Maltese people enjoy generally good health and one of the longest life expectancies in the European Union, but Malta’s sky-high obesity rate remains a major public health challenge along with binge drinking among adolescents, a report into the State of Health in Malta found.
The report, issued by the Organisation for Economic Co-operation and Development (OECD) and European Observatory on Health Systems and Policies in cooperation with the European Commission, also found that while investment has been made in new medical equipment and additional hospital units to improve capacity across several sectors, Malta is facing a critical issue in ensuring availability of new medicines, with the government’s list of approved medicines struggling to keep up with innovation.
It also found that Malta spent 9.3% of its GDP on health care in 2017, compared to an EU average of 9.8%, and noted that reorienting services away from hospital settings towards primary and outpatient care to improve efficiency and enhance care for chronic conditions is a priority.
“A reorientation of services to more cost-effective settings will help accommodate future projected increases in spending due to an ageing population”, the report concludes in its key findings.
Life expectancy at birth was 82.4 years in 2017, which is the seventh highest in the EU, which is an increase of more than four years since the year 2000.
Women can expect to live almost four and a half years longer than men (84.6 compared to 80.2 years), though this gender gap in life expectancy is smaller than the EU average (5.2 years).
Maltese people spend the majority of their lives in good health, the report notes, and in 2017 had the highest healthy life expectancy at birth for women in the EU (73.6 years) and the second highest for men (71.9 years) after Sweden.
In fact the Maltese population lives two thirds of their life after reaching the age of 65 free of health problems and disabilities. Just over half of people aged 65 and over report having at least one chronic disease, a proportion that is similar to other EU countries. However, only about one in eight people in this age group report severe disabilities in the form of limitations in basic activities of daily living, such as dressing and showering, lower than the average rate across the EU.
Looking at the risk factors, the report identifies obesity and behavioural risk factors such as poor diets, smoking, and low physical activity as risks.
The report states how the obesity rate in Malta has risen over the past decade and is now the highest in the EU for both adults and children. One in four adults in 2017 and almost one in three 15-year-olds in 2013–14 were obese.
These high rates are driven by a number of factors, such as sedentary lifestyles, larger portion sizes, access to ready-made foods and the traditional Mediterranean diet increasingly being replaced by intake of unhealthy foods, the report concluded.
The report found that the high prevalence of obesity likely links with the fact that Malta’s rate of diabetes is the third highest in the EU. The mortality rate from diabetes has increased slightly in recent years, the reports found.
Almost two in five deaths in Malta can meanwhile be attributed to behavioural risk factors, close to the EU average of 39%, the report finds. Dietary risks, including low vegetable and fruit intake, and high sugar and salt intake, were linked to one in five deaths in 2017, with tobacco consumption (including direct and second-hand smoking) and low physical activity responsible for an estimated 17 % and 4 % of all deaths respectively.
Smoking rates in adults have remained stable since 2008 in contrast to a downward trend in most EU countries, but smoking rates among 15 to 16 year olds have fallen substantially in the last decade and were fifth lowest in the EU in 2015.
Heavy alcohol consumption among 15 to 16 year-olds has declined since 2007 but remains a public health concern, the report reads. Half of 15 to 16 year-old girls and 45 % of boys reported at least one episode of binge drinking during the past month in 2015, above the EU average.
In terms of other causes of death, cardiovascular diseases remain the main cause, although mortality rates owing to such diseases have declined by almost 50% between 2000 and 2016.
Cancers meanwhile were the second leading cause of mortality, responsible for almost 27% of all deaths. Delving into specific cancers, the last 15 years has seen a marked decrease in the morality rate from breast cancer, while the mortality rate from lung cancer, while remaining the most common individual cause of cancer deaths as of 2016, has remained stable as one of the lowest in the EU.
There was a slight increase in deaths from prostate cancer between 2015 and 2016, but the overall trend is still one of decline. Similar progress however has not been observed in pancreatic cancer, with death rates in men continuing to rise.
The report notes that a second National Cancer Plan has been launched, aiming to further improve prevention and treatment of cancer in the country.
HIV is also identified as an important public health challenge even though it is noted that the rate of newly reported cases decreased between 2016 and 2017. The report does take note of efforts to improved the diagnosis rates with the support of increased provision of rapid-testing HIV kits. However, meeting the costs of new medicines for the increasing number of people living with HIV remains a major challenge, the report notes.
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