This month is set to be a busy one for both European sports and politics.

Euro 2016 is due to begin tomorrow, and the tournament which now includes teams from 24 nations is set to the largest ever.

And obviously, the news item which has been dominating the headlines over the past two months is the EU referendum, taking place in two week’s time.

Don’t worry: the debate as to whether our health system would benefit or be harmed by an exit is already a complex and crowded one, and it’s not one we intend to get involved in here.

However, with the subject of Europe taking over just about every mainstream headline there is, we thought it might be interesting to enter into the spirit of things with a little competition of our own.

So over the past week, the Treated.com team have been busy putting together the following: the European Championship of Health.

What did we look at?

We assessed a range of measures for each nation in continental Europe, gathering data from a range of sources including WHO, the OECD, the IHME and Indexmundi. These measures included:

  • Health expenditure per person
  • Hospital beds per capita
  • Number of physicians per capita
  • Life expectancy at birth
  • Obesity prevalence as a percentage
  • Overweight prevalence as a percentage
  • Percentage of daily smokers
  • Alcohol consumption in litres of pure alcohol per person per year (this figure is provided as an estimate by WHO on 2015 consumption, based on previous trends)
  • And urban area concentration of PM 2.5 as our air pollution measure. (This indicates the presence of air pollution particles in urban atmospheres, which may potentially be able to enter the respiratory tract and induce infections and inflammatory diseases.)

Here’s what we found:

TREATED - Euro 16 Health Winners And Losers Jun 16 Proof2 (1)

The Winners

  • Luxembourg and Monaco topped the tables on healthcare availability. Health expenditure in Luxembourg averages at $6518 per person, while Monaco has the highest number of hospital beds and physicians per person in continental Europe.
  • Monaco also topped the list for life expectancy at birth, with an impressive 89.57 average. We would speculate that the strong link between health care availability and affluence has contributed towards Monaco’s high figure.
  • Andorra had both the lowest obesity and overweight rates, which could at least be partly due to their access to rural natural produce, lifestyle and, again, relatively high affluence.
  • Sweden had the lowest score (5.9) in our air pollution measure (concentration of PM2.5 in urban areas).
  • Iceland has the lowest percentage of daily smokers at 16.1%; this is an example of an enforced indoor smoking ban being successful. Before the ban came into effect in 2007, the number of Icelandic smokers was much higher according to the OECD, at around 19-20%.
  • Turkey, a predominantly Islamic culture, had the lowest level of alcohol consumption, with 2.4 litres per year per person.

We also developed a points system taking each measure into account, awarding one point to a nation where it performed best in a single measure, two points for second place and so on.

  • The nation with the lowest points across all measures, and thereby our overall health champion, was Norway.
  • Switzerland came in at a close second, and Sweden third.

Full results are presented at the end of this article, along with a full list of data sources.

The Losers

  • Albania, one of the poorest nations on the continent, fared worst in terms of healthcare resources, with the lowest average health expenditure and physicians per capita.
  • Andorra had the fewest number of hospital beds per capita. However, in the case of Andorra, this may simply be because they don’t need them. Their very low obesity and overweight prevalence may partly be the reason behind this.
  • Ukraine had the lowest life expectancy at 69.14, a whole 20 years lower than first placed Monaco. Shorter life expectancy is a problem which has been endemic in many former Soviet countries, including Moldova, Belarus and Russia, many of which typically have high levels of alcohol consumption. However other factors, such as a high infant mortality rate, low investment in public health systems, and a high rate of infectious diseases, have been cited as contributing factors too.
  • Moldova had the highest level of alcohol consumption, around seven times higher than that of Turkey.
  • Greece was where smoking was most prolific. A whopping 42.4% of Greeks over the age of 15 smoke daily.
  • Malta was the most obese country with a 28.3% prevalence, but Iceland was the most overweight country; 67.1% of the population had a BMI of 25 or above.
  • Bosnia had the highest level of PM2.5 concentration, with a score of 56.

And overall:

  • Turkey had the lowest overall score when all measures were considered.
  • Montenegro and Russia were second and third lowest respectively.

What do the results tell us?

The link between low life expectancy and high alcohol consumption was probably the most significant we found. And this should come as no surprise. As we know, excessive alcohol use can lead to a plethora of physical (heart disease, cancer, liver disease) and mental (depression) health issues.

The link between life expectancy and level of affluence is also an obvious one. In typically richer countries, such as Monaco, Andorra and Switzerland, life expectancy was significantly higher.

In Andorra and Switzerland too, obesity and overweight prevalence was also low (BMI data for Monaco was unfortunately not available, but it would have been interesting to analyse), to an extent suggesting a link between high affluence and lower average BMI.

How did the UK do?

