infosantésuisse: dossier Comparaisons internationales_OECD deutsch 2/2011 by santésuisse

infosantésuisse : Dossier Die europäischen Gesundheitssysteme im Vergleich

Inhalt OECD Data 2009 1 Deutschland (E) 4 Ă&#x2013;sterreich (E) 7 Kanada (E) 10 DĂ¤nemark (E) 13 Spanien (E) 16 Finnland (E) 19 Frankreich (F) 22 Island (E) 25 Italien (E) 28 Norwegen (E) 31 Niederland (E) 34 Schweden (E) 37 Schweiz (F) 40 Grossbritannien (E) 43 USA (E)

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OECD-GESUNDHEITSDATEN 2009 Deutschland im Vergleich In Deutschland beliefen sich die Gesamtausgaben für Gesundheit im Jahr 2007 auf 10,4% des BIP und lagen damit um mehr als 1,5 Prozentpunkte über dem Durchschnitt der OECD-Länder von 8,9%. Nur in den Vereinigten Staaten (16%), Frankreich (11%) und der Schweiz (10,8%) lag im gleichen Jahr der Anteil der Gesundheitsausgaben an der Wirtschaftsleistung höher als in Deutschland. Gleichzeitig rangiert Deutschland 2007 bei den Pro-Kopf-Gesundheitsausgaben mit 3,588 US-$ (in Kaufkraftparitäten) nur an zehnter Stelle unter den OECD-Ländern. Im Durchschnitt wendeten die OECDLänder im Jahr 2007 pro Kopf 2,964 US-$ für Gesundheit auf. Die höchsten Pro-Kopf-Gesundheitsausgaben waren in den Vereinigten Staaten zu verzeichnen (7,290 US-$ pro Kopf im Jahr 2007), gefolgt von Norwegen, der Schweiz und Luxemburg (über 4,000 US-$ pro Kopf).

(1) 2006, (2) 2005. Gesundheitsausgaben für Belgien, Dänemark und Niederlande sind laufende Gesundheitsausgaben (ausgenommen Investitionen). Source: OECDGesundheitsdaten 2009, Juni 09. Die Daten sind in US-Dollar, bereinigt um Kaufkraftparitäten (KKP), ausgedrückt, was einen Ländervergleich der Ausgaben auf einer gemeinsamen Basis ermöglicht. KKP sind die Raten der Währungsumrechnung, die die Kosten eines gegebenen „Korbs“ von Waren und Dienstleistungen in verschiedenen Ländern auf das gleiche Niveau bringen.

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Die Gesundheitsausgaben sind in Deutschland zwischen 2000 und 2007 real um durchschnittlich 1,4% pro Jahr gestiegen. Das war verglichen mit allen anderen OECD-Ländern der geringste Anstieg in diesem Zeitraum. Die durchschnittliche Zuwachsrate bei den Gesundheitsausgaben lag in den OECD-Ländern zwischen 2000 und 2007 bei 3,7% jährlich. Das relativ langsame Wachstum der Gesundheitsausgaben in Deutschland ist teilweise Kostendämpfungsmaßnahmen zuzuschreiben, die im Rahmen der Gesundheitsreformen eingeführt wurden. Die Ausgaben für Arzneimittel machten 2007 in Deutschland 15,1% der gesamten Gesundheitsausgaben aus, ein unter dem OECD-Durchschnitt von 17,1% liegender Wert. Wie in vielen OECD-Ländern ist auch in Deutschland der Anteil der Arzneimittelkosten an den gesamten Gesundheitsausgaben in den letzten zehn Jahren zumindest geringfügig gestiegen. In allen OECD-Ländern werden die Gesundheitsausgaben überwiegend aus öffentlichen Mitteln finanziert, mit Ausnahme der Vereinigten Staaten und Mexikos, wo der Anteil des öffentlichen Sektors mit 45,4% bzw. 45,2% im Jahr 2007 am geringsten war. In Deutschland lag der öffentliche Anteil 2007 bei 76,9%, und mithin über dem OECD-Durchschnitt von 73%. Am höchsten war der öffentliche Anteil 2007 mit 90,9% in Luxemburg und relativ hoch (mit über 80%) noch in mehreren nordischen Ländern (Dänemark, Norwegen, Island und Schweden), der Tschechischen Republik, dem Vereinigten Königreich, Japan und Irland. Personelle, materielle, technologische Ressourcen im Gesundheitswesen Im Jahr 2007 kamen in Deutschland auf 1,000 Einwohner 3,5 niedergelassene Ärzte, verglichen mit 3,1 Ärzten je 1,000 Einwohner im OECD-Durchschnitt. Mit 9,9 praktizierenden Krankenpflegerinnen und -pflegern je 1,000 Einwohner lag Deutschland auch hier leicht über dem OECD-Durchschnitt von 9,6. Für die Akutversorgung standen 2007 in Deutschland 5,7 Betten je 1,000 Einwohner zur Verfügung, und damit deutlich mehr als im OECD-Durchschnitt, wo 3,8 Betten auf 1,000 Einwohner kommen. Wie in den meisten OECD-Ländern ist die Krankenhausbettendichte in Deutschland im Laufe der Zeit zurückgegangen, im Einklang mit dem Rückgang der durchschnittlichen Verweildauer im Krankenhaus. In den vergangenen zehn Jahren hat in das Angebot an neuen Diagnosetechniken, wie z.B. Computertomografie-Scannern (CT) und Magnetresonanztomografen (MRI) in den meisten OECDLändern stark zugenommen. In Deutschland hat sich die Zahl der MRI-Einheiten von rd. einer je eine Million Einwohner im Jahr 1992 auf 8,2 im Jahr 2007 erhöht. Trotz dieser Zunahme bleibt Deutschland immer noch hinter dem OECD-Durchschnitt von 11 MRI-Einheiten je eine Million Einwohner zurück. Auch bei den CT-Scannern liegt Deutschland mit 16,3 Geräten je eine Million Einwohner im Jahr 2007 unter dem OECD-Durchschnitt von 20,2. Unter den OECD-Ländern weist Japan die mit Abstand größte Dichte von MRI-Geräten und CT-Scannern auf. Gesundheitszustand und Risikofaktoren In den meisten OECD-Ländern hat sich die Lebenserwartung in den letzten Jahrzehnten dank besserer Lebensbedingungen, intensiverer Gesundheitsvorsorge sowie durch Fortschritte bei der medizinischen Versorgung erhöht. 2006 lag die Lebenserwartung bei Geburt für die gesamte Bevölkerung in Deutschland bei 79,8 Jahren und damit um nahezu ein Jahr über dem OECD-Durchschnitt von 79 Jahren. Unter den OECD-Ländern ist die Lebenserwartung (mit 82,6 Jahren) in Japan am höchsten, gefolgt von der Schweiz, Island, Australien, Italien und Spanien (die alle eine Lebenserwartung von über 81 Jahren verzeichnen). Die Säuglingssterblichkeit ist in Deutschland wie in anderen OECD-Ländern in den vergangenen zehn Jahren erheblich gesunken. Sie lag 2006 bei 3,8 Todesfällen je 1,000 Lebendgeburten, verglichen mit einem OECD-Durchschnitt von 4,9. Am niedrigsten war die Säuglingssterblichkeit 2007 in Luxemburg, Japan und in nordischen Ländern (Island, Schweden, Finnland und Norwegen). 2

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Der Anteil der täglichen Raucher unter den Erwachsenen ist während der letzten 25 Jahre in den meisten OECD-Ländern deutlich zurückgegangen. Dieser Rückgang ist größtenteils Politikmaßnahmen zuzuschreiben, die auf eine Verringerung des Tabakkonsums abzielten, wie öffentliche Aufklärungskampagnen, Werbeverbote sowie Steuer- und Abgabenerhöhungen. In Deutschland ist der Anteil der Raucher von 28,5% im Jahr 1978 auf 23,2% im Jahr 2005 zurückgegangen, eine Rate, die etwa dem derzeitigen OECD-Durchschnitt entspricht. Schweden, die Vereinigten Staaten und Australien sind Beispiele für Länder, die bemerkenswerte Erfolge bei der Reduzierung des Tabakkonsums erzielt haben, hier liegt der Anteil der Raucher an der Erwachsenenbevölkerung bei unter 18%. Fettleibigkeit hat in den letzten Jahrzehnten in allen OECD-Ländern zugenommen, wenngleich es zwischen den einzelnen Ländern nach wie vor erhebliche Unterschiede gibt. So bewegte sich der Anteil der Fettleibigen an der Erwachsenenbevölkerung im Jahr 2007 (oder dem letzten Jahr, für das Daten verfügbar sind) zwischen einem niedrigen Wert von 3,4% bzw. 3,5% in Japan und Korea und einem Höchstwert von 34,3% in den Vereinigten Staaten. Mexiko, Neuseeland, das Vereinigte Königreich, Island und Luxemburg verzeichneten mit Raten von über 20% ebenfalls einen hohen Anteil an Fettleibigen unter der Erwachsenenbevölkerung1. Die auf Eigenangaben beruhende Fettleibigkeitsrate für Deutschland belief sich 2005 auf 13,6%, gegenüber 11,5% im Jahr 1999. Weitere Informationen zu den OECD-Gesundheitsdaten 2009 finden Sie unter www.oecd.org/de/gesundheitsdaten. Die OECD-Gesundheitsdaten 2009 sind in deutscher Sprache erhältlich. Weitere Informationen zu den Arbeiten der OECD über Deutschland finden Sie auf der Website www.oecd.org/deutschland.

