Multinational Comparisons
of Health Systems Data, 2002
Gerard F. Anderson, Ph.D.
Varduhi Petrosyan
Peter S. Hussey
Johns Hopkins University
October 2002
Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not
be attributed to The Commonwealth Fund or its directors, officers, or staff.
Additional copies of this (#582) and other Commonwealth Fund publications are available online at www.cmwf.org. To learn about
new Fund publications when they appear, visit the Fund’s Web site and register to receive e-mail alerts.
9
II. Total Health Care Spending1,3
•
•
•
•
•
Countries spent between 7.3 percent (United Kingdom) and 13.0 percent
(United States) of their gross domestic product (GDP) on health care in 2000.
Health care spending is an increasing share of GDP: the percentage of GDP
spent on health care increased in all eight countries between 1990 and 2000.
Health care spending per capita in the United States was more than twice the
OECD median in 2000.
Health care spending per capita grew most rapidly between 1990 and 2000 in
Japan and the United Kingdom and least rapidly in Canada.
Health care spending per capita increased 2 percent to 4 percent faster than
overall inflation during the 1990s in all eight countries.
10
Chart II-1
Percentage of Gross Domestic Product (GDP) Spent on
Health Care in 1990 and 20002,3,4,5
14.0
12.0
13.0
1990
11.9
9.9
10.0
2000
10.6
9.5
8.6
9.0 9.1
7.8
8.0
8.3
7.4
8.0
8.0
7.8
7.3
6.9
5.9
6.0
6.0
4.0
2.0
0.0
United
States
a
Germanya France
1992–2000
Canada
Australia
OECD
Median
New
Zealand
Japan
United
Kingdom
Source: OECD Health Data 2002
11
Chart II-2
Percentage of GDP Spent on Health Care from 1990 to 2000
14
Australia
12
Canada
10
France
Germany
8
Japan
6
New Zealand
4
United Kingdom
2
United States
0
OECD Median
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Source: OECD Health Data 2002
12
Chart II-3
Health Care Spending per Capita in 2000
Adjusted for Differences in the Cost of Living6
$5,000
$4,631
$4,000
$2,748
$3,000
$2,535
$2,349
$2,211
$2,012
$2,000
$1,983
$1,763
$1,623
$1,000
$0
United
States
Germany Canada
France
Australia
Japan
OECD
United
New
Median Kingdom Zealand
Source: OECD Health Data 2002
13
Chart II-4
Average Annual Growth Rate of Real Health Care Spending
per Capita Between 1990 and 20007,8
Percent
4.0
3.9
3.7
3.2
3.1
3.1
3.0
2.9
2.3
2.1
1.8
2.0
1.0
0.0
Japan
a
United
Kingdom
1992–2000
United
States
Australia
OECD
Median
New
Zealand
France
Germany a Canada
Sources: OECD Health Data 2002; U.K. Department of Health
14
III. Public and Private Health Care Financing
•
•
•
•
•
Approximately three-quarters of health care spending was publicly financed in
all countries except the United States in 2000.
The eight countries spent between 5.8 percent and 8.0 percent of GDP on
publicly financed health care in 2000.
The United States spent approximately the same portion of the country’s GDP
on publicly financed health care as most other OECD countries in 2000,
although public programs covered only 45 percent of the U.S. population.
Per capita spending on publicly financed health care ranged from $1,266 in
New Zealand to $2,063 in Germany in 2000.
The United States spent 7.2 percent of GDP on privately financed health
care in 2000 while Germany, the country with the second-highest level, spent
2.6 percent.
15
•
•
•
Private health care spending per capita in the United States was 4 to 8 times
higher than in the other seven countries in 2000.
In the United States, private health insurance is used much differently than in
the other countries, typically providing primary coverage for medical care
rather than coverage that is supplementary to public insurance.
Out-of-pocket spending for uncovered services and cost-sharing varied
considerably across countries in 2000, with individuals in the United States
experiencing the highest out-of-pocket costs ($707) and those in the United
Kingdom the lowest ($171).
