Self-perceived health statistics
- Data extracted in April 2016. Most recent data: Further Eurostat information, Main tables and Database. Planned article update: November 2017.
This article presents an overview of the self-reported health status of the population of the European Union (EU). It focuses initially on two key indicators describing the levels and distribution of health status: self-perceived health gives an overall assessment by respondents of their health in general; chronic morbidity assesses the presence of a long-standing illness or health problem. Statistics on self-perceived health are supplemented by information concerning pain and physical discomfort.
- 1 Main statistical findings
- 2 Data sources and availability
- 3 Context
- 4 See also
- 5 Further Eurostat information
- 6 External links
Main statistical findings
Two out of three people perceived their health as very good or good
In the EU-28, 67 % of the population aged 16 and over perceived their health as very good or good in 2014, while 23 % perceived it as fair and 10 % as bad or very bad. Across the EU Member States, the share of people who perceived their health as very good or good ranged from 58 % in Hungary to 78 % in Cyprus, with Estonia (52 %), Portugal (46 %), Latvia (46 %) and Lithuania (45 %) below this range and Sweden (80 %) and Ireland (82 %) above it; Switzerland (79 %) also reported a high share (see Figure 1).
Self-perceived gender health gap: men tended to rate their health better than women
In 2014, men were more likely to rate their health as very good or good than women were in all EU Member States. By this measure, the largest gender health gaps were in Lithuania, Romania, Portugal, Latvia and Slovakia. Across the EU-28 as a whole, the gender health gap was 5 percentage points, as 70 % of men rated their health as very good or good compared with 65 % of women.
Conversely, when focusing on the population that rated their health as bad or very bad, the shares for women were generally higher than those for men, with the United Kingdom the only EU Member State that was an exception. In the EU-28 as a whole, 11 % of women and 9 % of men regarded their health as bad or very bad in 2014.
Negative perception of health increased with age as does the gender health gap
Self-perceived health also has a distinct age pattern as fewer people tended to rate their health as being very good or good in higher age groups than in lower age groups, while the share reporting bad or very bad health increased with age (see Figure 2), as did the share reporting that their health was fair.
The gender health gap concerning the share of the population reporting very good or good health could be observed in all age groups: the gap was lowest for the age group 16–24 (1 percentage point higher for women) and generally increased with age, to peak among people aged 75 to 84 (8 percentage points).
Higher educated people perceived their health as better
Clear differences appear when looking at the relationship between self-perceived health and educational attainment level. In the EU-28, 54 % of the population having completed at most lower secondary education, 70 % of the population having completed upper secondary or post-secondary non-tertiary education, and 81 % of the population having completed tertiary education perceived their health as very good or good in 2014. The health gap between educational attainment levels is apparent in nearly all EU Member States, generally with the same pattern as observed for the EU-28 as a whole. The one exception was Malta, where the share of people reporting very good or good health was not substantially different among those having completed tertiary education and those with at most upper secondary or post-secondary non-tertiary education.
The largest gap in the share of the population reporting very good or good health between those with the highest and the lowest educational attainment levels was observed in Croatia (41 percentage points), followed by Portugal and Poland (both 40 percentage points). The smallest gap, 17 percentage points, was observed in Denmark and Germany (see Figure 3).
Health inequalities increased with income
In the EU-28, 61 % of the population in the first income quintile group (the 20 % of the population with the lowest income) as well as the one in the second quintile group perceived their health as very good or good in 2014, compared with 66 % in the third quintile group, 72 % in the fourth quintile group and 78 % in the fifth income quintile group (the 20 % of the population with the highest income).
Figure 4 shows the share of the population that reported very good or good health for three of the income quintile groups, specifically the highest, middle and lowest quintiles. Nearly all EU Member States showed a similar pattern, with the lowest shares of people who perceived their health as very good or good recorded for the first income quintile group, the highest shares for the fifth income quintile group, and shares for the third income quintile group between these two. Only four EU Member States deviated from this pattern, Greece, Spain, Romania and Hungary, where the population with middle income were less likely to report very good or good health compared with the population with lower income; this was also the case in Montenegro.
By far the largest difference in the share of the population reporting very good or good health between the populations in the highest and lowest income quintiles was observed in Estonia (42 percentage points), followed by Latvia (33 percentage points). By contrast, relatively little difference in very good and good self-perceived health was observed between the various income groups in Romania, as was also the case in the former Yugoslav Republic of Macedonia.