Dabei ist jedoch zu beachten, dass die Daten für die Vereinigten Staaten, das Vereinigte Königreich, Australien und Neuseeland exakter sind als die der anderen Länder, da sie auf effektiven Messungen von Körpergröße und Gewicht basieren, während die Schätzungen für die anderen Länder auf Eigenangaben beruhen, die in der Regel die tatsächliche Prävalenz der Fettleibigkeit unterschätzen.

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OECD-GESUNDHEITSDATEN 2009 Österreich im Vergleich In Österreich beliefen sich die Gesamtausgaben für Gesundheit im Jahr 2007 auf 10,1% des BIP und lagen damit um mehr als einen Prozentpunkt über dem OECD-Durchschnitt von 8,9%. Den mit Abstand höchsten Anteil der Gesundheitsausgaben an der Wirtschaftsleistung verzeichnen die Vereinigten Staaten, wo sich die Gesundheitsausgaben 2007 auf 16% des BIP beliefen, gefolgt von Frankreich (11,0%), der Schweiz (10,8%) und Deutschland (10,4%). Auch auf Pro-Kopf-Basis lagen die Gesundheitsausgaben in Österreich 2007 mit mehr als 3,700 US-$ (in Kaufkraftparitäten) über dem Durchschnitt der OECD-Länder von 2,964 US-$. Dennoch sind die ProKopf-Gesundheitsausgaben in Österreich noch immer wesentlich niedriger als in den Vereinigten Staaten (7,290 US-$ pro Kopf im Jahr 2007), Norwegen, der Schweiz und Luxemburg.

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Die Gesundheitsausgaben sind in Österreich zwischen 2000 und 2007 real um durchschnittlich 2% pro Jahr gestiegen. Das war mit der geringste Anstieg unter den OECD-Ländern in diesem Zeitraum. Die durchschnittliche Zuwachsrate bei den Gesundheitsausgaben lag in den OECD-Ländern zwischen 2000 und 2007 bei 3,7% jährlich. In allen OECD-Ländern, mit Ausnahme der Vereinigten Staaten und Mexikos, werden die Gesundheitsausgaben überwiegend aus öffentlichen Mitteln finanziert. In Österreich lag der öffentliche Anteil 2007 bei 76% und mithin über dem OECD-Durchschnitt von 73%. Die Ausgaben für Arzneimittel machten 2007 in Österreich 13,3% der gesamten Gesundheitsausgaben aus, ein unter dem OECD-Durchschnitt von 17,1% liegender Wert. Wie in vielen OECD-Ländern ist auch in Österreich der Anteil der Arzneimittelkosten an den gesamten Gesundheitsausgaben in den letzten zehn Jahren gestiegen. Personelle, materielle, technische Ressourcen im Gesundheitswesen Im Jahr 2007 kamen in Österreich auf 1,000 Einwohner 3,8 niedergelassene Ärzte, verglichen mit 3,1 Ärzten je 1,000 Einwohner im Durchschnitt der OECD-Länder. Indessen lag Österreich mit 7,4 praktizierenden Krankenpflegerinnen und -pflegern je 1,000 Einwohner unter dem OECD-Durchschnitt von 9,6. Für die Akutversorgung standen 2007 in Österreich 6,1 Betten je 1,000 Einwohner zur Verfügung, und damit deutlich mehr als im OECD-Durchschnitt, wo 3,8 Betten auf 1,000 Einwohner kamen. Wie in den meisten OECD-Ländern, ist die Krankenhausbettendichte in Österreich im Laufe der Zeit zurückgegangen, im Einklang mit dem Rückgang der durchschnittlichen Verweildauer im Krankenhaus. In den vergangenen zehn Jahren hat das Angebot an neuen Diagnosetechniken, wie z.B. Computertomografie-Scannern (CT) und Magnetresonanztomografen (MRI) in den meisten OECDLändern stark zugenommen. In Österreich hat sich die Zahl der MRI-Einheiten im Laufe der Zeit von rd. 7 je eine Million Einwohner im Jahr 1996 auf 17,7 im Jahr 2007 erhöht. Hiermit liegt Österreich deutlich über dem OECD-Durchschnitt von 11 MRI-Einheiten je eine Million Einwohner. Nur Japan, die Vereinigten Staaten Italien und Island verzeichnen mehr MRI-Einheiten pro Kopf der Bevölkerung. Auch die Zahl der CT-Scanner pro Kopf ist in Österreich relativ hoch, mit 29,8 Geräten je eine Million Einwohner, gegenüber einem OECD-Durchschnitt von 20,2. Japan weist die mit Abstand größte Dichte von MRI-Geräten und CT-Scannern auf. Gesundheitszustand und Risikofaktoren In den meisten OECD-Ländern hat sich die Lebenserwartung in den letzten Jahrzehnten dank besserer Lebensbedingungen, intensiverer Gesundheitsvorsorge sowie durch Fortschritte bei der medizinischen Versorgung erhöht. 2007 lag die Lebenserwartung bei Geburt für die gesamte Bevölkerung in Österreich bei 80,1 Jahren und damit um etwas mehr als ein Jahr über dem OECD-Durchschnitt von 79 Jahren. Unter den OECD-Ländern ist die Lebenserwartung in Japan (mit 82,6 Jahren) am höchsten, gefolgt von der Schweiz, Island, Australien und Italien. Die Säuglingssterblichkeit ist in Österreich wie in anderen OECD-Ländern in den vergangenen zehn Jahren erheblich gesunken. Sie lag 2007 bei 3,7 Todesfällen je 1,000 Lebendgeburten und mithin unter dem OECD-Durchschnitt von 4,9. Am niedrigsten ist die Säuglingssterblichkeit in Luxemburg, Japan und in nordischen Ländern (Island, Finnland, Schweden und Norwegen). Der Anteil der täglichen Raucher unter den Erwachsenen ist während der letzten 25 Jahre in den meisten OECD-Ländern deutlich zurückgegangen. Dieser Rückgang ist größtenteils Politikmaßnahmen zuzuschreiben, die auf eine Verringerung des Tabakkonsums abzielten, wie öffentliche Aufklärungs2

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kampagnen, Werbeverbote sowie Steuer- und Abgabenerhöhungen. In Österreich lag der Anteil der Raucher im Jahr 2006 bei 23,2%, d.h. geringfügig unter dem OECD-Durchschnitt von 23,3%. Schweden, die Vereinigten Staaten und Australien sind Beispiele für Länder, die bemerkenswerte Erfolge bei der Reduzierung des Tabakkonsums erzielt haben, hier liegt der Anteil der Raucher an der Erwachsenenbevölkerung derzeit bei unter 18%. Fettleibigkeit hat in den letzten Jahrzehnten in allen OECD-Ländern zugenommen, wenngleich es zwischen den einzelnen Ländern nach wie vor erhebliche Unterschiede gibt. So bewegte sich der Anteil der Fettleibigen an der Erwachsenenbevölkerung im Jahr 2007 (oder dem letzten Jahr, für das Daten verfügbar sind) zwischen einem niedrigen Wert von 3,4% bzw. 3,5% in Japan und Korea und einem Höchstwert von 34,3% in den Vereinigten Staaten. Mexiko, das Vereinigte Königreich, Island, Luxemburg und Neuseeland verzeichneten mit Raten von über 20% ebenfalls einen hohen Anteil an Fettleibigen unter der Erwachsenenbevölkerung1. Die Fettleibigkeitsrate für Österreich belief sich 2006 auf 12,4%. Weitere Informationen zu den OECD-Gesundheitsdaten 2009 finden Sie unter www.oecd.org/de/gesundheitsdaten. Die OECD-Gesundheitsdaten 2009 sind in deutscher Sprache erhältlich. Weitere Informationen zu den Arbeiten der OECD über Österreich finden Sie auf der Website www.oecd.org/oesterreich.

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OECD Health Data 2009 How Does Canada Compare Total health spending accounted for 10.1% of GDP in Canada in 2007, more than one percentage point higher than the average of 8.9% in OECD countries. Health spending as a share of GDP is lower in Canada than in the United States (which spent 16.0% of its GDP on health in 2007) and in a number of European countries such as France (11.0%), Switzerland (10.8%), Germany (10.4%) and Belgium (10.2%). Canada also ranks above the OECD average in terms of total health spending per capita, with spending of 3895 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2964 USD. Health spending per capita in Canada remains nonetheless much lower than in the United States (which spent 7290 USD per capita in 2007) and in Norway, Switzerland and Luxembourg.

