Statistics Explained

Self-perceived health statistics


Data extracted in: November 2022.

Planned article update: December 2023.

Highlights

More than two-thirds (69.0 %) of people in the EU perceived their health as very good or good in 2021.

Self-perceived gender health gap in the EU in 2021: males tended to rate their health better than females.

More than one-third (35.2 %) of people in the EU reported having a long-standing (chronic) health problem in 2021.

This article presents an overview of the self-reported health status of the population of the European Union (EU). The data on self-perceived health come from EU statistics on income and living conditions (EU-SILC) which relate to the 2021 reference year and cover persons aged 16 years and over. These data focus on two key indicators describing the levels and distribution of health status:

Statistics on self-perceived health are supplemented by information concerning bodily pain. The data on bodily pain come from the European health interview survey (EHIS) which relate to the 2019 reference year and cover persons aged 15 years and over.

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.

Self-perceived health among people aged 16 years and over, 2021
(%)
Source: Eurostat (hlth_silc_10) and (hlth_silc_02)

Full article

Self-perceived health

More than two-thirds of people in the EU perceived their health as very good or good in 2021

Figure 1: Share of persons aged 16 years and over with very good or good self-perceived health, 2021
(%)
Source: Eurostat (hlth_silc_10)

In the EU, 69.0 % of the population aged 16 years and over perceived their health as very good or good in 2021 – 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 half in Lithuania (47.9 %) and Latvia (49.8 %) to more than three quarters in Belgium (76.4 %), Luxembourg (76.5 %), Cyprus (77.2 %), Greece (78.3 %) and Ireland (81.2 %). Among the non-EU member countries for which data are presented in Figure 1, Switzerland (2020 data), Albania (2020 data), Kosovo* (2018 data), Iceland (2018 data) and North Macedonia (2020 data) also recorded shares above three quarters.

Self-perceived gender health gap: males tended to rate their health better than females

In 2021, the gender health gap in the EU was 5.0 percentage points (pp), as 71.6 % of males rated their health as very good or good compared with 66.6 % of females. Males were more likely than females to rate their health as very good or good in nearly all of the EU Member States – see Table 1. The largest gender health gaps in percentage point terms were recorded in Latvia (8.5 pp) and Romania (8.4 pp). The only exception was in Ireland, where the gap was 0.4 pp with a higher share for females rather than males.

Table 1: Distribution of persons aged 16 years and over by self-perceived health status, 2021
(%)
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. In the EU, 9.6 % of females and 7.8 % of males regarded their health as bad or very bad in 2021.

Negative perception of health increased with age, as did 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 generally increased with age: for females, there was a small decrease in the share reporting that their health was fair between the age groups 75–84 years and 85 years and over.

Figure 2: Distribution of persons aged 16 years and over by self-perceived health, by sex and age, EU, 2021
(%)
Source: Eurostat (hlth_silc_10)

In the EU, the gender health gap concerning the share of the population reporting very good or good health was observed for all age groups. In 2021, the gap was lowest for the age groups 16–24 and 25–34 years (0.7 and 0.5 pp, respectively). It ranged between 2.6 and 3.0 pp for the 10-year age groups from 35–44 years through to 65–74 years and was then notably higher for the two oldest age groups: a 6.3 pp gap for people aged 75–84 years and a 5.0 pp gap for people aged 85 years and over.

People with a higher level of educational attainment perceived their health as better …

Clear differences appear when looking at the relationship between self-perceived health and educational attainment level in 2021 – see Figure 3. In the EU, the shares of people aged 16 years and over perceiving their health as very good or good were:

  • 56.1 % for people having completed, at most, lower secondary education;
  • 70.1 % for people having completed upper secondary or post-secondary non-tertiary education;
  • 81.5 % for people having completed tertiary education.
Figure 3: Share of persons aged 16 years and over with very good or good self-perceived health, by educational attainment level, 2021
(%)
Source: Eurostat (hlth_silc_02)

A health gap between educational attainment levels is apparent in nearly all EU Member States, nearly always with the same pattern as the one observed for the EU as a whole. The only exception was Latvia, where the share of people reporting very good or good health in 2021 was slightly lower for people having completed upper secondary and post-secondary non-tertiary education than for people having completed, at most, lower secondary education.

In 2021, the largest gaps in the share of the population aged 16 years and over reporting very good or good health between those with the highest and the lowest educational attainment levels were observed in Croatia (45.8 pp), Portugal (42.0 pp) and Cyprus (38.9 pp). The smallest gaps, 17.5 pp and 13.7 pp, respectively, were observed in Latvia and Sweden. Among the non-EU member countries for which data are presented in Figure 3, a relatively wide gap in the respective shares for persons with high and low levels of education was observed in Serbia (2020 data) and relatively narrow gaps in Norway and Switzerland (both 2020 data).

… as did people with a higher level of income

In the EU, 59.7 % of the population in the first income quintile (the 20 % of the population with the lowest income) perceived their health as very good or good in 2021. This can be compared with 62.4 % for the second quintile, 68.2 % for the third (middle) quintile, 74.1 % for the fourth quintile and 80.2 % for the fifth (highest) income quintile (the 20 % of the population with the highest income). For reasons of readability, Figure 4 shows these shares for the lowest, middle and highest quintiles only.