Pain and physical discomfort
The European health interview survey (EHIS) conducted between 2006 and 2010 surveyed persons aged 15 and over and included questions asking respondents about their health status; one question asked how much physical pain or physical discomfort respondents experienced in the four weeks prior to the interview. In all of the participating EU Member States (see Table 2), more than two fifths of all respondents reported no pain or discomfort. This share exceeded one half in a small majority of these Member States, was around three fifths in Bulgaria, the Czech Republic and Spain, and peaked at 63 % in Cyprus. The share of the population reporting moderate, severe or very severe physical pain or discomfort was highest in Poland and Slovenia (between 32 % and 33 %), while it was lowest in the Czech Republic and Malta (just over 17 %). Focusing just on severe and very severe pain or physical discomfort, Slovenia reported the highest share (12 %), followed by Poland, Spain and Greece with shares around 10 %. By far the lowest share was reported in Romania (4 %), with several Member States reporting shares around 6 %.
Women were more likely than men to report experiencing physical pain or discomfort
An analysis by sex indicates that a higher proportion of men than women reported experiencing no physical pain or discomfort, with the differences between the sexes ranging between 10 and 13 percentage points, with Spain, Greece (both 16 percentage points) and Slovenia (15 percentage points) above this range and Estonia (9 percentage points) below it.
Table 3 focuses on the share of the population aged 15 and over that reported at least moderate physical pain or discomfort, including therefore persons reporting moderate, severe or very severe physical pain or discomfort. For these levels of physical pain or discomfort the gender gap was somewhat narrower, ranging from 8 percentage points in Romania and Hungary to 10 percentage points in Malta and Cyprus, with Spain, Greece and Slovenia again above this range.
Age is another important factor, with the proportion of older people reporting at least moderate physical pain or discomfort many times higher than the proportion of younger people. For example, this can be seen clearly in the data for Bulgaria, where 4 % of those in the age group 15–24 reported at least moderate physical pain or discomfort, compared with 64 % among the age group 85 and over.
Equally, education attainment levels play a role, with the lowest likelihood of reporting at least moderate physical pain or discomfort among people having completed tertiary education and the highest among those having completed at most lower secondary education (see Figure 5). Greece was the only EU Member State to display a slightly different pattern, as the proportion of people reporting at least moderate physical pain or discomfort was similar among those having completed tertiary education and those having completed at most upper secondary or post-secondary non-tertiary education. Slovenia, Romania, Slovakia and Poland reported particularly large differences in the share of people declaring at least moderate physical pain or physical discomfort according to their level of educational attainment.
One out of three people in the EU aged 16 years or over reported a long-standing illness or health problem in 2014
In 2014, 33 % of the EU-28 population aged 16 and over reported a long-standing illness or health problem; this share has remained quite stable over time. Among the EU Member States, the lowest prevalence of such problems was observed in Romania (19 %) and Bulgaria (21 %), while most Member States reported shares between 24 % and 40 %, although Estonia and Finland (46 %) were above this range (see Table 4).
Men were less likely to have reported long-standing health problems than women
Similar to self-perceived health, men reported long-standing illnesses or health problems less often than women: in 2014, the EU-28 share for men was 30 % while that for women reached 35 % (see Figure 6). Among the EU Member States, the biggest gender gaps for this indicator were observed in Latvia and Portugal (9 percentage points) and Slovakia (8 percentage points); Norway and Serbia also reported large gaps (10, respectively 9 percentage points). By contrast, the narrowest gaps were in the United Kingdom, Germany (2 percentage points) while in Cyprus there was no gap.
A major factor in the prevalence of long-standing illnesses or health problems was age: while only 11 % of the population in the EU-28 aged 16–24 reported a chronic health problem in 2014, the share rose to 54 % for the age group 65–74 and to 72 % among people aged 85 and over (see Figure 7).
Employed persons were less likely to have reported long-standing health problems than unemployed persons
Looking at the working-age population (persons aged 16–64), there is also a relationship between working status and the prevalence of long-standing illnesses and health problems (see Figure 8). Whereas 21 % of employed persons in this age range in the EU-28 reported such problems in 2014, the share rose to 28 % for unemployed persons. The differences in self-reported long-standing illnesses or health problems between employed and unemployed persons were higher among the older working-age population: for persons aged 16–44 the prevalence of long-standing illnesses and health problems among unemployed persons was 4 percentage points higher than for employed persons, while for persons aged 45–64 the difference was 13 percentage points.