Data are expressed in US dollars adjusted for purchasing power parities (PPPs), which provide a means of comparing spending between countries on a common base. PPPs are the rates of currency conversion that equalise the cost of a given ‘basket’ of goods and services in different countries.

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Between 2000 and 2007, health spending per capita in Canada increased in real terms by 3.5% per year on average, a growth rate similar to the OECD average (3.7% per year). The public sector is the main source of health funding in all OECD countries, except the United States and Mexico. In Canada, 70% of health spending was funded by public sources in 2007, below the average of 73% in OECD countries. The share of public spending in Canada decreased from 74.5% in 1990. In 2007, the share of public spending among OECD countries was the lowest in the United States and Mexico (45%) and the highest in Luxembourg, the Czech Republic, several Nordic countries (Denmark, Iceland, Norway and Sweden), the United Kingdom and Japan. Resources in the health sector (human, physical, technological) Despite the relatively high level of health expenditure in Canada, there are fewer physicians per capita than in most other OECD countries. In 2007, Canada had 2.2 practising physicians per 1 000 population, well below the OECD average of 3.1. Between 1990 and 2007, the number of doctors per capita remained relatively stable in Canada, while it continued to increase in most OECD countries. There were 9.0 nurses per 1 000 population in Canada in 2007, also a lower number than the average of 9.6 in OECD countries. The number of acute care hospital beds in Canada was 2.7 per 1 000 population in 2006, the same number as in the United States, but lower than the OECD average of 3.8 beds per 1 000 population. As in most OECD countries, the number of hospital beds per capita in Canada has fallen over time. This decline has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Canada, the number of MRIs also increased over time, to reach 6.7 per million population in 2007. Despite this increase, Canada was still lagging behind the OECD average of 11.0 MRI units per million population. Similarly, the number of CT scanners in Canada stood at 12.7 per million population in 2007, below the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2006, life expectancy at birth in Canada stood at 80.7 years, more than 1 Â˝ year higher than the OECD average (79.0 years) and 2 Â˝ years greater than in the United States (78.1 years) . Still, a number of countries (e.g., Japan, Switzerland, Italy and Australia) registered a higher life expectancy than Canada. The infant mortality rate in Canada, as in other OECD countries, has fallen greatly over the past decades. It stood at 5.0 deaths per 1 000 live births in 2006, lower than in the United States (6.7), and almost equal to the OECD average (4.9). Infant mortality is the lowest in some Nordic countries (Iceland, Sweden and Finland), Luxembourg and Japan. The proportion of daily smokers among adults has shown a marked decline over the past twenty-five years in most OECD countries. Canada provides an example of a country that has achieved remarkable progress in reducing tobacco consumption, with the rate of daily smokers among adults having been cut by nearly half since 1980 (from 34% in 1980 to 18% in 2007). Much of this decline in Canada, as well as in other countries, can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. At the same time, obesity rates have increased in recent decades in all OECD countries, although there remain notable differences across countries. In Canada, the obesity rate among adults, based on self2

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reported data was 15% in 2007, up from 12% in 1994. It is lower than in the United States (34.3% in 2006) and the United Kingdom (24.0% in 2007), but higher than in many other OECD countries1. Given the time lag between the onset of obesity and related health problems (such as diabetes, cardiovascular diseases and asthma), the growing prevalence of obesity in most OECD countries, including Canada, will mean higher health care costs in the future. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Canada, please visit www.oecd.org/canada.

It should be noted that the data for the United States and the United Kingdom are more accurate than those from other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries (including for Canada) are based on self-reported data, which generally under-estimate the real prevalence of obesity.

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OECD Health Data 2009 How Does Denmark Compare Total health spending accounted for 9.8% of GDP in Denmark in 2007, above the average in OECD countries of 8.9%. Health spending as a share of GDP is highest in the United States (which spent 16.0% of its GDP on health in 2007), followed by France (11.0%), Switzerland (10.8%) and Germany (10.4%). Denmark also ranks above the OECD average in terms of total health spending per capita, with current spending of 3362 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2964 USD. Health spending per capita in Denmark remains nonetheless much lower than in the United States (which spent 7290 USD per capita in 2007) and in Norway, Switzerland and Luxembourg.

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Spending on pharmaceuticals in Denmark in 2006 accounted for 8.6% of total health expenditure, well below the OECD average of 17.1%. As in many OECD countries, the share of total health spending allocated to pharmaceuticals has increased in Denmark over the past decade, although at a slower rate. The public sector is the main source of health funding in all OECD countries, except the United States and Mexico. In Denmark, 85% of health spending was funded by public sources in 2007, third highest among OECD countries, and significantly higher than the average of 73%. In 2007 (or latest year available), the share of public spending among OECD countries was the lowest in Mexico (45%) and the United States (45%), and the highest in Luxembourg (91%) and the Czech Republic (85%). Resources in the health sector (human, physical, technological) In 2006, Denmark had 3.2 practising physicians per 1,000 population, similar to the OECD average of 3.1. There were 14.3 nurses per 1,000 population in Denmark in 2006, well above the average of 9.6 in OECD countries. The estimated number of acute care hospital beds in Denmark was 2.9 per 1,000 population in 2007, lower than the OECD average of 3.8 beds per 1,000 population. As in most OECD countries, the number of hospital beds per capita in Denmark has fallen over time. This decline has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Denmark, the number of MRIs also increased over time, to reach 10.2 per million population in 2004 (latest year available), which is similar the OECD average of 11.0 in 2007. The number of CT scanners in Denmark was 17.4 per million population in 2007, below the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2006, life expectancy at birth in Denmark stood at 78.4 years, Â˝ year lower than the OECD average of 79.0 years in 2007. Life expectancy in Denmark is more than four years lower than in Japan (82.6 years, the highest among OECD countries), and is also lower than in most Western European countries and in other Nordic countries. The infant mortality rate in Denmark, as in other OECD countries, has fallen greatly over the past decades. It stood at 3.8 deaths per 1,000 live births in 2006, lower than the OECD average of 4.9 in 2007. Infant mortality is the lowest in other Nordic countries (Iceland, Finland and Sweden), Luxembourg and Japan. The proportion of daily smokers among adults has shown a marked decline over the past twenty years in most OECD countries. In Denmark, the percentage of adults who report to smoke everyday has decreased from 47% in 1984 to 25% in 2006. Despite this marked reduction, smoking rates among adults in Denmark remain slightly higher than the OECD average of 23.3%. Sweden, the United States and Australia provide examples of countries that have achieved remarkable success in reducing tobacco consumption, with current smoking rates among adults below 18%. At the same time, obesity rates have increased in recent decades in all OECD countries, although notable differences remain across countries. In Denmark, the obesity rate among adults, based on self-reported data, more than doubled over the past twenty years, moving up from 5.5% in 1987 to 11.4% in 2005.

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While it remains much lower than in the United States (34.3% in 2006)1, the obesity rate in Denmark is higher than in Japan and Korea (3.4% and 3.5% respectively) as well as in Switzerland (8.1%). Given the time lag between the onset of obesity and related health problems (such as diabetes, cardiovascular diseases and asthma), the growing prevalence of obesity in most OECD countries, including Denmark, will mean higher health care costs in the future. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Denmark, please visit www.oecd.org/denmark.

It should be noted that the data for the United States are more accurate than those from other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries are based on self-reported data, which generally under-estimate the real prevalence of obesity.

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OECD Health Data 2009 How Does Spain Compare Total health spending accounted for 8.5% of GDP in Spain in 2007, below the average of 8.9% in OECD countries. In 2007, health spending as a share of GDP was the highest in the United States (which spent 16% of its GDP on health), followed by France (11%), Switzerland (10.8%) and Germany (10.4%). Spain also ranks below the OECD average in terms of health spending per capita, with spending of 2,671 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2,964 USD.