Figure 4: Share of persons aged 16 years and over with very good or good self-perceived health, by income, 2021
(%)
Source: Eurostat (hlth_silc_10)

In 2021, 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, the highest shares for the fifth income quintile, and shares for the third income quintile between these two. Three EU Member States deviated from this pattern:

  • in Greece and Italy, people in the middle income quintile were slightly less likely to report very good or good health compared with people in the lowest income quintile;
  • in Luxembourg, people in the middle income quintile were slightly more likely to report very good or good health compared with people in the highest income quintile.

The largest differences in the shares of the population reporting very good or good health between the populations in the highest and lowest income quintiles were observed in the Baltic Member States: in 2021, the differences were 41.4 pp in Estonia and Lithuania and 40.1 points in Latvia. The income health gap was also relatively wide in Croatia (38.0 pp). By contrast, relatively little difference was observed between the highest and lowest income groups in Italy (7.1 pp), Luxembourg (6.3 pp) and Greece (6.0 pp).

Bodily pain

The third wave of the European health interview survey (EHIS), conducted for the 2019 reference year, surveyed persons aged 15 years and over. It included questions asking respondents about their health status which, among other subjects, 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 aged 15 years and over according to self-declared severity of bodily pain, by sex, 2019
(%)
Source: Eurostat (hlth_ehis_pn1e)

In 2019, close to half (47.3 %) of people aged 15 years and over in the EU reported no bodily pain – see Table 2. The highest shares of people reporting no bodily pain were in Cyprus (65.7 %) and Greece (63.5 %), while the lowest shares were in Finland (30.1 %) and Sweden (25.0 %).

In the EU, the share of people reporting no bodily pain in 2019 was above half (52.5 %) among males compared with just over two-fifths (42.4 %) for females. In all EU Member States, males were more likely than females to report no bodily pain. This gap was narrowest in Ireland (4.2 pp difference) and widest in Spain (14.9 pp).

The share of the population reporting moderate, severe or very severe bodily pain was 24.6 % in the EU in 2019. This share was highest in Estonia (35.3 %), while it was lowest in Malta (11.7 %). Focusing just on severe or very severe bodily pain, Portugal reported the highest share (14.4 %), followed by Estonia (13.6 %) and Austria (12.5 %). Shares below 5.0 % were recorded for Malta, Czechia, Romania and Bulgaria.

Table 3: Share of persons aged 15 years and over declaring moderate, severe or very severe bodily pain, by sex and age, 2019
(%)
Source: Eurostat (hlth_ehis_pn1e)

Women were more likely than men to report experiencing bodily pain

Table 3 focuses on the share of the population aged 15 years and over that reported moderate, severe or very severe bodily pain. In the EU, the share of people reporting these levels of bodily pain in 2019 was one-fifth (19.9 %) among males compared with nearly three-tenths (29.0 %) among females. In all EU Member States, males were less likely than females to report moderate, severe or very severe bodily pain. The gap was narrowest in Czechia (3.8 pp difference) and widest in Portugal (13.9 pp), with a wider gap (17.2 pp) observed in Türkiye. Focusing just on severe or very severe bodily pain, the shares were again lower for males than for females in all EU Member States.

Age is another important factor, with the proportion of older people in the EU reporting at least moderate bodily pain in 2019 several times higher than the proportion of younger people – see Table 3. In the EU, the share ranged from 11.0 % for people aged 15–24 years to 3.9 times as high (43.2 %) for people aged 75 years of over.

  • This age gradient was steepest in Romania, where 0.7 % of people aged 15–24 years reported at least moderate physical pain, compared with 70.1 % among people aged 75 years and over.
  • The shallowest age gradient among the EU Member States was in Estonia, as 24.3 % of people aged 15–24 years reported at least moderate physical pain, compared with 44.7 % among people aged 75 years and over.
Figure 5: Share of persons aged 15 years and over declaring moderate, severe or very severe bodily pain, by educational attainment level, 2019
(%)
Source: Eurostat (hlth_ehis_pn1e)

Educational attainment levels also play a role in relation to the proportion of persons aged 15 years and over declaring some form of bodily pain. In the EU in 2019, the lowest likelihood of reporting at least moderate bodily pain was recorded among people having completed tertiary education (18.3 %) and the highest among people having completed, at most, lower secondary education (30.6 %) – see Figure 5. Four EU Member States displayed slightly different patterns:

  • in Denmark, Estonia and Finland, the proportion of people reporting at least moderate bodily pain was higher among people having completed upper secondary or post-secondary non-tertiary education than among people having completed, at most, lower secondary education;
  • Portugal was the only Member State where people having completed tertiary education were not the least likely to report at least moderate bodily pain, as the share was somewhat lower for people having completed upper secondary or post-secondary non-tertiary education.

