A new OECD analysis of health systems around the world has shown how the COVID-19 pandemic contributed to a 16% increase in the expected number of deaths in 2020 and the first half of this year.
“Investing more into health systems contributes to gains in health outcomes, by offering more accessible and higher quality care,” the report said.
“Differences in risk factors such as smoking, alcohol and obesity also explain cross-country variation in health outcomes. Social determinants of health matter too, notably income levels, better education and improved living environments.”
During the relevant period, life expectancy in the US was cut by 1.6 years and dropped by 1.5 years in Spain. Life expectancy fell across 24 of 30 OECD countries with comparable data, with the exception of Norway, Japan, Costa Rica, Denmark, Finland and Latvia.
By definition, life expectancy at birth is a measure of how long on average people are expected to live given age-specific death rates. This means that actual life spans will be higher than calculated life expectancy.
The overall decline in life expectancy, which in some nations slowed down over time, was multifaceted, according to the OECD. Its report cited the impact of economic recessions like the 2008 Global Financial Crisis and associated austerity measures that exacerbated mental health deterioration across populations, as well as increased suicide rates.
The ‘exceptionally high number of deaths’ caused by the COVID-19 pandemic was also expected to have a major impact on life expectancy data going forward, the report suggested, with 1.7 million excess deaths recorded in OECD countries in 2020 and the first half of 2021.
“Principal among [the causes of a slowdown in life expectancy gains] is slowing improvements in heart disease and stroke,” the report said.
“Rising levels of obesity and diabetes, as well as population ageing, have made it difficult for countries to maintain previous progress in cutting deaths from such circulatory diseases.
“Respiratory diseases such as influenza and pneumonia have claimed more lives in recent years – most notably in 2015, but also in the winters of 2012-13 and 2016-17.”
Factors slowing life expectancy growth included rates of smoking, alcohol abuse, and obesity (on average 60% of people were measured as being overweight or obese), the report said. The OECD said its analysis showed spending on disease prevention was still ‘relatively low’ and counted for only 2.7% of health spending on average.
The report also signalled air pollution as a major environmental threat that was estimated to cause 6 to 9 million premature deaths annually by 2060.
“Premature deaths attributable to ambient particulate matter ranged from over 70 per 100, 000 people in Poland and Hungary, to less than 7 deaths per 100, 000 people in Iceland, New Zealand and Sweden, in 2019,” the OECD said.
“What is clear is that continued gains in longevity should not be taken for granted, with better protection of older people and other at-risk populations paramount to extending life expectancy.”
The OECD analysis also revealed a sharp increase in health spending in line with the timeline of the global pandemic — those countries which were more severely affected reported ‘unprecedented increases’. Health spending represented around 13% of spending on average for OECD countries. In Australia, primary health care spending was more than 17% of government expenditure.
“At a country-specific level, general outpatient care provided by ambulatory providers is particularly high in Australia, Mexico and Poland, reaching around 12% of all health spending,” the report said.
Scary day for hospital workers in Vic tomorrow. Very mixed feelings re opening up despite thousands of active cases. UK experience shows this is nowhere near over. Help them help you. Get #vacced. https://t.co/DZYhSmNKjs
— AMA President (@amapresident) October 21, 2021
In September, the Australian Medical Association was raising a flag, declaring that with the closure of international borders, staffing levels had thinned right out. Responding to a national cabinet review of hospital capacity in the event of an outbreak, AMA president Dr Omar Korshid said Australia had the lowest bed-to-patient ratio in decades, emergency and elective performance were on a trajectory of decline, and Australia’s doctors and nurses were barely coping with their workloads and the constraints of the system.
The report also outlined the experience of health systems in the last two years, showing that ongoing nurse and doctor shortages persisted. Lack of long-term care staff proved to be more of a care constraint than the provision of available hospital beds and equipment, the OECD determined.
In the UK, health spending was estimated to increase from 10.2% in 2019 to 12.8% in 2020, while Slovenia anticipated its share of spending on health rising from 8.5% to more than 10%.
“In Canada, Switzerland, Austria, Germany and Luxembourg, spending on general outpatient care is much lower overall, accounting for less than 5% of health spending,” the report said.