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The rise in pharmaceutical spending has been one of the factors behind the increase in total health spending in Spain, as in many other OECD countries. In 2007, spending on pharmaceuticals accounted for 21% of total health spending in Spain, above the OECD average of 17.1%. The public sector is the main source of health funding in all OECD countries, except the United States and Mexico, where public spending is the lowest at 45.4% and 45.2% respectively. In Spain, 71.8% of health spending was funded by public sources in 2007, one percentage point below the average of 72.8% in OECD countries. The share of public spending in Spain decreased from 78.7% in 1990. In 2007, the share of public spending among OECD countries was the highest in Luxembourg (90.9%) and relatively high (above 80%) in the Czech Republic, the United Kingdom, Japan and in several Nordic countries (Denmark, Norway, Iceland, and Sweden). Resources in the health sector (human, physical, technological) Despite the relatively low level of health expenditure in Spain, there are more physicians per capita than in most other OECD countries. In 2007, Spain had 3.7 practising physicians per 1,000 population, above the OECD average of 3.1. On the other hand, there were 7.5 qualified nurses per 1,000 population in Spain, a lower figure than the average of 9.6 in OECD countries. The number of acute care hospital beds in Spain was 2.5 per 1,000 population in 2006, lower than the OECD average of 3.8 beds. As in most OECD countries, the number of hospital beds per capita in Spain has fallen over time. This reduction has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Spain, the number of MRIs also increased over time, to reach 9.3 per million population in 2007, which was less, however, than the OECD average of 11. The number of CT scanners in Spain was 14.6 per million population in 2007, also below the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2006, life expectancy at birth in Spain stood at 81.1 years, more than two years higher than the OECD average (79 years). Only Japan, Switzerland, Australia, Iceland and Italy registered a higher life expectancy than Spain. The infant mortality rate in Spain, as in other OECD countries, has fallen greatly over the past decades. It stood at 3.8 deaths per 1,000 live births in 2006, lower than the OECD average (4.9 deaths). Infant mortality is the lowest in Luxembourg, Japan and in several Nordic countries (Iceland, Sweden and Finland). The proportion of daily smokers among adults has shown a marked decline over the past twenty years in most OECD countries. Spain has achieved some progress in reducing tobacco consumption, with current rates of daily smokers among adults standing at 26.4% in 2006, down from 41% in 1985. However, smoking rates in Spain still remain higher than the OECD average of 23.3%. Sweden, the United States and Australia provide examples of countries that have achieved remarkable success in reducing tobacco consumption, with current smoking rates among adults below 17%. Obesity rates have increased in the past two decades in nearly all OECD countries, although there remain notable differences across countries. In 2007 (or the latest year available), the prevalence of obesity among adults varied from a low of 3.4% and 3.5% in Japan and Korea, to a high of 34.3% in the United States. Mexico, New Zealand, the United Kingdom and Australia, also have relatively high levels of obesity

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among adults, with rates of over 21%1. The obesity rate in Spain, based on self-reported data, stood at 14.9% in 2006, up from 6.8% in 1987. The time lag between the onset of obesity and increases in related chronic health problems (such as diabetes or asthma) suggests that the rise in obesity that has occurred in most OECD countries will have substantial implications on the future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. Note that OECD Health Data 2009 is available in Spanish. For more information on OECD's work on Spain, please visit www.oecd.org/spain.

It should be noted however that the data for the United States, the United Kingdom, Australia and New Zealand are more accurate than those from other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries are based on self-reported data, which generally underestimate the real prevalence of obesity.

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OECD Health Data 2009 How Does Finland Compare Total health spending accounted for 8.2% of GDP in Finland in 2007, a slightly lower share than the average of 8.9% in OECD countries. Health spending as a share of GDP is lower in Finland than in all other Nordic countries. Finland also ranks below the OECD average in terms of total health spending per capita, with spending of 2840 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2964 USD. Health spending per capita in Finland is nonetheless higher than in several other European countries and in Japan.

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Between 2000 and 2007, health spending per capita in Finland increased in real terms by 4.6% per year on average, a growth rate higher than the OECD average of 3.7% per year. The public sector is the main source of health funding in all OECD countries, except the United States and Mexico. In Finland, 75% of health spending was funded by public sources in 2007, above the average of 73% in OECD countries. The share of public spending in Finland was, however, lower than in other Nordic countries (Denmark, Iceland, Norway and Sweden) where it exceeds 80%. Resources in the health sector (human, physical, technological) In 2006, Finland had 3.0 practising physicians per 1 000 population, just below the OECD average of 3.1. There were more than twice as many specialists as general practitioners (1.6 vs. 0.7 per 1 000 population). There were 10.3 nurses per 1 000 population in Finland, a higher figure than the average of 9.6 in OECD countries. The number of acute care hospital beds in Finland was 3.7 per 1 000 population in 2007, similar to the OECD average of 3.8 beds per 1 000 population. As in most OECD countries, the number of hospital beds per capita in Finland has fallen over time. This decline has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Finland, the number of MRIs increased very rapidly since 1990, to reach 15.3 per million population in 2007, a higher figure than the OECD average of 11.0 MRI units per million population. On the other hand, Finland had 16.4 CT scanners per million population in 2007, less than the OECD average of 20.2. Health status and risk factors In 2006, life expectancy at birth in Finland stood at 79.5 years, Â˝ year higher than the OECD average (79.0 years in 2007). As in other OECD countries, there have been remarkable improvements in life expectancy in Finland over the past few decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Since 1960, life expectancy at birth in Finland increased by more than 10 years, a gain that is equivalent to the average across OECD countries. In 2007, Japan registered the highest life expectancy among OECD countries, with 82.6 years. The infant mortality rate in Finland, as in other OECD countries, has fallen greatly over the past decades. It stood at 2.8 deaths per 1 000 live births in 2006, one of the lowest rates among OECD countries (together with other Nordic countries such as Iceland and Sweden, as well as Japan and Luxembourg). The OECD average was 5.2 deaths per 1 000 live births. The proportion of daily smokers among adults has shown a marked decline over the past twenty-five years in most OECD countries. Much of this decline can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. Smoking rates among adults in Finland in 2007 stood at 20.6%, less than the OECD average of 23.3%. At the same time, obesity rates have increased in recent decades in all OECD countries, although there remain notable differences across countries. In Finland, the obesity rate among adults was 14.9% in 2007, up from 8.4% in 1990. It is lower than in the United States (34.3% in 2006) and the United Kingdom

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(24.0% in 2007), but higher than in other Nordic countries such as Denmark, Norway and Sweden1. Given the time lag between the onset of obesity and related health problems (such as diabetes, cardiovascular diseases and asthma), the growing prevalence of obesity in most OECD countries, including Finland, will mean higher health care costs in the future. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Finland, please visit www.oecd.org/finland.

It should be noted that the data for the United States and the United Kingdom are more accurate than those from other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries (including for Finland) are based on self-reported data, which generally under-estimate the real prevalence of obesity.

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Eco-Santé OCDE 2009 Comment la France se positionne Les dépenses de santé totales représentaient en France 11% du PIB en 2007, soit plus de 2 points de pourcentage de plus que la moyenne des pays de l’OCDE (8.9%). En termes de dépenses de santé par rapport au PIB, la France est le pays, après les États-Unis (16%), qui enregistre le niveau le plus élevé de dépenses. La France se situe aussi au-dessus de la moyenne des pays de l’OCDE en termes de dépenses de santé par habitant, avec des dépenses de 3 601 USD (ajustées sur la base de la parité de pouvoir d’achat des monnaies), par rapport à une moyenne de 2 964 USD pour l’ensemble des pays de l’OCDE. Les dépenses de santé par habitant en France restent cependant bien en dessous des dépenses de santé aux États-Unis, qui s’élèvent à 7 290 USD par habitant.

Les données sont exprimées en dollars US ajustés pour les parités de pouvoir d'achat (PPA). Les PPA permettent la comparaison des dépenses entre les pays sur une base commune. Les PPA sont des taux de conversion monétaire qui égalisent le coût d'un "panier" donné de produits et services dans différents pays.

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Le financement public représente la principale source de financement des dépenses de santé dans tous les pays de l’OCDE, à l’exception des États-Unis et du Mexique. En France, 79% des dépenses de santé sont financées par des fonds publics, un niveau sensiblement plus élevé que la moyenne des pays de l’OCDE (72.8%). Parmi les pays européens, la part du financement public des dépenses de santé est plus élevée en France que dans des pays comme l’Autriche, l’Espagne et la Suisse, mais plus faible que dans la plupart des pays nordiques (le Danemark, la Norvège et la Suède) et au Royaume-Uni. Les ressources du secteur de la santé (humaines, physiques et technologiques) La France compte 3.4 médecins par millier d’habitants, un chiffre un peu plus élevé que la moyenne de 3.1 dans les pays de l’OCDE. Par ailleurs, la France compte 7.7 infirmières par millier d’habitants, un nombre inférieur à la moyenne de 9.6 dans les pays de l’OCDE1. En France, le nombre de lits d’hôpitaux pour soins aigus est de 3.6 lits par milliers d’habitants en 2007, un nombre assez proche de la moyenne des pays de l’OCDE (3.8 lits). Comme dans la plupart des autres pays développés, le nombre de lits d’hôpitaux disponibles par habitant en France a diminué au cours des 20 dernières années. La réduction du nombre de lits d’hôpitaux dans la plupart des pays de l’OCDE a coïncidé avec une réduction de la durée moyenne des séjours à l’hôpital et une augmentation du recours à la chirurgie de jour. La diffusion des technologies médicales modernes est l’un des facteurs principaux de l’augmentation des dépenses de santé dans les pays de l’OCDE. Par exemple, le nombre d’appareils d’imagerie par résonance magnétique (IRM) utilisés pour diagnostiquer de nombreuses maladies a plus que quintuplé en moyenne dans les pays de l’OCDE depuis le début des années 1990. Bien que le nombre d’IRM et de scanners CT ait aussi augmenté en France, leur nombre par habitant y est moins élevé en 2007 que dans la majorité des pays de l’OCDE. Le pays qui dispose, et de loin, du plus grand nombre d’IRM et de scanners CT par habitant est le Japon. La France en revanche détient le plus grand nombre d’appareils de mammographie par habitant parmi l’ensemble des pays de l’OCDE. L’état de santé de la population et les facteurs de risque La plupart des pays de l’OCDE ont enregistré d’importants gains d’espérance de vie à la naissance au cours des dernières décennies. En France, l’espérance de vie à la naissance a augmenté de plus de 10 ans entre 1960 et 2007, ce qui est proche des gains enregistrés en moyenne dans les pays de l’OCDE. Après une stagnation en 2003 en raison de la mortalité exceptionnelle due à la canicule, l’espérance de vie en France a franchi le seuil des 80 ans en 2004 et atteint les 81 ans en 2007, soit 2 ans de plus que la moyenne des pays de l’OCDE (79 ans). Le Japon enregistre l’espérance de vie la plus élevée, avec 82.6 ans, suivi de la Suisse, l’Australie, l’Islande et l’Italie. La proportion d’adultes déclarant fumer quotidiennement a diminué dans la plupart des pays de l’OCDE au cours des deux dernières décennies. En France, la proportion d’adultes qui fument quotidiennement est passée de 30% en 1980 à 25% en 2006. La Suède, les États-Unis et l’Australie fournissent des exemples de pays qui ont réduit de manière encore plus importante la prévalence du tabagisme. Ils enregistrent des taux de moins de 17% de la population adulte qui fume quotidiennement. La consommation d’alcool par habitant a diminué dans la plupart des pays de l’OCDE au cours des dernières décennies. En France, la consommation globale d’alcool a fortement chuté depuis 1970, même si elle reste nettement plus élevée que la moyenne des pays de l’OCDE. La baisse de la consommation a coïncidé avec des mesures de contrôle plus strictes.