In 2019, relatively large differences in the share of people declaring at least moderate bodily pain according to their level of educational attainment were observed in Croatia (27.2 pp), Romania (23.7 pp) and Slovakia (22.1 pp). The narrowest gap was in Estonia (2.5 pp).

Chronic morbidity: long-standing illnesses or health problems

In 2021, more than one-third of people in the EU reported having a long-standing illness or health problem

In 2021, 35.2% of the EU population aged 16 years and over reported having a long-standing illness or health problem.

Table 4: Share of persons aged 16 years and over with or without a long-standing illness or health problem, 2021
(%)
Source: Eurostat (hlth_silc_11)

Among the EU Member States, the lowest shares of the population with such problems were observed in Italy (18.6 %) and Romania (19.9 %). Lower shares were observed in Montenegro (17.6 %, 2020 data), North Macedonia (17.3 %, 2020 data) and Kosovo (10.6 %, 2018 data). Most Member States reported shares ranging between 24.0 % and 43.9 %, higher shares were observed in Estonia (47.3 %) and Finland (51.0 %) – see Table 4.

A long-standing illness or health problem was less common among males than females

Similar to self-perceived health, a lower share of males than females reported a long-standing illnesses or health problem: in 2021, the share for males in the EU was 32.9 % while the corresponding share for females was 4.5 pp higher at 37.4 % – see Figure 6.

Figure 6: Share of persons aged 16 years and over with a long-standing illness or health problem, 2021
(%)
Source: Eurostat (hlth_silc_11)

In all EU Member States, a lower share of males than females reported a long-standing illnesses or health problem in 2021. The widest gender gaps for this indicator were observed in Romania (7.8 pp), Finland (8.2 pp), Hungary (8.4 pp) and Latvia (9.7 pp). Wider gaps were observed in Türkiye (10.0 pp, 2020 data) and Iceland (11.4 pp, 2018 data). The narrowest gaps among the Member States were in Slovenia (0.5 pp) and Ireland (0.1 pp).

Figure 7: Persons aged 16 years and over with a long-standing illness or health problem, by sex and age, EU, 2021
(%)
Source: Eurostat (hlth_silc_11)

A major factor in the prevalence of long-standing illnesses or health problems is age. More than one quarter (27.7 %) of people in the EU aged 16–24 years reported a long-standing illness or health problem in 2021, with this share notably lower among people aged 25–34 years, at just under one-fifth (19.1 %). From this age group upwards, there was a fairly regular age gradient, with the prevalence of long-standing illnesses or health problems peaking at close to three quarters (74.0 %) among people aged 85 years and over – see Figure 7.

A smaller share of employed persons reported a long-standing illness or health problem than did unemployed persons

There is also a relationship between working status and the share of people with a long-standing illness or health problem – see Figure 8. Whereas one quarter (25.0 %) of employed persons in the EU reported such problems in 2021, the share was closer to two-fifths (37.5 %) for unemployed persons.

Figure 8: Share of persons aged 16 years and over with a long-standing illness or health problem, by working status, 2021
(%)
Source: Eurostat (hlth_silc_04)

All of the EU Member States reported the same overall pattern as described for the EU, with a lower share of persons reporting a long-standing illness or health problem among employed persons than among unemployed persons in 2021. In percentage point terms, the largest difference was reported for Germany (2019 data), as the share for employed persons was 33.9 %, which was 36.2 pp lower than the share for unemployed persons (70.1 %). The next largest differences were 30.9 pp in the Netherlands and 26.3 pp in Austria. The smallest differences were reported in Greece (1.9 pp), Bulgaria (1.1 pp) and Italy (0.7 pp).

Among the non-EU member countries shown in Figure 8, Norway also reported a relatively large difference (32.7 pp, 2020 data). Türkiye was the only non-EU member country for which data are available to have a higher share of persons reporting a long-standing illness or health problem among employed persons than among unemployed persons, with a difference of 6.1 pp (2020 data).

Source data for tables and graphs

Data sources

Self-perceived health and long-standing illnesses or health problems

The data used in this article concerning self-perceived health and long-standing illnesses or health problems are derived from EU statistics on income and living conditions (EU-SILC). This source provides annual data for the EU Member States as well as most EFTA and enlargement countries on income, poverty, social exclusion and other aspects of living conditions.

The reference population for EU-SILC is limited to private households and their current members residing in the territory of the surveying country at the time of data collection. People living in collective households and institutions are generally excluded from the reference population. All household members are surveyed, but only those aged 16 years and over are interviewed.

The 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.

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 years and over living in private households. The third wave of the EHIS was conducted for the 2019 reference year.

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 analyses 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 the share of the population with 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, despite substantial and continuous efforts for harmonisation, the implementation of EU-SILC and EHIS is 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 Organization 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 and the EU4Health programme 2021–2027 – a vision for a healthier European Union.

Health status monitoring is also important for more topical policies such as active and healthy living in the digital world, 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:

Notes

* This designation is without prejudice to positions on status and is in line with UNSCR 1244/1999 and the ICJ Opinion on the Kosovo Declaration of Independence.

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Health status (hlth_state)
Self-perceived health and well-being (hlth_sph)
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