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MALTATODAY 16 January 2022

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2 maltatoday | SUNDAY • 16 JANUARY 2022 NEWS Malta has fourth lowest death rate from preventable diseases But deaths from diabetes and ischaemic heart disease higher than in EU average with Malta's high obesity rate JAMES DEBONO Mortality from preventable causes in Malta is the fourth lowest in the European Union, an OECD report on the state of health in European Union shows. Mortality rates from lung can- cer, accidents, chronic lower respiratory diseases and alco- hol-related diseases are far low- er than the EU average. But the mortality rate from diabetes is the third highest in the EU. And mortality rates from treatable causes – those that should not have occurred in the presence of timely and effective health care – have fallen by 15 % in Malta since 2011, and are now the same as the EU average. The overall decline in treat- able mortality reflects "im- provements in health system performance, with increased availability of key services, in- novative medicines and medical technologies", the report states. Ischaemic heart disease is the leading cause of treatable mor- tality in Malta, and death rates remain significantly above the EU average. Relatively high mortality rates from diabetes and ischaemic heart disease are partly attrib- utable to the high prevalence of overweight and obesity among Malta's population. In the 2021 budget, funding was committed to support ed- ucational campaigns to address eating disorders and obesity among minors - €11 million were committed to promote a new culture of physical activity by refurbishing and developing sport venues and facilities. According to the report, life expectancy gains in Malta since 2000 have been driven by a de- cline in premature deaths from leading causes – notably, cardi- ovascular diseases and cancers. Life expectancy at birth in Malta stands at 82.6 years in 2020 – the second highest in the EU and two years higher than the EU average. Overall, the gap in life expectancy between men and women is lower than the EU average, with women living on average 3.8 years longer than men, compared to the EU aver- age of 5.6 years. From 2000 to 2018, age-stand- ardised mortality rates per 100 000 population from cardiovas- cular diseases fell by more than 50%, and for all cancers by 14%. Cardiovascular diseases nev- ertheless remained the leading cause of death in 2018, account- ing for 34% of all deaths, fol- lowed by cancer (28%). In terms of individual causes of disease, ischaemic heart dis- ease was the leading cause of mortality in 2018, accounting for 17% of all deaths, followed by stroke. Deaths attributable to diabetes (50.8 per 100 000 population) were the third highest in the EU, which is partly linked to Malta's high prevalence of obesity. Hospital admission rates in Malta for asthma and chronic obstructive pulmonary disease (COPD), chronic heart failure and diabetes are all higher than in many other EU countries. Drop in cancer deaths When it comes to specific can- cers, mortality rates for breast cancer are higher than the EU average, but for colorectal can- cer are the same as the EU av- erage. An estimated 2,400 people in Malta were diagnosed with can- cer in 2020. The main cancer sites among men are prostate (26%), lung (16%) and colorec- tal (13%), while among women breast cancer is the leading can- cer (36%), followed by colorec- tal (11%) and uterus (7%). Malta also recorded a substan- tial increase in five-year survival rates for lung, breast and pros- tate cancers between 2000-04 and 2010-14, reflecting earlier diagnosis and more effective treatment. The survival rate for lung can- cer is now the same as the EU average, while survival rates for breast and prostate cancers are higher. The five-year survival rate for colon cancer has been sta- ble over the past decade and remains slightly below the EU average. The survival rate for cervical cancer is also slightly below the EU average. Attendance rates for breast cancer screening have increased by more than 20 percentage points since 2010, but more than 30% of women in the tar- get group did not attend routine mammography appointments in 2019. In 2016, a national cervical cancer screening programme for women aged 25-35 was launched. Programme data for 2018 indicate that only 22% of eligible people had attended cervical cancer screening in the prior two years, but national survey data indicate that uptake may be as high as 62 %, suggest- ing that people are opting to undertake screening in the pri- vate sector. Healthcare shortages The number of doctors and nurses has also been rising steadily over the past decade. Malta now has a higher num- ber of doctors per capita (4.1 per 1 000 population) than the EU average (3.9), and a number of nurses (7.9 per 1 000 popula- tion) just below the EU average (8.4). Moreover, the number of medical graduates more than trebled from 2008 to 2018, and the number of nursing gradu- ates almost doubled. However, recruitment and re- tention of GPs has proved chal- lenging; the share of GPs within the physician workforce has de- clined since 2009, and at 20.5% in 2019 remained below the EU average of 26. %. Malta also has a shortage of nursing staff in hospitals, and is increasingly reliant on recruit- ing foreign trained nurses nota- bly from India, Pakistan and the Philippines. Shortage of nurses is attributed to the migration of these foreign-trained nurses to the United Kingdom and other countries that offer more com- petitive working conditions. Cyprus 104 Italy 104 Malta 111 Spain 113 Iceland 115 Sweden 118 Norway 120 Netherlands 129 Luxembourg 130 Ireland 132 France 134 Portugal 138 Greece 139 Belgium 146 Denmark 152 Germany 156 Finland 159 EU-27 160 Slovenia 175 Czechia 195 Poland 222 Bulgaria 226 Croatia 239 Slovakia 241 Estonia 253 Lithuania 293 Romania 306 Latvia 326 Hungary 326 Preventable causes of mortality per 100,000 population (lung cancer, ischaemic heart disease, accidents, diabetes, cere- brovascular disease)

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