Il est à noter que les infirmières auxiliaires (aides-soignantes) ne sont pas comptabilisées pour la France.

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Les problèmes d’obésité ont considérablement augmenté au cours des deux dernières décennies, même s’il existe des différences notables de prévalence de l’obésité chez les adultes selon les pays. En France, le taux d’obésité parmi la population adulte (10.5% en 2006) reste bien inférieur aux taux enregistrés dans la plupart des autres pays développés, bien qu’il soit en augmentation. Les taux d’obésité les plus élevés se retrouvent aux États-Unis (34.3% en 2006), au Mexique (30% en 2006), en Nouvelle-Zélande (26.5% en 2007), au Royaume-Uni (24% en 2007) et en Australie (21.7% en 1999)2. Le temps de latence entre l’apparition de l’obésité et l’accroissement des maladies chroniques qui y sont liées (comme le diabète et l’asthme) laisse à penser que la forte augmentation de la population obèse dans la plupart des pays de l’OCDE aura, dans l’avenir, des implications considérables en termes de santé et de dépenses de santé. Pour plus d’informations concernant Eco-Santé OCDE 2009, veuillez consulter www.oecd.org/sante/ecosante. Pour plus d’informations concernant les travaux de l’OCDE sur la France, veuillez vous rendre sur le site www.oecd.org/france.

Il est à noter cependant que ces données pour les États-Unis, la Nouvelle-Zélande, le Royaume-Uni et l’Australie sont plus fiables et précises que celles des autres pays car elles sont fondées sur un examen médical au cours duquel on a mesuré la taille et le poids réel des individus, alors que les données pour les autres pays (incluant la France) sont basées sur de simples déclarations des répondants, ce qui entraîne généralement une sous-estimation des taux d’obésité.

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OECD Health Data 2009 How Does Iceland Compare Total health spending accounted for 9.3% of GDP in Iceland in 2007, above the OECD average of 8.9%. The United States is, by far, the country that spends the most on health as a share of its economy (with 16.0% of its GDP allocated to health in 2007), followed by France (11.0%), Switzerland (10.8%) and Germany (10.4%).

Iceland also spends more on health per capita than many OECD countries, with spending of 3,319 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2,964 USD. Countries with the highest health expenditure per capita in 2006 were the United States (which spent 7,290 USD per capita), followed by Norway, Switzerland and Luxembourg (which all spent over 4,000 USD).

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The rise in pharmaceutical spending has been one of the factors behind the rise in total health spending in many OECD countries in recent years. In 2007, spending on pharmaceuticals in Iceland accounted for 13.5% of total health expenditure, well below the OECD average of 17.1%. The public sector is the main source of health funding in all OECD countries, except in both the United States and Mexico where public spending was the lowest at 45%. In Iceland, 83% of health spending was funded by public sources in 2007, above the average of 73% in OECD countries, and fifth highest among all OECD countries. Public spending was, by far, the highest in Luxembourg at 91% and relatively high (above 80%) in other Nordic countries (Denmark and Norway), and the Czech Republic. Resources in the health sector

Iceland employs more resources in the health sector than most other OECD countries. In 2007, Iceland had 3.7 practising physicians per 1,000 population, compared with an average of 3.1 in OECD countries. Iceland also had 14.0 nurses per 1,000 population, compared with an OECD average of 9.6. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Iceland, the number of MRIs also increased over time, to reach 19.3 per million population in 2007, third highest in OECD countries and well above the OECD average of 11.0 MRI units per million population. Similarly, the number of CT scanners in Iceland stood at 32.1 per million population in 2007, above the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2007, life expectancy at birth for the whole population in Iceland stood at 81.2 years, more than two years above the OECD average of 79.0 years. Japan enjoyed the highest life expectancy among OECD countries (with 82.6 years), followed by Switzerland (81.7 years). The infant mortality rate in Iceland, as in other OECD countries, has fallen greatly over the past decades. It stood at 2.0 deaths per 1,000 live births in 2007, the lowest rate among OECD countries and well below the OECD average of 4.9. The proportion of daily smokers among the adult population has shown a marked decline over the past twenty-five years in most OECD countries. Much of this decline can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. In Iceland, the proportion of smokers among adults has been reduced from 33% in 1988 to 19.4% in 2007, below the OECD average of 23.3%. Sweden, the United States, Australia and New Zealand have also been remarkably successful in reducing tobacco consumption, with current smoking rates among adults below 18%. While smoking rates have decreased, obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences across countries. In 2007 (or the latest available year), the prevalence of obesity among adults varied from a low of 3.4% and 3.5% in Japan and Korea, respectively, to a high of 34.3% in the United States.

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Mexico, New Zealand, the United Kingdom and Australia also have a high prevalence of obesity among adults, with rates of over 20%1. The obesity rate in Iceland, based on self-reported data, stood at 20.1% in 2007, up from 7.5% in 1990, and highest among all Nordic countries. The time lag between the onset of obesity and increases in related chronic diseases (such as diabetes, cardiovascular diseases and asthma) suggests that the rise in obesity that has occurred in most OECD countries, including Iceland, will have substantial implications for future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Iceland, please visit www.oecd.org/iceland.

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OECD Health Data 2009 How Does Italy Compare Total health spending accounted for 8.7% of GDP in Italy in 2007, slightly below the average of 8.9% in OECD countries. Health spending as a share of GDP is highest in the United States (which spent 16% of its GDP on health in 2007), followed by France (11%), Switzerland (10.8%) and Germany (10.4%). Italy ranks below the OECD average in terms of health spending per capita, with spending of about 2686 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2964 USD.

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Between 2000 and 2007, health spending per capita in Italy increased, in real terms, by 1.9% per year on average, a growth rate lower than the OECD average of 3.7% per year. The public sector is the main source of health funding in all OECD countries, except the United States and Mexico. In Italy, 76.5% of health spending was funded by public sources in 2007, above the average of 72.8% in OECD countries. In 2007, the share of public spending among OECD countries was the lowest in Mexico (45.2%) and the United States (45.4%), and relatively high (over 80%) in several Nordic countries (Denmark, Iceland, Norway and Sweden), the United Kingdom and Japan. Resources in the health sector (human, physical, technological) Despite the relatively low level of health expenditure in Italy, there are more physicians per capita than in most other OECD countries. In 2007, Italy had 3.7 practising physicians per 1 000 population, above the OECD average of 3.1. On the other hand, there were 7 nurses per 1 000 population in Italy in 2007, a lower figure than the average of 9.6 in OECD countries. The number of acute care hospital beds in Italy was 3.1 per 1 000 population in 2007, lower than the OECD average of 3.8 beds per 1 000 population. As in most OECD countries, the number of hospital beds per capita in Italy has fallen over time. This decline has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. In Italy, the number of MRIs also increased over time, to reach 18.6 per million population in 2007, well above the OECD average of 11 MRI units per million population. Similarly, the number of CT scanners in Italy stood at 30.3 per million population in 2007, above the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2006, life expectancy at birth in Italy stood at 81.2 years, more than two years over the OECD average (79 years). Only Japan, Switzerland and Australia registered a higher life expectancy than Italy. The infant mortality rate in Italy, as in other OECD countries, has fallen greatly over the past decades. It stood at 3.7 deaths per 1 000 live births in 2006, lower than the OECD average (4.9 deaths). The proportion of daily smokers among adults has shown a marked decline over the past two decades in most OECD countries. Italy has achieved some progress in reducing tobacco consumption, with current rates of daily smokers among adults standing at 22.4% in 2007, down from 27.8% in 1990. Smoking rates in Italy is now slightly lower than the OECD average of 23.3%. Sweden, the United States and Australia provide examples of countries that have achieved remarkable success in reducing tobacco consumption, with current smoking rates among adults in these countries below 17%. Obesity rates have increased in the past two decades in nearly all OECD countries, although there remain notable differences across countries. The prevalence of obesity among adults varies from a low of 3.4% and 3.5% in Japan and in Korea, to a high of 34.3% in the United States. Mexico, New Zealand, the United