16
Chart III-1
Public Versus Private Health Care Spending in 2000
Private Spending
Percent
Public Spending
100
19
22
23
24
25
26
28
28
80
56
60
40
81
78
77
76
75
74
72
72
44
20
0
United
Kingdom
New
Zealand
Japan
France
Germany
OECD
Median
Australia
Canada
United
States
Source: OECD Health Data 2002
17
Chart III-2
Public Spending on Health Care as a Percentage of GDP in 2000
8.0
8.0
7.2
7.0
6.5
6.2
6.0
5.9
5.9
5.9
5.8
New
Zealand
Australia
Japan
United
Kingdom
OECD
Median
United
States
6.0
5.0
4.0
3.0
2.0
1.0
0.0
Germany
France
Canada
Source: OECD Health Data 2002
18
Chart III-3
Public Spending on Health Care per Capita in 2000
Total Public Spending Divided by Total National Population,
Adjusted for Differences in the Cost of Living9
$2,500
$2,063
$2,051
$2,000
$1,826
$1,785
$1,600
$1,542
$1,500
$1,502
$1,429
$1,266
$1,000
$500
$0
Germany
United
States
Canada
France
Australia
Japan
OECD
United
New
Median Kingdom Zealand
Source: OECD Health Data 2002
19
Chart III-4
Private Spending on Health Care as a Percentage of GDP in 200010,11
8.0
7.2
7.0
6.0
5.0
4.0
2.6
3.0
2.5
2.3
2.3
2.0
2.0
1.8
1.8
Japan
New
Zealand
1.4
1.0
0.0
United
States
Germany
Canada
Australia
France
OECD
Median
United
Kingdom
Source: OECD Health Data 2002
20
Chart III-5
Private Spending on Health Care per Capita in 2000
Adjusted for Differences in the Cost of Living9
$3,000
$2,580
$2,500
$2,000
$1,500
$1,000
$709
$685
$611
$564
$500
$469
$451
Japan
OECD
Median
$357
$335
$0
United
States
Canada Germany Australia
France
New
United
Zealand Kingdom
Source: OECD Health Data 2002
21
Chart III-6
Out-of-Pocket Health Care Spending per Capita in 2000
Adjusted for Differences in the Cost of Living12,13
$800
$707
$700
$600
$500
$405
$400
$399
$335
$328
$300
$290
$249
$240
$171
$200
$100
$0
United
States
Canada a Australiab OECD
Median
Japana
Germany
New
Zealand
France
United
Kingdomc
a
1999
1998
c 1996
b
Source: OECD Health Data 2002
22
IV. Role of Public Insurance Program Coverage14
•
•
•
•
In the United States, fewer than half the population received health insurance
coverage from government and public programs in 2000.
In Germany, the most affluent are permitted to self-insure or buy private health
insurance coverage. Nearly all of them (about 8% of the population) purchase
private health insurance.
The United States is the only country with a large portion of its population
(one of seven) without health insurance coverage.15
Germany, Canada, and the United States did not have universal public
coverage for pharmaceuticals in 2000.
23
Chart IV-1
Percentage of Total Population with Health Insurance
Coverage Through Public Programs in 2000
100
100
100
100
100
100
100
100
92
80
60
45
40
20
0
Australia
a
1997
Canada
Japan
New
Zealand
United
Kingdom
OECD
Median
France
Germany a United
States a
Source: OECD Health Data 2002
24
Chart IV-2
Percentage of Total Population with Pharmaceutical
Insurance Coverage through Public Programs in 2000
100
100
100
100
100
100
100
92
80
60
50
40
20
12
0
Australia
a
1995
Japan
New
Zealand
United
Kingdom
OECD
Median
France
Germany a Canada
United
States a
Source: OECD Health Data 2002
25
V. Hospital Spending, Capacity, and Utilization
•
•
•
•
•
•
•
•
•
Hospital care represented the largest component of total health care spending in all eight
countries in 2000 (see Appendix).16
Hospital spending declined as a share of total health care spending from 1990 to 2000 in
all countries except Germany.
Between 2.3 percent (Japan) and 4.2 percent (United States) of GDP was spent on
hospital care in 2000.
Hospital spending per capita in the United States was substantially higher than in the
other countries in 2000.
Germany had approximately twice as many acute care hospital beds per capita as Canada,
the United Kingdom, and the United States in 2000.17
The number of hospital beds per 1,000 population decreased in almost all the countries
during the 1990s.
In 2000, people were approximately twice as likely to be admitted for inpatient acute care
in Germany and France as in the United States and Canada.
The average length of hospital stay for acute care varied widely among the countries.
Despite a common clinical literature across the eight countries, average length of hospital
stay after a heart attack or normal delivery differed by a factor of about two or three.
