Maltese people generally enjoy good health and one of the highest life expectancies in Europe thanks to improved health systems over the past two decades, the Malta Country Health Profile has found.

The report is compiled for all member states, as well as Iceland and Norway, by the Organisation for Economic Cooperation and Development and the European Observatory on Health systems and policies, with the aim of grouping factual health data in European countries.

Malta was found to have the seventh highest life expectancy at birth at 82.4 years, 1.5 years higher than the EU average of 80.9 years. Spain had the highest life expectancy in Europe with 83.4 years, while Bulgaria has the lowest at 74.8 years.

The gender gap in life expectancy sees women living an average of 4.4 years longer than men, 0.8 years lower than the EU average of 5.2 years.

An overview of Maltese health

Thanks to improved health services, the mortality rate for cardiovascular disease fell by almost 50 per cent between 2000 and 2016, however still remains the leading cause of death for both men and women.

Cancer was the second leading cause of death among adults, with different cancers being responsible for almost 27 per cent of deaths.

The mortality rate for breast cancer has fallen sharply in the past 15 years, going from the highest in the EU in 2000 to below the EU average in 2016.

Deaths from prostate cancer are also some of the lowest in the EU, however similar progress has not been made in pancreatic cancer, with death rates among men continuing to rise.

HIV has proved to be a significant public health challenge, with Malta reporting the third highest notification of new HIV cases in the EU. The diagnosis of new cases has shot up by 50% since 2008, contrary to the downward trend observed in the rest of Europe.

The profile also found that there was a substantial disparity in reported good health in income groups. Nine in ten people in the highest income percentile report to be in good health, while only six in ten of people in the lowest income quintile report similarly.

Bad habits die hard

Around two in five deaths in Malta could be attributed to behavioural risk factors, while one in five deaths were linked to dietary risk, such as low fruit and vegetable intake and high sugar and salt intake.

Tobacco consumption and low physical activity were found to be responsible for an estimated 17 per cent and 4 per cent of all deaths respectively.

Obesity in Malta still remains a major public health threat, with obesity rates rising to the highest in the EU in both adults and children. One in four adults in 2017 and one in three 15-year-olds in 2014 were obese.

This is attributed to a number of factors, chiefly sedentary lifestyles, large portion sizes and traditional diet being replaced by unhealthy foods. Only half of adults said they ate a vegetable every day, while two in five people do not participate in the recommended 150 minutes of moderate exercise a week.

Smoking rates have more or less remained stable in adults since 2008, with one in five adults saying they smoke daily, which is slightly higher than the EU average.

However, smoking in teens has decreased substantially over the past decade, with smoking among 15 to 16-year-olds being the fifth lowest in the EU.

Binge drinking was found to be of public health concern, as one in five adults in Malta reported heavy drinking at least once a month, which was equitable with the EU average.

In 15 to 16-year-olds, 50 per cent of girls and 45 per cent of boys reported at least one episode of bingeing in the past month.

Health services expanding

Malta spends 9.3 per cent of its GDP on healthcare, which is slightly below the 9.8 per cent EU average. The report highlighted that while primary care was being strengthened through the upskilling of the workforce and the upgrading of facilities, it is essential to reorient services away from hospitals and towards primary and outpatient care.

Reports of unmet medical needs on public healthcare are generally low in Malta, however Maltese people’s out of pocket spending on private primary and outpatient care is some of the highest in the EU, largely in attempts to bypass long waiting lists.

While waiting lists for inpatient care have successfully been reduced, waiting lists for outpatient care continue to grow.

Malta has seen an increase in physicians and nurses working in healthcare, however the report posed that a reliance on migrant nurses in acute and long-term care may pose workforce challenges in the future.