Self-perceived health statistics


Data extracted in November 2019

Planned update of the article: December 2020

Highlights

More than two out of three people in the EU perceived their health as very good or good in 2018.

Self-perceived gender health gap in the EU: men tended to rate their health better than women in 2018.

More than one out of three people in the EU aged 16 years or over reported having a long-standing illness or health problem in 2018.

Infographic: Self-perceived health

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:

Statistics on self-perceived health are supplemented by information concerning bodily pain.

This article is one of a set of statistical articles concerning health status in the EU which forms part of an online publication on health statistics.

Full article

Self-perceived health

More than two out of three people in the EU-28 perceived their health as very good or good in 2018

Figure 1: Persons with very good or good self-perceived health, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_10)


In the EU-28, 68.4 % of the population aged 16 and over perceived their health as very good or good in 2018 (see Figure 1). Across the EU Member States, the share of people who perceived their health as very good or good ranged from less than 50 % in Lithuania (44.0 %), Latvia (47.0 %) and Portugal (49.3 %) to more than 75 % in Malta (75.0 % ), the Netherlands (75.7 %), Sweden (76.1 %), Greece (76.4 %), Cyprus (77.8 %) and Ireland (83.3 % - 2016 data). Among the candidate countries, North Macedonia recorded a relatively high share of persons perceiving their health as good or very good (75.4 % - 2016 data).

Self-perceived gender health gap: men tended to rate their health better than women

In 2018, men were more likely to rate their health as very good or good than women in all EU Member States (Table 1). By this measure, the largest gender health gaps (more than 9 percentage points - pp) were recorded in Romania (10.1 pp), Portugal (9.7 pp) and Latvia (9.0 pp). Across the EU-28 as a whole, the gender health gap was slightly more than 5 pp, as 71.1 % of men rated their health as very good or good compared with 65.9 % of women.

Table 1: Distribution of persons by self-perceived health status, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_10)


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 Ireland the only EU Member State that was an exception (a difference of 0.7 pp in 2017). In the EU-28 as a whole, 9.5 % of women and 7.5 % of men regarded their health as bad or very bad in 2018.

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). Similarly, the share of persons reporting that their health was fair increased up to the age group 85 and over, where a decrease of 2.5 pp was recorded compared to the age group 75–84.

Figure 2: Self-perceived health of persons by sex and age, 2018
(% share of the EU-28 persons aged 16 and over)
Source: Eurostat (hlth_silc_10)

The gender health gap concerning the share of the population reporting very good or good health was evident across all age groups; the gap received the lowest value for the age group 16–24 (1.4 pp) and generally increased with age, peaking among people aged 75–84 (8.4 pp).

Higher educated people perceived their health as better

Clear differences appear when looking at the relationship between self-perceived health and educational attainment level (see Figure 3). In the EU-28, 56.3 % of the population having completed at most lower secondary education, 70.0 % of the population having completed upper secondary or post-secondary non-tertiary education, and 80.6 % of the population having completed tertiary education perceived their health as very good or good in 2018.

Figure 3: Persons with very good or good self-perceived health, by educational attainment level, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_02)


The health gap between educational attainment levels is apparent in nearly all EU Member States, generally with the same pattern as the one observed for the EU-28 as a whole. In Latvia, the share of people reporting very good or good health was not substantially different among those having completed upper secondary and post-secondary non-tertiary education and those with 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 Portugal (40 pp), followed by Czechia (39.6 pp) and Lithuania (38.1). The smallest gap, around 12 pp, was observed in Denmark. From the candidate countries for which data are available, Serbia recorded a relatively large difference in the respective shares for persons with high and low levels of education (37.6 pp).

Health inequalities increased with income

In the EU-28, 59.4 % of the population in the first income quintile group (the 20 % of the population with the lowest income) and 68.4 % in the third quintile group perceived their health as very good or good in 2018, compared with 78.7 % in the fifth income quintile group (the 20 % of the population with the highest income)(see Figure 4).

Figure 4: Persons with very good or good health, by income, 2018 (1)
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_10)


The graph 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 being 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 one EU Member State deviated from this pattern, Greece, where the population with middle income were less likely to report very good or good health compared with the population with lower income.

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 Latvia and Estonia (45.7 pp and 42.8 pp, respectively). By contrast, relatively little difference in very good and good self-perceived health between the highest and lowest income groups was observed in Italy and Greece (7.1 pp each).

Bodily pain

The second wave of the European health interview survey (EHIS), conducted between 2013 and 2015, surveyed persons aged 15 and over and included questions asking respondents about their health status; which among others, recorded the intensity of bodily (physical) pain that respondents experienced – on average – during the four weeks prior to the interview.


Table 2: Distribution of persons according to self-declared severity of bodily pain, by sex, 2014
(% share of the persons aged 15 and over)
Source: Eurostat (hlth_ehis_pn1e)


In all countries, except for Germany, France, Luxembourg, the Netherlands, Slovenia, Finland as well as Iceland (see Table 2), more than two fifths of all respondents reported no bodily pain. This share was around three fifths of the reference population in just two Member States, namely, Greece and Italy, and peaked at 69.3 % in Cyprus. The share of the population reporting moderate, severe or very severe bodily pain was highest in Poland and Slovenia (between 31 % and 32 %), while it was lowest in Latvia and Malta (just over 13.5 % and 14 %, respectively). Focusing just on severe and very severe bodily pain, Portugal reported the highest share (15.3 %), followed by Poland, Estonia, the Netherlands and Belgium, as well as Iceland, with shares ranging from 10 % to 12 %. Turkey also recorded a relatively high share of severe or very severe bodily pain among the reference population (14.3 %). By far the lowest shares were reported in Latvia, Czechia, Romania, Ireland and Bulgaria (around 5 %), 17 Member States reporting shares between 7 % and 9 %.

