This article is part of our special report Tackling Chronic Diseases in the EU.
SPECIAL REPORT / Cancer, diabetes, mental disorders, and chronic respiratory illnesses account for 86% of deaths, and 77% of the disease burden in Europe, with the main risk factors being tobacco use, alcohol abuse, poor diets and lack of physical activity.
The issue was discussed last week (3-4 April) at a summit in Brussels, organised at the initiative of Health Commissioner Tonio Borg. The reason for this forum, the first of its kind, is the fact that the is EU is heavily impacted by chronic diseases, and the trend is increasing.
“We have taken a lot of steps through joint actions, but also through financing programs in the member states. But I think it (chronic diseases) should occupy a more important position on the political agenda,” Borg told EurActiv in an interview in November, explaining why the summit is urgently needed.
Alberico Catapano, professor of Pharmacology at the Faculty of Pharmacy at the University of Milan, told EurActiv that while the EU’s population is becoming older due to better health systems, there is a side effect: chronic diseases such as diabetes, obesity, hypertension and dyslipidemia are on the rise. Altogether, they are creating a big burden, Catapano said.
Economic burden and slow politicians
According to France’s Mutuelle Générale de l’Education Nationale (MGEN) and the poll taker Opinion Way, obesity is rapidly becoming a European epidemic. Though overweight and obesity may not cause major physical or medical complications at a young age, they might trigger physical, as well as psychological and social problems, later in life.
Despite a clear rationale, and calls from the World Health Organization (WHO) and the Organisation for Economic Co-operation and Development (OECD), among others, to halt and revert obesity trends, governments are not really engaging in effective measures to curb obesity, according to the European Centre for International Political Economy (ECIPE).
“On current trends, and if no changes are made to the healthcare coverage, governments in Europe will soon be facing rapidly increasing costs related to the treatment of illnesses and health problems associated with obesity,” the ECIPE wrote in a policy document recently published.
Catapano said that while politicians have short term goals, it is the long-term approaches that are the best ways to help patients.
“This is what we are missing; long-term plans which are independent of the interests of politicians, but in the interest of the populations. As long as we deal with these short-term views we get the results thereafter,” the professor stated.
The ECIPE said that there are a number of possible measures, which EU member states, in a more or less extensive way, have been experimenting with, in order to tackle and prevent obesity, and excessive weight, gain and thereby chronic diseases.
Such measures include those suggested by the OECD: food education and physical activity at school level, or food taxes targeting food products with high content of sugar or saturated fat.
The effects of special taxes have not been encouraging, the ECIPE stated, partly depending on the use of the resulting revenue. In France, attempts have been made to reinvest tax revenues in the healthcare sector, whereas similar tax revenues in Denmark and Hungary were disconnected from the healthcare sector.
Special focus on diabetes
The ECIPE has also stressed the need for special attention to diabetes, a chronic disease linked to heart disease and stroke. Around 9.3% of the total health budget of the EU is spent on diabetes because 32 million people in the EU have the disease, and the number is growing.
Only a month ago, experts in Brussels called for the chronic disease curve to be broken, as it has not only great economic consequences, but also generates social inequality.
On top of the healthcare costs related to treatment, diabetes also creates many indirect costs for a society due to lower productivity among the workforce, early retirement and payments of social benefits. This is despite the fact that type 2 diabetes, to a large extent, is preventable. The risk factors include excessive weight gain and obesity, an unhealthy diet, and lack of physical activity.
The Danish minister for health, Nick Hækkerup, told EurActiv in an interview that the disease needs attention at an earlier stage to make the treatment more efficient and the consequences fewer.
However, another chronic disease needs special attention: familial hypercholesterolemia (genetic disorder characterised by high levels of the bad cholesterol), but this is often overlooked, Catapano said.
For every 250 people, there is one person living with familial hypercholesterolemia, which puts them at high risk of getting a cardiovascular disease.
Even though people with high levels of bad cholesterol do not have any symptoms, such as headaches, which affects persons with high blood pressure, many are living with the dangerous condition without knowing it. At the same time, those who are being treated often tend to be more relaxed when taking their medicines as they do not feel any pain, Catapano stressed.
He added that the EU can play an important role in addressing the consequences of a chronic disease, such as familial hypercholesterolemia.
“The EU does have some ways to deal with the problems. At least in can stimulate the discussions around these points and show that there’s money available for research and implementation programmes. The EU can put money in the areas of education, prevention and research that are related to chronic diseases,” Catapano stated.
According to the World Health Organization (WHO), chronic diseases, such as cardiovascular disease and cancer are by far the leading cause of mortality in the world, representing 60% of all deaths.
Approximately four million people in Europe and 1.5 million people in the EU die of cardiovascular disease each year, according to the European Heart Network (EHN) and the European Society for Cardiology (ESC). The main forms of heart disease are coronary heart disease and stroke.
To reduce the amounts of death from heart diseases, European Union countries agreed to tackle the underlying health determinants behind cardiovascular health in its 2014-2020 health programme.
A key element in fighting cardiovascular disease is to address the underlying health determinants, including bad cholesterol, tobacco use, obesity, diet and physical activity and high blood pressure.
- 30 Apr.: European Congress on Obesity
- 17 May: European Obesity Day
- 19-24 May: World Health Assembly in Geneva
- European Commission: EU Register of nutrition and health claims made on foods
- European Commission: EU health budget 2014-2020
- European Food Safety Authority (EFSA): Scientific opinion on plant stanol esters and blood cholesterol
- MEP Heart Group: Cardiovascular Health Week: Mind your Heart - for a Heart Healthy Europe, 4-8 November 2013