The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019
Authors: Santos João Vasco , Padron-Monedero Alicia , Bikbov Boris , Grad Diana Alecsandra , Plass Dietrich , Mechili Enkeleint A. , Gazzelloni Federica , Fischer Florian , Sulo Gerhard , Ngwa Che Henry , Noguer-Zambrano Isabel , Peñalvo José L. , Haagsma Juanita A. , Kissimova-Skarbek Katarzyna , Monasta Lorenzo , Ghith Nermin , Sarmiento-Suarez Rodrigo , Hrzic Rok , Haneef Romana , O’Caoimh Rónán , Cuschieri Sarah , Mondello Stefania , Kabir Zubair ,   GBD 2019 EU State of Health Collaborators, Abbafati Cristiana , Abolhassani Hassan , Adekanmbi Victor , Ahmadi Keivan , Ahmadi Sepideh , Al-Jumaily Adel , Alla François , Alonso Jordi , Ancuceanu Robert , Andrei Catalina Liliana , Andrei Tudorel , Androudi Sofia , Antó Josep M. , Appiah Seth Christopher Yaw , Aremu Olatunde , Armocida Benedetta , Ärnlöv Johan , Arumugam Ashokan , Attia Sameh , Aujayeb Avinash , Ausloos Marcel , Ayuso-Mateos Jose L. , Banach Maciej , Bärnighausen Till Winfried , Barone-Adesi Francesco , Barteit Sandra , Basu Sanjay , Baune Bernhard T. , Beghi Massimiliano , Belo Luis , Bennett Derrick A. , Biondi Antonio , Bohluli Mahdi , do Nascimento Israel Júnior Borges , Bragazzi Nicola Luigi , Braithwaite Tasanee , Brenner Hermann , Buonsenso Danilo , Busse Reinhard , Calina Daniela , Carreras Giulia , Carvalho Márcia , Castelpietra Giulio , Catapano Alberico L. , Cattaruzza Maria Sofia , Chandan Joht Singh , Charalampous Periklis , Chattu Vijay Kumar , Chen Simiao , Chowdhury Rajiv , Christensen Hanne , Chung Sheng-Chia , Conde Joao , Corso Barbara , Cruz-Martins Natália , Damiani Giovanni , de la Torre-Luque Alejandro , Demetriades Andreas K. , Dervenis Nikolaos , Dianatinasab Mostafa , da Silva Diana Dias , Douiri Abdel , Edvardsson David , Bain Luchuo Engelbert , Esposito Francesco , Fagbamigbe Adeniyi Francis , Farinha Carla Sofia eSá , Fereshtehnejad Seyed-Mohammad , Fernandes João C. , Ferrara Pietro , Gaal Peter Andras , Gallus Silvano , Galluzzo Lucia , Fonseca Mariana Gaspar , Gazzard Gus , Gialluisi Alessandro , Giampaoli Simona , Gill Paramjit Singh , Glasbey James C. , Gorini Giuseppe , Grivna Michal , Hafiz Abdul , Haro Josep Maria , Hartvigsen Jan , Hay Simon I. , Heibati Behzad , Hillus David , Hosseinzadeh Mehdi , Hostiuc Mihaela , Hostiuc Sorin , Hussain Salman , Isola Gaetano , Johnson Olatunji , Jonas Jost B. , Joo Tamas , Jozwiak Jacek Jerzy , Jürisson Mikk , Karanikolos Marina , Kauppila Joonas H. , Khan Moien A. B. , Khatab Khaled , Klugar Miloslav , Koyanagi Ai , Kurmi Om P. , Kusuma Dian , La Vecchia Carlo , Lacey Ben , Lamnisos Demetris , Larson Heidi Jane , Larsson Anders O. , Lasrado Savita , Lauriola Paolo , Lazarus Jeffrey V. , Ledda Caterina , Lee Paul H. , Leinsalu Mall , Leonardi Matilde , Levi Miriam , Li An , Linehan Christine , Logroscino Giancarlo , Lorkowski Stefan , Loureiro Joana A. , Lyons Ronan A. , Madureira-Carvalho Áurea M. , Majeed Azeem , Mathioudakis Alexander G. , McAlinden Colm , McGrath John J. , Menezes Ritesh G. , Mentis Alexios-Fotios A. , Meretoja Atte , Meretoja Tuomo J. , Mestrovic Tomislav , Jonasson Junmei Miao , Miazgowski Bartosz , Miazgowski Tomasz , Mirica Andreea , Mohammed Shafiu , Mokdad Ali H. , Mons Ute , Morgado-da-Costa Joana , Mulita Francesk , Murray Christopher J. L. , Negoi Ionut , Negoi Ruxandra Irina , Negru Serban Mircea , Nena Evangelia , Noor Nurulamin M. , Ntaios George , Oancea Bogdan , Osei Frank B. , Otoiu Adrian , Palladino Raffaele , Panda-Jonas Songhomitra , Pardhan Shahina , Patel Jay , Paun Mihaela , Pedersini Paolo , Pensato Umberto , Pereira Renato B. , Pérez-Gómez Jorge , Perico Norberto , Petcu Ionela-Roxana , Peterson Carrie B. , Pinheiro Marina , Postma Maarten J. , Raggi Alberto , Rahmani Amir Masoud , Rao Chythra R. , Rawaf Salman , Rawassizadeh Reza , Remuzzi Giuseppe , Riad Abanoub , Sacco Simona , Saeb Mohammad Reza , Sathian Brijesh , Sattin Davide , Scarmeas Nikolaos , Schwendicke Falk , Shiri Rahman , Shivarov Velizar , Sibhatu Kibrom T. , Simonetti Biagio , Skou Søren T. , Soriano Joan B. , Soyiri Ireneous N. , Steel Nicholas , Stefan Simona Cătălina , Steinbeis Fridolin , Steiropoulos Paschalis , Stockfelt Leo , Stranges Saverio , Sundström Johan , Tabarés-Seisdedos Rafael , Thiyagarajan Arulmani , Topor-Madry Roman , Tovani-Palone Marcos Roberto , Tsilimparis Nikolaos , Unim Brigid , Vacante Marco , Van den Eynde Jef , Vasankari Tommi Juhani , Veroux Massimiliano , Villafañe Jorge Hugo , Violante Francesco S. , Wang Yanzhong , Westerman Ronny , Wolfe Charles D. A. , Wyper Grant M. A. , Yaya Sanni , Zadnik Vesna , Zeitoun Jean-David , Zumla Alimuddin , Freitas Alberto , Devleesschauwer Brecht 
Published: May 2024

Abstract
Background
The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010.

Methods
We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE).

Results
In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for “HIV/AIDS and sexually transmitted diseases” and “transport injuries” (each -19%). “Diabetes and kidney diseases” showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, “mental disorders” showed an increasing age-standardised YLL rate (14.5%).

Conclusions
There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.