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Kingdom and Australia, also have relatively high levels of obesity among adults, with rates of over 21%1. The obesity rate in Italy, based on self-reported data, stood at 9.9% in 2007, up from 7.0% in 1994. The time lag between the onset of obesity and increases in related chronic health problems (such as diabetes or asthma) suggests that the rise in obesity that has occurred in Italy and in most other OECD countries will have substantial implications on the future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. Note that OECD Health Data 2009 is available in Italian. For more information on OECD's work on Italy, please visit www.oecd.org/italy.

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OECD Health Data 2009 How Does Norway Compare Total health spending accounted for 8.9% of GDP in Norway in 2007, identical to the OECD average (8.9%). The United States is, by far, the country that spends the most on health as a share of its economy (with 16.0% of its GDP allocated to health in 2007), followed by France (11.0%), Switzerland (10.8%) and Germany (10.4%).

In terms of health spending per capita, Norway ranked 2nd among OECD countries in 2007 (after the United States), with spending of 4,763 USD (adjusted for purchasing power parity), well above the OECD average of 2,964 USD.

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Health spending per capita in Norway increased, in real terms, by 2.5% per year on average between 2000 and 2007, below the OECD average of 3.7%. The rise in pharmaceutical spending has been one of the factors behind the rise in total health spending in many OECD countries in recent years. In 2007, spending on pharmaceuticals in Norway accounted for 8.0% of total health expenditure, considerably below the OECD average of 17.1%. The public sector is the main source of health funding in all OECD countries, except in the United States and Mexico where public spending in 2007 was the lowest at 45.4% and 45.2% respectively. In Norway, 84.1% of health spending was funded by public sources in 2007, over 10 percentage points above the average of 72.8% in OECD countries and higher than in other Nordic countries, except Denmark (84.5%). Resources in the health sector

Norway employs more human resources in the health sector than most OECD countries. In 2007, Norway had 3.9 practising physicians per 1,000 population, compared with an average of 3.1 in OECD countries. Norway also employed more nurses than any other OECD country (31.9 per 1,000 population), significantly above the OECD average of 9.6 practising nurses per 1,000 population. 1 On the other hand, the number of acute care hospital beds in Norway stood at 2.9 per 1,000 population in 2007, below the OECD average of 3.8. As in most OECD countries, the number of hospital beds per capita in Norway has fallen over time, coinciding with a reduction of average length of stays in hospitals. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2006, life expectancy at birth for the whole population in Norway stood at 80.6 years. Japan enjoyed the highest life expectancy (with 82.6 years), followed by Switzerland, Australia, Iceland and Spain (all with life expectancies of over 81 years). The infant mortality rate in Norway, as in other OECD countries, has fallen greatly over the past decades. It stood at 3.2 deaths per 1,000 live births in 2006, well below the OECD average of 4.9 in 2007. The proportion of daily smokers among the adult population has shown a marked decline over the past twenty-five years in most OECD countries. Much of this decline can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. In Norway, the proportion of smokers among adults has been reduced from 36% in 1980 to 22% in 2007, slightly above the OECD average of 23.3%. Sweden, the United States and Australia have been remarkably successful in reducing tobacco consumption, with current smoking rates among adults below 17%. While smoking rates have decreased, obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences across countries. In 2007 (or the latest available year), the prevalence of obesity among adults varied from a low of 3.4% and 3.5% in Japan and Korea, respectively, to a high of 34.3% in the United States. Mexico, New Zealand, the United Kingdom and

It is important to note, however, that the comparability of data on nurses is more limited, due to the inclusion of different classes of nurses and midwives in the data reported by different countries.

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Australia also have a high prevalence of obesity among adults, with rates of over 20%2. The obesity rate in Norway, based on self-reported data, stood at 9% in 2005, up from 5% in 1995, but still 4th lowest among those OECD countries supplying data. However, the time lag between the onset of obesity and increases in related chronic diseases (such as diabetes, cardiovascular diseases and asthma) suggests that the rise in obesity that has occurred in most OECD countries, including Norway, will have substantial implications for future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Norway, please visit www.oecd.org/norway.

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OECD Health Data 2009 How Does the Netherlands Compare Total health spending accounted for 9.8% of GDP in the Netherlands in 2007, slightly more than the average of 8.9% in OECD countries. The United States is, by far, the country that spends the most on health as a share of its economy, with 16% of its GDP allocated to health in 2007. France and Switzerland followed with 11% and 10.8% of their GDP spent on health, respectively. Several EU countries – Germany, Belgium and Austria– also devote more than 10% of their GDP to health. The Netherlands also ranks above the OECD average in terms of health spending per capita, with current spending of 3527 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2964 USD. Health spending per capita in the Netherlands remains nonetheless much lower than in the United States (which spent 7290 USD per capita in 2007), Norway (with spending of 4763 USD), Switzerland and Luxembourg (which spent over 4000 USD).

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The public sector is the main source of health funding in all OECD countries, except Mexico and the United States. In the Netherlands, 81.4% of current health spending was funded by public sources in 2007, well above the average of 72.8% in OECD countries. In 2007, the share of public spending among OECD countries was the lowest in Mexico (45.2%) and the United States (45.4%). Resources in the health sector (human, physical) The number of physicians per capita in the Netherlands was 3.9 per 1 000 population in 20071, above the OECD average of 3.1. As in most other OECD countries, the number of doctors per capita increased between 1990 and 2006. There were 8.7 nurses per 1 000 population in the Netherlands in 2007, a slightly lower figure than the average of 9.6 in OECD countries. Norway and Ireland have in excess of 15 nurses per 1 000 population. The number of acute care hospital beds in the Netherlands was 3.0 per 1 000 population in 2007, less than the OECD average of 3.8 beds. As in most OECD countries, the number of hospital beds per capita in the Netherlands has fallen over time. This reduction has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2007, life expectancy at birth in the Netherlands stood at 80.2 years, almost one year higher than the OECD average (79). Still, a third of the 30 OECD countries registered life expectancies over 80 years in 2007. The infant mortality rate in the Netherlands, as in other OECD countries, has fallen greatly over the past decades. It stood at 4.1 deaths per 1 000 live births in 2007, lower than the OECD average of 4.9. Infant mortality is the lowest in Nordic countries (Iceland, Sweden, Finland and Norway), in Luxembourg, Japan and Ireland. The proportion of daily smokers among adults has shown a marked decline over the past twenty-five years in most OECD countries. In the Netherlands, the rate of daily smokers among adults has fallen from 43% in 1980 to 29% in 2007. But compared to the current OECD average of 23.3%, and current smoking rates in countries like Sweden, the United States and Australia (14-17%), the smoking rate among adults in the Netherlands is still relatively high. Whereas smoking rates have decreased, obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences across countries. In 2007, the United States (34.3%), Mexico (30.0%), New Zealand (26.5%) and the United Kingdom (24.0%) had the highest obesity rates among adults2. The obesity rate in the Netherlands, based on self-reported data, stood at 11.2% in 2007, up from 6.1% in 1990. There is a time lag of several years between the onset of obesity and related health problems (such as diabetes and asthma), suggesting that the rise in obesity that has occurred in most OECD countries, including the Netherlands, will mean higher health care costs in the future. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. 1

The Netherlands however reports the number of physicians entitled to practise rather than only practising physicians (resulting in an upward bias). 2

It should be noted however that the data for the United States, New Zealand and the United Kingdom are more accurate than those from most other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries are based on self-reported data, which generally underestimate the real prevalence of obesity.

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For more information on OECD's work on the Netherlands, please visit www.oecd.org/netherlands.

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OECD Health Data 2009 How Does Sweden Compare Total health spending accounted for 9.1% of GDP in Sweden in 2007, slightly above the OECD average of 8.9%. The United States is, by far, the country that spends the most on health as a share of its economy (with 16.0% of its GDP allocated to health in 2007), followed by France (11.0%), Switzerland (10.8%) and Germany (10.4%).

