Romania has the highest death rate from preventable and treatable causes are among in the EU, reads the latest European Commission report on the State of Health in Romania.
“Although it has increased, Romania has among the lowest life expectancy in the EU. This reflects unhealthy behaviours, but also socioeconomic inequalities as well as substantial deficiencies in health service delivery. The Social Health Insurance system provides a comprehensive benefit package – however, about 11% of the population remains uninsured and is entitled to only a minimal basket of services. Key challenges for the health system include fixing the imbalance between primary care and hospital care, and tackling the growing shortages of health professionals,” the Commission points out.
Th report says that life expectancy at birth in Romania has increased by more than four years since 2000 (from 71.2 years to 75.3 years in 2017). “However, there are large disparities in life expectancy by gender and education level, particularly for men: the least educated men can expect to live about 10 years less than the most educated. Ischaemic heart disease remains the main cause of death, although cancer mortality is on the rise. Romania also faces challenges in controlling some infectious diseases, with the highest rate of tuberculosis cases in the EU.”
Around half of all deaths in Romania are attributable to behavioural risk factors. One in five Romanian adults are daily smokers, with a much higher rate among men (32 %) than women (8 %). Adult obesity rates are among the lowest in the EU (10 %), but overweight and obesity rates in children have increased over the last decade to reach 15 %. Alcohol consumption is a major public health threat, with the binge drinking rate (35 %) far exceeding the EU average of 20 %. In men, this rate is over 50 %.
Health spending in Romania is the lowest in the EU, both on a per capita basis (EUR 1 029, EU average EUR 2 884) and as a proportion of GDP (5 %, EU 9.8 %). The share of publicly financed health spending (79.5 %) is in line with the EU average (79.3 %), and while out-of-pocket payments are generally low, except for outpatient medicines, informal payments are both substantial and widespread. In absolute terms, spending in all sectors is low and the health system is significantly underfunded.
The death rates from preventable and treatable causes are among the highest in the EU. More effective public health and prevention policies, and an enhanced role for primary care and improved access to services, could substantially reduce premature mortality.
Chronic disease or disability after age 65 affect women more than men
Romanians aged 65 could expect to live an additional 16.7 years in 2017, an increase of almost two years from 2000. However, several years of life after age 65 are spent with some chronic disease or disability, above the EU average. While the gender gap in life expectancy at age 65 remains substantial (with Romanian men living about three and a half years less than women), the gap is in line with the EU average. Regarding healthy life years1, on average, women live only slightly longer in good health than men (5.1 years for men compared to 5.9 per women in 2017).
While only 46 % of Romanians over 65 report having one or more chronic disease (compared to 54 % in the EU), most are able to continue to live independently into old age. However, 31 % of Romanians over 65 report some limitations in their activities of daily living (ADL) such as dressing and eating, which is well above the EU average.
Tuberculosis remains an important public health issue in Romania
The control of certain infectious diseases, such as tuberculosis (TB) and measles, continues to be an important public health issue in Romania. The number of TB cases has declined over the past decade, but is still the highest in the EU (around 13 000 cases
in 2017). The notification rates for all TB cases are also falling but remain well above the EU/EEA average (66.2 compared to 10.7 per 100 000 in 2017). Measles is also a persistent public health issue in Romania, with one of the highest notification rates in the EU (102.1 per million in 2018, compared with 26.2 in the EU as a whole). This trend is linked to low immunisation coverage.
One in five Romanian adults smokes on a daily basis
Tobacco consumption is a major public health challenge in Romania. Despite a slight reduction in smoking rates since 2008, one in five adults still smoked daily in 2014, in line with the EU average (Figure 7). There is a large gender gap in smoking, with smoking rates among men (32 %) four times higher than among women (8 %). Regular tobacco consumption in adolescents is also a matter of concern, with nearly one third of 15- and 16-year-olds reporting having smoked during the preceding month in 2015, among the highest rates in the EU. The effects of the 2016 Law on Prevention and Control of Tobacco are yet to be seen, the EC report mentions.