Interview: ‘Huge health gaps remain inside the EU’


A project examining the health gap between the eastern and western members of the EU concludes that the main reasons for differences in premature death rates and ill-health are lifestyle-related.

“Huge gaps in health exist between eastern and western [European] countries,” said Professor Witold A. Zato?ski, summarising the results of an EU-funded project which studied health inequalities between the EU 15 and the ten new eastern member states.

“This gap is characterised by much higher mortality rates for cardiovascular (CDV) diseases in eastern European countries, which is very strongly connected to access to related medical services but also to lifestyle factors. Tobacco smoking, diet and alcohol seem to be essential factors with regard to decreasing mortality from CDV diseases,” stated Zato?ski.

According to the findings of the Closing the Gap project, published on 23 October 2007, the ten new eastern European member states can be divided into three different categories: the EU 5 (Czech Republic, Hungary, Poland, Slovenia and Slovakia), the EU 3 (the Baltic countries: Estonia, Latvia and Lithuania) and the EU 2 (Bulgaria and Romania). 

The project found that premature adult mortality, which was increasing in all of these countries between 1960 and 1990, has rapidly decreased in the EU 5, mainly due to a significant decline in CDV diseases. The CDV disease situation is, however, stagnating or even increasing in the Baltic countries, as well as in Bulgaria and Romania. 

Reduction of CDV diseases in the EU 5 is caused by the decrease in the use of animal fat, it is argued. “After 1990, state subsidies for animal products disappeared and vegetables became relatively cheap, so there was a big change in the consumption of fat as vegetable fat, and in particular seed oil, replaced butter,” explained Zato?ski.

Another interesting finding is that fatal injuries still account for about half of premature, adult male mortality in the Baltic countries, whereas the rate has somewhat decreased in the other new member states. According to the project, fatal injuries are mainly due to excess alcohol consumption.

Regarding alcohol, the project partners also point to a high burden of alcohol-related diseases such as cancer and liver cirrhosis, and in particular in Hungary, Romania, Slovakia and Slovenia. Harm is said to result mainly from the drinking pattern (‘binge drinking’) and the quality of alcohol consumed (often homemade or products not intended for consumption).

Whereas tobacco remains a leading cause of premature death throughout the EU, a positive improvement is noticeable in the east, as the number of smokers is declining.

Asked what can be done to change people’s lifestyles, Zato?ski said that “we can look at good examples in the West. Finland, for example, [once] had very similar nutritional habits as eastern countries and a high mortality rate from CDV, but it was able to change it. It cost a lot of money and took a lot of work, but they changed. The change was connected to knowledge, attitude and a change in behaviour. This can only be done by very close co-operation between a government and the population.”

To read the full interview with Professor Witold A. Zatonski, please click here.

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