.7% of GDP is spent on disability and paid sick leave each year on average in EU countries, more than what is spent on unemployment benefits. Greater efforts are needed to prevent chronic diseases among the working-age population, and better integration is needed between health and labour market policies to reduce the detrimental labour market impacts of ill‑health, and thus contribute to better lives and more inclusive economies.

The demand for health care is evolving rapidly in EU countries in a context of population ageing and the growing number of people living with one or more chronic conditions. To meet the challenge of these demographic and epidemiological shifts, EU health systems need to strengthen primary care systems to provide continuous, comprehensive, and co-ordinated care for their populations.This chapter looks at the organisation and provision of primary care across EU countries. It uses a number of indicators to measure access to primary care and its effectiveness and quality, either directly through indicators such as pharmaceutical prescribing quality or indirectly through potentially avoidable hospital admissions. The chapter identifies possible policy options that countries could consider to strengthen their primary care systems, drawing lessons from the recent series of OECD Reviews of Health Care Quality and other relevant OECD work. This chapter shows that some countries, such as Denmark and the Netherlands, generally perform relatively well on several indicators related to access to and quality of primary care. All EU countries, particularly those in Central and Eastern Europe, need to pursue comprehensive reforms to strengthen their primary care system to better address the needs of ageing populations and reduce the unnecessary use of hospital care.