Women were more likely than men to report experiencing bodily pain

An analysis by sex indicates that a higher proportion of men than women reported experiencing no bodily pain, with the differences between the sexes ranging between 7 and 15 pp, with Portugal (18.6 pp), Spain (16.7 pp) above this range and France and Ireland (both close to 5 pp) below it. Turkey also recorded a high difference in the respective proportions between the sexes (a difference of 19.3 pp).

Table 3: Distribution of persons declaring moderate, severe or very severe bodily pain, by sex and age, 2014
(% share of the persons aged 15 and over)
Source: Eurostat (hlth_ehis_pn1e)


Table 3 focuses on the share of the population aged 15 and over that reported moderate, severe or very severe bodily pain. For these levels of bodily pain, the gender gap varied from 4.5 pp in Czechia to 13 pp in Lithuania and Spain, with Portugal again above this range (a difference of 17 pp). Similarly, in Turkey the respective gender gap exceeded 17 pp.

Age is another important factor, with the proportion of older people reporting at least moderate bodily pain many times higher than the proportion of younger people (Table 3). For example, this was especially the case in Romania, where 1.6 % of those in the age group 15–24 reported at least moderate physical pain, compared with 66.8 % among the age group 75 and over.

Figure 5: Distribution of persons declaring moderate, severe or very severe bodily pain, by educational attainment level, 2014
(% share of the persons aged 15 and over)
Source: Eurostat (hlth_ehis_pn1e)


Equally, educational attainment levels play a role, with the lowest likelihood of reporting at least moderate bodily pain among people having completed tertiary education and the highest among those having completed at most lower secondary education (see Figure 5). Finland was the only EU Member State to display a slightly different pattern, as the proportion of people reporting at least moderate bodily pain was higher among those having completed upper secondary or post-secondary non-tertiary education than those having completed at most lower secondary education. Slovenia, Hungary, Croatia, Slovakia, Portugal and Romania reported relatively large differences in the share of people declaring at least moderate bodily pain according to their level of educational attainment.

Chronic morbidity

More than one out of three people in the EU aged 16 years or over reported having a long-standing illness or health problem in 2018

Table 4: Persons with or without long-standing (chronic) health problems, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_11)


In 2018, 36.1% of the EU-28 population aged 16 and over reported having a long-standing illness or health problem; this share has slightly increased over time. Among the EU Member States, the lowest prevalence of such problems was observed in Greece (23.4 %), Bulgaria (23.3 %), Romania (19.5 %) and Italy (15.4 %), while most Member States reported shares ranging between 30.0 % and 40.0 %, although Denmark (29.7 %), Ireland (27.7 % - 2017 data), Luxembourg (26.0 %) and Belgium (24.8 %) were below this range, whereas Estonia (48.4 %), Finland (48.3 %), Germany (43.8 %) and Portugal (41.5 %) were above this range (see Table 4).

Men were less likely to have reported long-standing health problems than women

Figure 6: Persons with or without long-standing (chronic) health problems, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_11)


Similar to self-perceived health, men reported long-standing illnesses or health problems less often than women: in 2018, the EU-28 share for men was 34.2 % while the respective share for women reached 38.0 % (see Figure 6). Among the EU Member States, the largest gender gaps for this indicator were observed in Finland, Latvia and Lithuania (8 pp or more); Iceland (2016 data) and Turkey (2017 data) from the candidate countries also reported large gaps (10 pp or more). By contrast, the narrowest gaps were in France and Malta ( 2.0 pp each), while in Ireland (2017 data) the respective share of men was higher than that for women by 0.8 pp.

Figure 7: Persons with long-standing (chronic) health problems, EU-28, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_11)


A major factor in the prevalence of long-standing illnesses or health problems was age: while 29.4 % of the population in the EU-28 aged 16–24 reported a chronic health problem in 2018, the share rose to 66.0 % for the age group 75–84 and to 72.5 % among people aged 85 and over (see Figure 7).

Employed persons were less likely to have reported long-standing health problems than unemployed persons

Figure 8: Persons with long-standing (chronic) health problems, by labour status, 2018
(% share of the persons aged 16 and over)
Source: Eurostat (hlth_silc_04)


Looking at the reference population (persons aged 16 and over), there is also a relationship between working status and the prevalence of long-standing illnesses and health problems (see Figure 8). Whereas 26.8 % of employed persons in this age range in the EU-28 reported such problems in 2018, the share rose to 44.2 % for unemployed persons.

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 57.1% for the unemployed and 23.1% for employed persons resulting in a difference of 34 pp. Other Member States where the difference exceeded 20 pp included Germany (33.9 pp), Czechia (30.5 pp - unreliable data), Austria (24.4 pp), Sweden (23.8 pp) and Slovenia (21.2 pp). Iceland also reported a relatively large difference (21.3 pp - 2016 data) in the shares of employed and unemployed persons reporting long-standing illnesses and health problems. The lowest differences (4 pp or less) in the prevalence of long-standing illnesses and health problems between employed and unemployed persons were reported in Greece, Bulgaria, Italy and Romania.

Source data for tables and graphs

Data sources

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.

Bodily pain

The data concerning bodily pain 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 and over living in private households. The second wave of the EHIS was conducted in all EU Member States during 2013–2015 according to European Commission Regulation 141/2013 and its subsequent amendment to take account of the accession of Croatia to the EU (European Commission Regulation 68/2014). The data presented here are the results for individual EU Member States from this second wave of the survey.

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 the 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.

Context

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:

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Health status (hlth_state)
Self-perceived health and well-being (hlth_sph)
Self-reported chronic morbidity (hlth_srcm)

Methodology