All of the Member States reported the same broad pattern for the working-age population as described for the EU-28, with a lower share of persons reporting long-standing illnesses and health problems among employed persons than among unemployed persons. In percentage point terms, the largest difference was reported for the Netherlands, the shares of 57 % for the unemployed and 25 % for employed persons resulting in a difference of 32 percentage points. Other Member States where the difference exceeded 20 percentage points included Austria, Germany and Denmark. The lowest differences (2 percentage points or less) in the prevalence of long-standing illnesses and health problems between employed and unemployed persons were reported in Cyprus, Greece and Italy. Among the non-member countries included in Figure 8, Iceland reported a relatively large difference (19 percentage points) in the shares of employed and unemployed persons reporting long-standing illnesses and health problems, while Montenegro and Serbia (2 percentage points) reported a small difference.
Data sources and availability
Self-perceived health and chronic morbidity
The data used in the article concerning self-perceived health and chronic morbidity are derived from EU statistics on income and living conditions (EU-SILC). This source is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.
The general coverage of EU-SILC is all private households and their members (who are residents at the time of data collection); this therefore excludes people living in collective households. Data refer to the population aged 16 years or over.
Pain and physical discomfort
The data concerning pain and physical discomfort come from the European health interview survey (EHIS). This source is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.
The general coverage of the EHIS is the population aged 15 or over living in private households. However, this coverage is not uniform and some national surveys also include children in the population, use an upper age limit, or include people living in institutions like homes for the elderly.
Limitations of the data
All of the indicators presented in this article are derived from self-reported data so they are, to a certain extent, affected by respondents’ subjective perception as well as by their social and cultural background. Despite their subjective nature, the statistics that are presented are considered to be relevant and reliable estimators of the health status of populations as well as good predictors of health care needs; they are useful for trend analysis and for measuring socioeconomic disparities.
EU-SILC and the EHIS do not cover the institutionalised population, for example, people living in health and social care institutions whose health status is likely to be worse than that of the population living in private households. It is therefore likely that, to some degree, both of these data sources under-estimate health problems. Another factor that may influence the results shown is the different organisation of health care services, be that nationally or locally. Furthermore, the indicators presented are not age-standardised and thus reflect the current national age structures. Finally, the implementation of EU-SILC and EHIS was organised nationally, which may impact on the results presented, for example, due to differences in the formulation of questions or their precise coverage.
The World Health Organisation defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’, which alludes to its multidimensional nature and a range of different indicators for measuring it.
Good health is an asset in itself. It is not only of value to the individual as a major determinant of quality of life, well-being and social participation, but it also contributes to general social and economic growth. Many factors influence the health status of a population and these can be addressed by health and other policies regionally, nationally or across the EU.
Indicators on health status are given high importance in EU health policies. The monitoring of health status of populations was included in the overarching EU strategy 'Together for Health: A Strategic Approach for the EU 2008-2013' (COM(2007) 630 final) and in the more recent 'Investing in health' working document. Health status monitoring is also important for more topical policies such as active and healthy ageing, health inequalities and social protection and social inclusion.
Three general health questions on self-perceived health, chronic morbidity and long-term activity limitation (see the article on functional and activity limitations) constitute the Minimum European Health Module (MEHM). Indicators based on the three questions are included in the health status chapter of the European core health indicators (ECHI).
The health status of individuals and of the population in general is determined by a complex set of factors: genetic dispositions, individual behaviour, environmental, cultural and socioeconomic conditions, as well as by the functioning of healthcare services. Eurostat provides data on different health determinants that can help to explain the different levels and distribution of health status among the population, such as:
- healthcare services;
- accidents at work and work-related health problems;
- living conditions and welfare;
- the labour market, in particular unemployment;
- education and training.
General health statistics articles
Further Eurostat information
- Health status (hlth_state)
- Self-perceived health and well-being (hlth_sph)
- Self-reported chronic morbidity (hlth_srcm)
Methodology / Metadata
- European health interview survey (ESMS metadata file — hlth_det_esms)
- Health variables of EU-SILC (ESMS metadata file — hlth_silc_01_esms)
Source data for tables and figures (MS Excel)
- European Commission — Directorate-General for Employment, Social Affairs & Inclusion — Indicators of the health and long-term care strand developed under the open method of coordination on social protection and social inclusion
- European Commission — Directorate-General for Health and Public Safety — European Core Health Indicators (ECHI)
- European Commission — Directorate-General for Health and Public Safety — Public Health — Social determinants and health inequalities
- Regulation (EU) No 282/2014 of the European Parliament and of the Council of 11 March 2014 on the establishment of a third Programme for the Union's action in the field of health (2014-2020)
- Report on health inequalities in the European Union (SWD(2013) 328 final) — European Commission Staff Working Document