Chronic diseases are the most prevalent illnesses in Europe to date and affect about 4 out of 5 European citizens above 65 years. They account for 86% of the annual deaths and 77% of the disease burden in the European region, with cardiovascular diseases, cancers, respiratory diseases and diabetes being the main contributors to these figures.
Living with a chronic condition does not only affect one’s quality of life but also leads to absenteeism from school or work, decreased productivity and higher employee turnover. Chronic diseases also have a strong link with age and the ageing population. While only 7% of young people (16-24 years) report having a chronic condition, this figure rises to 61% for people aged 65 and older. Often, older people suffer from more than one chronic disease – a condition called multimorbidity, that appears in 85% of people 85 years and older and that affects around 50 million Europeans.
At least 700 billion Euros spent annually on chronic diseases
In addition to strains they place on individual’s lives, chronic diseases are a big economic burden to society. 70% to 80% of annual healthcare costs are spent on chronic diseases with a total of more than 700 billion Euros in the European Union. While there is much evidence for the positive impact of health promotion on public health and health status of citizens, it is often underused in policymaking. Currently, an average of only around 3% of the healthcare expenditures in the European region is spent on prevention, while 97% of health budgets are allocated to the treatment of NCDs.
A recent publication by the European Observatory on Health Systems and Policies makes the economic case for health promotion and disease prevention, in particular for chronic diseases. The authors suggest that there is strong evidence for cost-effectiveness, especially when various measures are applied, like fiscal policies, regulation and better health information.
European countries join forces to act on chronic diseases
One initiative at EU-level to reduce the burden of chronic diseases is the Joint Action CHRODIS (JA-CHRODIS). This European collaboration brings together over 70 associated and collaborating partners from national and regional departments of health, research institutions and organizations from 25 European countries. They work together to identify, validate, exchange and disseminate good practices on chronic diseases across Europe and to facilitate their scaling up and transfer across local, regional and national borders. For this, JA-CHRODIS focuses on three main topics: health promotion and primary prevention, the management of multimorbid chronic conditions and the management of diabetes as a case study.
The work on health promotion, led by EuroHealthNet member BZgA (Germany) together with EuroHealthNet, has found that most European countries have developed approaches to health promotion and healthy ageing across the life cycle. Starting off with a comparative overview of key policies, approaches, gaps and needs based on 14 country reports, partners outlined the health promotion and primary prevention landscape. Though there are significant differences in terms of systems and structures across partner countries, the overview also showed that there is the same and strong need for consistent investment in health promotion and primary prevention in order to make health systems more sustainable.
In a subsequent stage, partners selected a total of 41 good practice examples, which have shown to have a positive impact on the health status of populations and groups, with a focus on vulnerable populations. These evidence-based and highly promising examples reflect a broad thematic range of interventions across the life cycle and in various settings as well as examples of policies and strategies.
As a last step in the life span of JA-CHRODIS, the transferability of a few selected good practices is assessed during five study visits in the Netherlands, Portugal, Iceland, Italy and the UK. Questions being discussed in the study visits include: How can a certain practice potentially be transferred or scaled up? What elements are needed to adapt the practice to a new setting or a different local context? What are key lessons the JA-CHRODIS network can benefit from? The conclusions of the discussion will be documented and a recommendations report will be produced, describing success factors and barriers for transferring or scaling up promising practices into different contexts.
More information can be found on the JA-CHRODIS website