TREATED - Euro 16 Health Winners And Losers Jun 16 UK (4)

  • Overall, the UK came in at 26th.
  • The UK had the fourth fewest hospital beds in our study per capita, and the tenth fewest physicians.
  • The UK also had the fourth highest obesity and overweight prevalence.
  • But the UK had the third lowest daily smoking rate, which has to be considered another success for indoor smoking bans and cigarette advertising restrictions.

In summary then, while the UK has succeeded in lowering smoking prevalence, it still has ground to make up in other areas, before it can be considered the healthiest player in Europe.

In fairness, the UK does have one of the highest population densities in Europe, which is undoubtedly a factor in its comparatively sparse hospital bed and physician count.

But what the figures seemingly affirm is that tackling obesity is perhaps one of the biggest challenges our health system faces in improving the nation’s health as a whole.

Below are the full results. All figures used are from the most recent available data. Highest and lowest performers highlighted in bold. Monaco, whose obesity and overweight data figures were not available, have been excluded from the full results.

CountryHealth expenditure ($ per capita)Hospital beds per 100,000Physicians per 100,000Life expectancy at birthObesity prevalence %Overweight prevalence %Annual urban area concentration of PM2.5Daily smokers (%)Alcohol consumption (WHO estimated litres per person per year)Overall position
Norway630838643181.618.652.99.122.271
Switzerland618746840482.3917.748.212.623.210.42
Sweden424425940181.8919.352.15.920.68.73
Austria488576549980.171851.217.235.18.54
Netherlands560146632981.1214.34914.924.89.65
Italy312634239082.0318.249.818.623.86.16
France433464832281.6619.549.212.727.611.67
Denmark455230736279.0919.851.910.51710.28
Andorra333825431682.658.935.710.532.59.19
Germany481282840580.4422.256.714.530.310.610
Belgium452662329579.9220.952.61623.110.811
Spain284629738181.4720.754.41029.110.612
Iceland364631736181.2227.967.17.716.16.913
Finland360448630279.6921.756.47.120.811.914
Luxembourg651849328680.0124.951.316.623.611.215
Belarus1081110539472.1511.844.718.126.817.116
Greece251347662380.319.461.312.742.49.317
Ireland386727627880.5622.758.41022.110.918
Malta265246736680.1128.36614.5257.219
Portugal250834042679.0122.359.29.622.212.519
Albania53928912877.9610.25117.129.16.621
Bulgaria121368239874.3318.654.330.53511.322
Estonia145350132874.0722.8578.532.39.423
Slovenia259545526377.832158.819.420.210.924
Czech Republic198264636978.3119.457.920.933.114.124
United Kingdom331127628180.422561.812.519.21226
Cyprus219734232280.524.159.617.233.29.127
Lithuania157972842875.9821.860.219.529.416.228
Poland155165022176.6519.856.825.827.911.529
Ukraine68788035069.1420.558.3173011.830
Slovakia214758030076.692058.120.328.212.530
Moldova55362029870.1221.652.617.124.217.432
Latvia131058031973.4422.156.420.235.310.633
Romania98862724874.6919.455.420.429.512.934
Serbia98756531075.021853.121.541.612.935
Croatia151758630376.4119.958.320.536.411.736
Hungary183970432175.4623.460.222.928.212.437
Bosnia and Herzegovina92835018876.3318.154.65638.37.538
Russia158781823970.1622.857.117.139.114.539
Montenegro92639621574.7621.958.624.33111.540
Turkey105326617673.2927.66535.725.52.441

Sources:

http://www.euro.who.int/en/countries
http://www.indexmundi.com/g/g.aspx?c=al&v=26
http://www.numbeo.com/pollution/rankings_by_country.jsp
http://www.theguardian.com/news/datablog/2014/may/29/how-obese-is-the-uk-obesity-rates-compare-other-countries
http://apps.who.int/gho/data/node.main.152?lang=en
http://apps.who.int/gho/data/node.sdg.3-a-viz?lang=en
http://apps.who.int/gho/data/view.main.1805?lang=en
http://www.who.int/tobacco/surveillance/policy/country_profile/mco.pdf
http://www.who.int/tobacco/surveillance/policy/country_profile/mne.pdf
http://www.who.int/tobacco/surveillance/policy/country_profile/tkm.pdf
http://www.tobaccoatlas.org/country-data/cyprus/
http://apps.who.int/gho/data/node.sdg.3-5-viz?lang=en
http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
http://www.indexmundi.com/blog/wp-content/uploads/2013/04/weight-of-the-world.jpg
http://apps.who.int/gho/data/node.main.A904?lang=en
http://data.worldbank.org/indicator/SH.MED.PHYS.ZS
https://www.cia.gov/library/publications/the-world-factbook/fields/2226.html