Posted by Clare Bambra, Fuse Associate Director & Professor of Public Health Geography, Durham University
If Euro 2016
was based on how healthy each nation is, there would be some surprising
results. England would
get knocked out in the quarter finals of Euro 2016 if the tournament was based
on how healthy each nation is. Based on health statistics, Switzerland would
walk away as European Champions for the first time in the competition’s
history, narrowly beating Iceland on penalties in the final.
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The European Health Championship is an accessible way to shed light on
these stark differences. It scores each nation’s football team based on the
country’s male life expectancy at birth for 2013. From these scores, the winners and
losers of each group are decided as well as the results of the games in the
knock out stages.
England, with a
male life expectancy of 79 years, would be winners of their group by beating
Russia (63 years), Slovakia (72 years) and Wales (78 years). England would then
beat Czech Republic (75 years) in the round of 16 knockout stage but would lose
to Iceland (81 years) in the quarter-finals. Likewise, Wales and Northern
Ireland, with a male life expectancy of 78 years each, would be beaten by Austria
and France (79 years each) in the round
of 16 knockout stages. Switzerland and Iceland both with male life expectancy
of 81 years meet in the final, with Switzerland winning on penalties because
female life expectancy there is 85 years compared to 84 years in Iceland.
The European
Health Championship also reveals a clear east-west gap with worse health in the
countries of Eastern Europe compared to those in the West. For example, in the
host country France (the runners-up in group A), baby boys are expected to live
up to 79 years old whilst in Ukraine, who finish bottom of group C, it is just
66 and in Russia (bottom of group B) it is a mere 63 years. Spain and Italy
also fare well with men expected to live up to 80 in those countries.
But what
explains these differences in health across European countries? Why do some
countries perform so much better in health terms than others? Geographical
research suggests that the answer is twofold: the health of places is
determined by the population composition (who
lives here) and the environmental context (where you live).
Who lives here? The demographic, health behaviours and socio-economic profile of the people within a place influences its health outcomes. Generally speaking, health deteriorates with age, women live longer than men, and health status also varies by ethnicity. Levels of smoking, alcohol, physical activity, diet, and drugs – all influence the health of populations significantly. Indeed, research has strongly linked Russia’s comparatively low life expectancy amongst men with the high levels of alcohol consumption in the country particularly since the collapse of communism. The socio-economic status – or social class in “old money” – of people living in a country also matters as those with higher occupational status (e.g. professionals such as teachers or lawyers) have better health outcomes than non-professional workers (e.g. manual workers). So differences in the characteristics of people in the countries of Europe will contribute to these country level differences in life expectancy.
However,
research also shows that where you live
matters. The economic environment of
a country, such as poverty rates, unemployment rates, or wage levels can
influence health. Countries with lower poverty rates, for example Switzerland
or Iceland, do better than countries with higher poverty rates such as England.
The social environment, including the services provided within a country to
support people in their daily lives such as child care or health care and
welfare, can also impact on population level health. The physical environment
is also important determinant with research suggesting that proximity to waste facilities
and brownfield or contaminated land, as well as levels of air pollution can
negatively affect health. So countries with worse economic, social or physical
environments will have worse health outcomes.
Infographics
Infographics
The underlying research
to the European Health Championship and these links between health and place
are explored further in Professor Bambra’s forthcoming book Health
Divides: where you live can kill you. Reducing
health inequalities between and within the countries of Europe is also the
focus of HiNEWS, an international
project led by the Department of Geography at Durham University. It is funded by the New Opportunities for Research
Funding Agency Co-operation in Europe (NORFACE) which is a partnership of European research councils
including the Economic and Social Research Council (ESRC).
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