Sweden also spends more on health per capita than many OECD countries, with spending of 3,323 USD in 2007 (adjusted for purchasing power parity), compared with an OECD average of 2,964 USD. Countries with the highest health expenditure per capita in 2007 were the United States (which spent 7,290 USD per capita), followed by Norway, Switzerland and Luxembourg (which all spent over 4,000 USD).

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The rise in pharmaceutical spending has been one of the factors behind the rise in total health spending in many OECD countries in recent years. In 2007, spending on pharmaceuticals in Sweden accounted for 13.4% of total health expenditure, but this was well below the OECD average of 17.1%. The public sector is the main source of health funding in all OECD countries, except in the United States and Mexico where public spending was the lowest at 45.4% and 45.2% respectively. In Sweden, 81.7% of health spending was funded by public sources in 2007, above the average of 72.8% in OECD countries. Public spending was, by far, the highest in Luxembourg at 90.9% and relatively high (above 80%) in other Nordic countries (Denmark, Norway, Iceland), the Czech Republic, the United Kingdom and Japan. Resources in the health sector

Sweden employs more resources in the health sector than most other OECD countries. In 2006, Sweden had 3.6 practising physicians per 1,000 population, compared with an average of 3.1 in OECD countries in 2007. In recent years, the proportion of foreign-trained doctors has increased in many OECD countries, including Sweden. Sweden also had 10.8 nurses per 1,000 population, compared with an OECD average of 9.6. On the other hand, the number of acute care hospital beds in Sweden stood at 2.1 per 1,000 population in 2006, below the OECD average of 3.8. As in most OECD countries, the number of hospital beds per capita in Sweden has fallen over time, coinciding with a reduction of average length of stays in hospitals. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2007, life expectancy at birth for the whole population in Sweden stood at 81.0 years, two years above the OECD average of 79.0 years. Japan enjoyed the highest life expectancy among OECD countries (with 82.6 years), followed by Switzerland, Australia, Iceland and Spain (all with life expectancies of over 81 years). The infant mortality rate in Sweden, as in other OECD countries, has fallen greatly over the past decades. It stood at 2.5 deaths per 1,000 live births in 2007, the second lowest rate in OECD countries following only Iceland (2.0), and well below the OECD average of 5.2. The proportion of daily smokers among the adult population has shown a marked decline over the past twenty-five years in most OECD countries. Much of this decline can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. Sweden has been especially successful, in that the proportion has been reduced from 25.8% in 1980 to 14.5% in 2007, the lowest rate among OECD countries, and well below the average of 23.3%. The United States and Australia have also been successful in reducing tobacco consumption, with current smoking rates among adults below 17%. While smoking rates have decreased, obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences across countries. In 2007 (or the latest available year), the prevalence of obesity among adults varied from a low of 3.4% and 3.5% in Japan and Korea, respectively, to a high of 34.3% in the United States. Mexico, New Zealand, the United Kingdom and Australia also have a high prevalence of obesity among adults, with rates of over 20%1. The obesity rate in 1

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Sweden, based on self-reported data, stood at a modest 10.2% in 2007, up from 5.5% in 1989. The time lag between the onset of obesity and increases in related chronic diseases (such as diabetes, cardiovascular diseases and asthma) suggests that the rise in obesity that has occurred in most OECD countries, including Sweden, will have substantial implications for future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on Sweden, please visit www.oecd.org/sweden.

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Eco-Santé OCDE 2009 Comment la Suisse se positionne Les dépenses de santé totales représentaient en Suisse 10.8% du PIB en 2007, soit 2 points de pourcentage de plus que la moyenne des pays de l’OCDE (8.9%). Les dépenses de santé par rapport au PIB restent cependant moins élevées en Suisse qu’aux États-Unis (qui enregistre le niveau le plus élevé avec 16%), et en France (11%). La Suisse se situe aussi bien au-dessus de la moyenne des pays de l’OCDE concernant les dépenses totales de santé par habitant. Avec des dépenses de 4 417 USD par habitant (ajustées sur la base de la parité de pouvoir d’achat des monnaies) en 2007, la Suisse a le niveau le plus élevé de dépenses derrière les États-Unis (7 290 USD) et la Norvège (4 763 USD).

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Entre 2000 et 2007, les dépenses de santé par habitant en Suisse, en terme réels (c’est-à-dire hors inflation), ont augmenté en moyenne de 2.1% par année, un chiffre moins élevé que la moyenne de 3.7% observée dans les pays de l’OCDE durant cette période. Le financement public représente la principale source de financement des dépenses de santé dans tous les pays de l’OCDE, à l’exception des États-Unis et du Mexique. En Suisse, 59.3% des dépenses de santé sont financées par des fonds publics, un niveau moins élevé que la moyenne des pays de l’OCDE (72.8%). Les ressources du secteur de la santé (humaines, physiques et technologiques) La Suisse compte 3.9 médecins par millier d’habitants, un chiffre beaucoup plus élevé que la moyenne de 3.1 dans les pays de l’OCDE. Par ailleurs, la Suisse compte 14.9 infirmiers par millier d’habitants, un nombre également nettement plus élevé que la moyenne de 9.6 dans les pays de l’OCDE. En Suisse, le nombre de lits d’hôpitaux pour soins aigus est de 3.5 lits par milliers d’habitants en 2007, un nombre proche de la moyenne des pays de l’OCDE (3.8 lits). Comme dans la plupart des autres pays développés, le nombre de lits d’hôpitaux disponibles par habitant a diminué au cours des 20 dernières années en Suisse. La réduction du nombre de lits d’hôpitaux dans la plupart des pays de l’OCDE a coïncidé avec une réduction de la durée moyenne des séjours à l’hôpital et une augmentation du recours à la chirurgie de jour. La diffusion des technologies médicales modernes est l’un des facteurs principaux de l’augmentation des dépenses de santé dans les pays de l’OCDE. Par exemple, le nombre d’appareils d’imagerie par résonance magnétique (IRM) utilisés pour diagnostiquer de nombreuses maladies a plus que quintuplé en moyenne dans les pays de l’OCDE depuis le début des années 1990. En 2007, le nombre d’IRM par million de population en Suisse (14.4) était plus élevé qu’en moyenne dans les pays de l’OCDE (11), alors que le nombre de scanners CT (18.7 par million de population) y était légèrement inférieur à la moyenne des pays de l’OCDE (20.2). Le pays qui dispose, et de loin, du plus grand nombre d’IRM et de scanners CT par habitant est le Japon. L’état de santé de la population et les facteurs de risque La plupart des pays de l’OCDE ont enregistré d’importants gains d’espérance de vie à la naissance au cours des dernières décennies. En Suisse, l’espérance de vie à la naissance a augmenté de 10.3 ans entre 1960 et 2006, ce qui est proche des gains enregistrés en moyenne dans les pays de l’OCDE. En 2006, l’espérance de vie en Suisse était de 81.7 ans, soit presque 3 ans de plus que la moyenne des pays de l’OCDE (79 ans). Seul le Japon enregistre une espérance de vie plus élevée que la Suisse. La proportion d’adultes déclarant fumer quotidiennement a diminué dans la plupart des pays de l’OCDE au cours des deux dernières décennies. En Suisse, la proportion d’adultes qui fument quotidiennement est passée de 28.2% en 1992 à 20.4% en 2007, un pourcentage inférieur à la moyenne des pays de l’OCDE (23.3%). L’Australie, les États-Unis et la Suède fournissent des exemples de pays qui ont réduit de manière encore plus importante la prévalence du tabagisme. Ils enregistrent des taux de moins de 17% de la population adulte qui fume quotidiennement. La consommation d’alcool par habitant a diminué dans la plupart des pays de l’OCDE au cours des dernières décennies. En Suisse, la consommation globale d’alcool a fortement reculé depuis 1970, mais elle reste néanmoins plus élevée que la moyenne des pays de l’OCDE.

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Les problèmes d’obésité ont considérablement augmenté au cours des deux dernières décennies, même s’il existe des différences notables de prévalence de l’obésité chez les adultes selon les pays. En Suisse, le taux d’obésité parmi la population adulte est de 8.1% en 2007, en augmentation de 2.7 points de pourcentage en 15 ans, mais restant bien inférieur aux taux enregistrés dans la plupart des autres pays développés. Les taux d’obésité les plus élevés se retrouvent notamment aux ÉtatsUnis (34.3% en 2006), au Royaume-Uni (24% en 2007) et en Australie (21.7% en 1999)1. Le temps de latence entre l’apparition de l’obésité et l’accroissement des maladies chroniques qui y sont liées (comme le diabète et l’asthme) laisse à penser que la forte augmentation de la population obèse dans la plupart des pays de l’OCDE aura, dans l’avenir, des implications considérables en termes de santé et de dépenses de santé. Pour davantage d’informations concernant Eco-Santé OCDE 2009, veuillez consulter www.oecd.org/sante/ecosante. Pour plus d’informations concernant les travaux de l’OCDE sur la Suisse, veuillez vous rendre sur le site www.oecd.org/suisse.

