{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T23:53:08Z","timestamp":1772149988229,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The Global Burden of Disease study has generated a wealth of data on death and disability in Europe. At a time of change for the European Union and European Region of WHO, with a new Health Commissioner and Regional Director, respectively, a review of health trends can contribute to identify outstanding needs and gaps. This paper reports a summary of the burden of disease in the European Union (EU) in 2017 (compared with 2007).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>For the whole EU and each country, mortality by causes of death, disability-adjusted life years (DALYs) and life expectancies are reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2017, the age-standardized mortality and DALY rates were of 452.6 and 19 663.3 per 100 000 inhabitants, respectively. The diseases contributing most to mortality were ischaemic heart disease (IHD), dementias and stroke, while low back pain and IHD accounted for the highest burden of DALYs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, there was an improvement in the state of health in the EU but substantial differences between countries remain. Cardiovascular diseases still represent the major burden, although there have been substantial improvements. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckz203","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T22:19:39Z","timestamp":1571177979000},"page":"590-595","source":"Crossref","is-referenced-by-count":16,"title":["The state of health in the European Union (EU-28) in 2017: an analysis of the burden of diseases and injuries"],"prefix":"10.1093","volume":"30","author":[{"given":"Jo\u00e3o Vasco","family":"Santos","sequence":"first","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"},{"name":"Public Health Unit, ACES Grande Porto VIII (ARS Norte), Espinho\/Gaia, Portugal"}]},{"given":"J\u00falio","family":"Souza","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Jos\u00e9","family":"Valente","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Vera","family":"Alonso","sequence":"additional","affiliation":[{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Andr\u00e9","family":"Ramalho","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Viana","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Walter","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Section of Hygiene, Institute of Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, Rome, Italy"}]},{"given":"Alberto","family":"Freitas","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"CINTESIS\u2014Centre for Health Technology and Services Research, Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"2020072014164785300_ckz203-B1","volume-title":"Health at a Glance: Europe 2018: State of Health in the EU Cycle","year":"2018"},{"key":"2020072014164785300_ckz203-B2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s10198-014-0602-8","article-title":"Changes in the health status of the population of Central and Eastern European countries between 1990 and 2010","volume":"15","author":"Boncz","year":"2014","journal-title":"Eur J Health Econ"},{"key":"2020072014164785300_ckz203-B3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10654-012-9747-x","article-title":"Convergence and divergence of life expectancy in Europe: a centennial view","volume":"28","author":"Mackenbach","year":"2013","journal-title":"Eur J Epidemiol"},{"key":"2020072014164785300_ckz203-B4","volume-title":"Health Policy and European Union Enlargement","year":"2004"},{"key":"2020072014164785300_ckz203-B5","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1093\/intqhc\/12.3.217","article-title":"European Union health policy and its implications for national convergence","volume":"12","author":"Cucic","year":"2000","journal-title":"Int J Qual Health Care"},{"key":"2020072014164785300_ckz203-B6","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1177\/1355819618790609","article-title":"Include, invest, innovate: health systems for prosperity and solidarity","volume":"23","author":"McKee","year":"2018","journal-title":"J Health Serv Res Policy"},{"key":"2020072014164785300_ckz203-B7","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":". 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