Life expectancy at birth remains one of the most frequently used health status indicators. Gains in life expectancy at birth in OECD countries in recent decades can be attributed to a number of factors, including rising living standards, improved lifestyle and better education, as well as greater access to quality health services. Other factors, such as better nutrition, sanitation and housing also played a role, particularly in countries with emerging economies.

Infant mortality reflects the effect of economic and social conditions of mothers and newborns, the social environment, individual lifestyles as well as the characteristics of health systems. Some countries have low levels of infant mortality and also low levels of health expenditure, suggesting that higher spending is not necessarily a precondition to improve outcomes in this area.

The intentional killing of oneself can be evidence not only of personal breakdown, but also of a deterioration of the social context in which an individual lives. Suicide may be the end-point of a number of different contributing factors. It is more likely to occur during crisis periods associated with upheavals in personal relationships, alcohol and drug abuse, unemployment, clinical depression and other forms of mental illness. Because of this, suicide is often used as a proxy indicator of the mental health status of a population.

Tobacco is responsible for about one-in-ten adult deaths worldwide, equating to about 6 million deaths each year. It is a major risk factor for at least two of the leading causes of premature mortality – circulatory disease and cancer, increasing the risk of heart attack, stroke, lung cancer, cancers of the larynx and mouth, and pancreatic cancer. It also causes peripheral vascular disease and hypertension. In addition, it is an important contributory factor for respiratory diseases such as chronic obstructive pulmonary disease (COPD), while smoking among pregnant women can lead to low birth weight and illnesses among infants. It remains the largest avoidable risk to health in OECD countries.

The health burden related to excessive alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world. High alcohol intake is associated with numerous harmful health and social consequences, such as increased risk of heart, stroke and vascular diseases, as well as liver cirrhosis and certain cancers. Foetal exposure to alcohol increases the risk of birth defects and intellectual impairments. Alcohol also contributes to death and disability through accidents injuries, assault, violence, homicide and suicide. It is estimated to cause more than 2 million deaths worldwide per year. In the Russian Federation, the sharp rise in premature mortality and decline in life expectancy during the 1990s was due, in part, to excessive alcohol consumption.

The rise in overweight and obesity is a major public health concern. Obesity is a known risk factor for numerous health problems, including hypertension, high cholesterol, diabetes, cardiovascular diseases, respiratory problems (asthma), musculoskeletal diseases (arthritis) and some forms of cancer. At an individual level, several factors can lead to obesity, including excessive calorie consumption, lack of physical activity, genetic predisposition and disorders of the endocrine system.

Access to high-quality health services depends crucially on the size, skill mix, geographic distribution and productivity of the health workforce. Health workers, and in particular doctors and nurses, are the cornerstone of health systems. Many OECD countries are concerned about current or looming doctor shortages. Forecasting the future supply and demand of doctors is difficult, because of uncertainties concerning overall economic growth, changes in physician productivity, advances in medical technologies, changing roles of physicians versus other care providers, as well as changes in the health needs of the population.

Nurses are usually the most numerous health profession, greatly outnumbering physicians in most OECD countries. Nurses play a critical role in providing health care not only in traditional settings such as hospitals and long-term care institutions but increasingly in primary care (especially in offering care to the chronically ill) and in home care settings. However, there are concerns in many countries about shortages of nurses, and these concerns may well intensify in the future as the demand for nurses continues to increase and the ageing of the “baby-boom” generation precipitates a wave of retirements among nurses. These concerns have prompted actions in many countries to increase the training of new nurses combined with efforts to increase the retention of nurses in the profession.

In most OECD countries, spending on health is a large and growing share of both public and private expenditure. Health spending as a share of GDP varies widely across countries, reflecting market and social factors as well as the diverse financing and organisational structures of the health system in each country.