Il est à noter cependant que ces données pour les États-Unis, le Royaume-Uni et l’Australie sont plus fiables et précises que celles des autres pays car elles sont fondées sur un examen médical au cours duquel on a mesuré la taille et le poids réel des individus, alors que les données pour les autres pays (incluant la Suisse) sont basées sur de simples déclarations des répondants, ce qui entraîne généralement une sousestimation.

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OECD Health Data 2009 How Does the United Kingdom Compare Total health spending accounted for 8.4% of GDP in the United Kingdom in 2007, compared with an average of 8.9% across OECD countries. The United States is, by far, the country that spends the most on health as a share of its economy, with 16% of its GDP allocated to health in 2007. France and Switzerland followed with 11.0% and 10.8% of their GDP spent on health, respectively. Several EU countries – Germany, Belgium and Austria – and Canada also devote more than 10% of their GDP to health. In terms of per capita spending on health, the United Kingdom closely matches the OECD average, with spending of 2992 USD in 2007 (adjusted for purchasing power parity). Health spending per capita in the United Kingdom remains much lower however than in the United States (which spent 7290 USD per capita in 2007), and significantly lower than some other big spenders, such as Norway and Switzerland (with spending of over 4400 USD per person).

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Between 2000 and 2007, health spending per capita in the United Kingdom increased in real terms by 4.7% per year on average, a faster growth rate than the OECD average (3.7% per year). The public sector continues to be the main source of health funding in all OECD countries, except Mexico and the United States. In the United Kingdom, 82% of health spending was funded by public sources in 2007, well above the average of 73% for OECD countries. Resources in the health sector (human, physical, technological) Following a perceived shortage of health professionals in the United Kingdom, there has, over recent years, been a determined and active campaign to increase numbers. Latest figures show that in 2007, the United Kingdom had 2.5 practising physicians per 1 000 population, up from 1.9 doctors per 1 000 population in 2000, but still below the OECD average of 3.1, and well behind some other European countries such as France, Germany, Italy and Sweden, which all record 3.4 or more physicians per 1 000 population. In 2007, there were 10.0 nurses per 1 000 population in the United Kingdom, up from 9.2 in 2000. The OECD average was 9.6 nurses per 1 000 population in 2007. The number of acute care hospital beds in the United Kingdom was 2.6 per 1 000 population in 2007, below the OECD average of 3.8 beds per 1 000 population. In line with many OECD countries, the number of hospital beds per capita in the United Kingdom has fallen gradually over the past decade or so. This decline has coincided with a reduction of average length of stays in hospitals and an increase in the number of surgical procedures performed on a same-day (or ambulatory) basis. During the past decade, there has been rapid growth in the availability of diagnostic technologies such as computed tomography (CT) scanners and magnetic resonance imaging (MRI) units in most OECD countries. Although the United Kingdom has also seen some increase in such technologies, the number of MRIs in 2007 was 8.2 per million population, below the OECD average of 11.0. Furthermore, the number of CT scanners in the United Kingdom stood at 7.6 per million population, less than half the OECD average of 20.2. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades, linked to improvements in living conditions, public health interventions and progress in medical care. In 2005, life expectancy at birth in the United Kingdom was 79.1 years, just above the OECD average of 78.9 years. However, several major European countries â&#x20AC;&#x201C; France, Italy and Spain â&#x20AC;&#x201C; registered a higher life expectancy than the United Kingdom. The infant mortality rate in the United Kingdom, as in other OECD countries, has fallen significantly over the past decades. It stood at 4.8 deaths per 1 000 live births in 2007. Although lower than the OECD average of 4.9, this is still higher than most European countries. The lowest infant mortality rates are reported in some Nordic countries (Iceland, Sweden and Finland), Luxembourg and Japan. The proportion of daily smokers among adults has shown a marked decline over the past two decades in most OECD countries. The United Kingdom has achieved some progress in reducing tobacco consumption, with current rates of daily smokers among adults standing at 21% in 2007, below the OECD average of 23%. Currently, the lowest rates among all OECD countries are in Australia, Sweden and the United States, all with fewer than 17% of adults reporting to be daily smokers. Obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences across countries. In the United Kingdom, the obesity rate among adults, at 24% in 2007, ranks 2

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as one of the highest in the OECD, although it remains lower than in the United States (34% in 2006) and similar to Australia and New Zealand1. The rate of obesity has more than doubled over the past twenty years in the United States, while it has almost tripled in Australia and more than tripled in the United Kingdom. There is a time lag of several years between the onset of obesity and related health problems (such as diabetes and asthma), suggesting that the rise in obesity that has occurred in most OECD countries, including the United Kingdom, will mean higher health care costs in the future. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on the United Kingdom, please visit www.oecd.org/uk.

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OECD Health Data 2009 How Does the United States Compare Total health spending accounted for 16.0% of GDP in the United States in 2007, by far the highest share in the OECD. Following the United States were France, Switzerland and Germany, which allocated respectively 11.0%, 10.8% and 10.4% of their GDP to health. The OECD average was 8.9% in 2007. The United States also ranks far ahead of other OECD countries in terms of total health spending per capita, with spending of 7,290 USD (adjusted for purchasing power parity), almost two-and-a-half times greater than the OECD average of 2,964 USD in 2007. Norway follows, with spending of 4,763 USD per capita, then Switzerland with spending of 4,417 USD per capita. Differences in health spending across countries may reflect differences in price, volume and quality of medical goods and services consumed.

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Between 2000 and 2007, health spending per capita in the United States increased, in real terms, by 3.7% per year on average, the same rate as the OECD average. The public share of health expenditure in the United States (45%) is much lower than in any other OECD country (except Mexico, also 45%), but nevertheless public expenditure on health is higher than in most other OECD countries, because overall spending per capita is so much greater. For this amount of expenditure in the United States, government provides insurance coverage only for the elderly and disabled (through Medicare, which primarily insures persons aged 65 and over and people with disabilities) and some of the poor (through Medicaid and the State Childrenâ&#x20AC;&#x2122;s Health Insurance Program, SCHIP), whereas in most other OECD countries this is enough for government to provide universal primary health insurance. Private insurance accounts for 35% of total health spending in the United States, by far the largest share among OECD countries. Beside the United States, Canada and France are the only two other OECD countries where private insurance represents more than 10% of total health spending. Resources in the health sector (human, physical) Despite the relatively high level of health expenditure in the United States, there are fewer physicians per capita than in most other OECD countries. In 2007, the United States had 2.4 practising physicians per 1,000 population, below the OECD average of 3.1. There were 10.6 nurses per 1 000 population in the United States in 2007, which is slightly higher than the average of 9.6 across OECD countries. The number of acute care hospital beds in the United States in 2007 was 2.7 per 1 000 population, lower than the OECD average of 3.8 beds. As in most OECD countries, the number of hospital beds per capita has fallen over the past twenty-five years in the United States. This decline has coincided with a reduction in average length of stays in hospitals and an increase in day surgeries. Health status and risk factors Most OECD countries have enjoyed large gains in life expectancy over the past decades. In the United States, life expectancy at birth increased by 8.2 years between 1960 and 2006, which is less than the increase of almost 15 years in Japan, or 9.4 years in Canada. In 2006, life expectancy in the United States stood at 78.1 years, almost one year below the OECD average of 79.0 years. Japan, Switzerland and Australia were the three countries with the highest life expectancy. Infant mortality rates in the United States have fallen greatly over the past few decades, but not as much as in most other OECD countries. It stood at 6.7 deaths per 1 000 live births in 2006, above the OECD average of 4.9. Among OECD countries, infant mortality is the lowest in some of the Nordic countries (Iceland, Sweden and Finland), Luxembourg and Japan, with rates between 2 and 3 deaths per 1 000 live births. The proportion of daily smokers among the adult population has shown a marked decline over recent decades across most OECD countries. Much of this decline can be attributed to policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. In the United States, the proportion of daily smokers among adults has been cut by more than half over the past twenty-five years, falling from 33.5% in 1980 to 15.4% in 2007. This is the lowest rate among OECD countries after Sweden. At the same time, obesity rates have increased in recent decades in nearly all OECD countries, although there remain notable differences in obesity rates across countries. In the United States, the obesity rate among adults (34.3% in 2006) is the highest in OECD countries, followed by Mexico (30.0%) and the 2

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United Kingdom (24.0%)1. Obesity rates in Continental European countries are lower, but are also rising. The time lag between the onset of obesity and increases in related chronic diseases (such as diabetes, cardiovascular diseases and asthma) suggest that the rise in obesity that has occurred in the United States and other OECD countries will have substantial implications for future incidence of health problems and related spending. More information on OECD Health Data 2009 is available at www.oecd.org/health/healthdata. For more information on OECD's work on the United States, please visit www.oecd.org/us.

It should be noted however that the data for the United States and the United Kingdom are more accurate than those from most other countries since they are based on actual measures of peopleâ&#x20AC;&#x2122;s height and weight, while estimates for other countries are in many cases based on self-reported data, which generally under-estimate the real prevalence of obesity.