26
Chart V-1
Percentage of Total Health Care Spending on Hospital Care16,18
50
44
1990
44
40
40
40
38
35
2000
37
33
32
32
33
30
30
25 26
20
10
0
New
Zealand
a
b
France
1990–1999
1992–2000
Australia
Canada
United
States
OECD
Median
Japan a
Germany b
Sources: OECD Health Data 2002; Australian Department of Health
27
Chart V-2
Percentage of GDP Spent on Hospital Care in 2000
5.0
4.2
4.0
3.7
2.9
3.0
2.7
2.4
2.3
Australia a
Japan b
2.0
1.0
0.0
United States
a
b
1998
1999
France
Canada
Germany
Source: OECD Health Data 2002
28
Chart V-3
Hospital Spending per Capita in 2000
Adjusted for Differences in the Cost of Living13
$1,600
$1,498
$1,400
$1,200
$929
$1,000
$823
$800
$703
$618
$600
$581
$400
$200
$0
United States
a
b
1998
1999
France
Canada
Germany
Australia a
Japanb
Source: OECD Health Data 2002
29
Chart V-4
Number of Acute Care Hospital Beds per 1,000 Population17,19
8.0
8.0
1990
7.3
7.0
2000
6.4
6.0
5.2
5.0
4.2
4.0
4.4
4.3
3.8
3.8
4.0
3.3
3.3
3.7
3.0
3.0
2.0
1.0
0.0
New
Zealand
Germany a
France
Australiab
OECD
Median
Canada c
United
Kingdom
United
States
a
1992–2000
1991–1999
c 1990–1999
b
Source: OECD Health Data 2002
30
Chart V-5
Hospital Admissions for Acute Care per 1,000 Population in 200020
250
205
204
200
155
154
151
150
118
99
100
50
0
Germany
a
1999
France a
Australia
OECD
Median
England
United States
Canada a
Sources: OECD Health Data 2002; U.K. Department of Health
31
Chart V-6
Average Length of Hospital Stay for Acute Care
in 1998, 1999, or 200021,22
Days
10.0
9.6
8.0
7.1
6.4
6.2
6.2
5.9
6.0
5.5
4.9
4.0
2.0
0.0
Germany a
Canada b
OECD
Median a
Australiab
England
a
United
States b
Franceb
New
c
Zealand
a
2000
1999
c 1998
b
Source: OECD Health Data 2002
32
Chart V-7
Average Length of Hospital Stay for Acute Myocardial Infarction
in 1999 or 200021,22
Days
14.0
12.6
12.0
9.2
10.0
8.2
8.1
8.0
7.9
6.5
6.4
6.0
5.6
4.0
2.0
0.0
Germany a
a
b
1999
2000
OECD
Medianb
Canadaa
England b
Francea
New
Zealand b
Australiaa
United
States a
Sources: OECD Health Data 2002; U.K. Department of Health
33
Chart V-8
Average Length of Hospital Stay for Normal Delivery
in 1999 or 200021,22
Days
6.0
5.2
4.8
5.0
4.0
3.2
3.0
2.9
2.2
2.0
2.0
1.8
New
b
Zealand
Canadaa
United
States a
2.0
1.0
0.0
France a
a
b
1999
2000
Germany a
OECD
Medianb
Australia a
England b
Source: OECD Health Data 2002
34
VI. Pharmaceutical Spending23
•
•
•
•
•
•
•
Pharmaceuticals were the second largest component of health care spending in
three of the eight countries (Canada, France, and Germany) in 2000 (see
Appendix).
Pharmaceuticals were a growing percentage of total health care spending
between 1990 and 2000 in all countries except Germany and Japan.
The percentage of health care spending on pharmaceuticals ranged from 11.6
percent in Australia to 20.1 percent in France in 2000.
Between 1.0 percent (Australia) and 1.9 percent (France) of GDP was spent on
pharmaceuticals in 2000.
In 2000, the United States and France spent the most per capita on
pharmaceuticals and New Zealand spent the least.
Pharmaceutical spending per capita increased approximately 1 to 7 percentage
points faster than inflation between 1990 and 2000 in all eight countries.
The public share of pharmaceutical spending varied from 18 percent in the
United States to 71 percent in New Zealand in 2000.
35
Chart VI-1
Percentage of Total Health Care Spending
on Pharmaceuticals
25.0
20.1
1990
21.4
2000
20.0
16.8
16.4
15.0
15.9
13.5
14.6 15.3
15.2
11.4
14.7
13.8 14.4
13.6
12.0
9.2
10.0
11.6
9.0
5.0
0.0
France
Japan a
United
OECD
b
Kingdom Median
Canada
New
Germany c United
b
Zealand
States
Australiad
a
1990–1999
1990–1997
c 1992–2000
d 1990–1998
b
Source: OECD Health Data 2002
36
Chart VI-2
Percentage of GDP Spent on Pharmaceuticals in 2000
2.0
1.9
1.6
1.4
1.4
1.2
1.2
1.1
1.1
1.0
1.0
0.0
France
United
States
Canada
Germany
Japan a
OECD
Median
New
United Australiac
b
Zealand Kingdomb
a
1999
1997
c 1998
b
Source: OECD Health Data 2002
37
Chart VI-3
Spending per Capita on Pharmaceuticals in 2000
Adjusted for Differences in the Cost of Living13
$600
$556
$473
$500
$385
$400
$375
$313
$300
$262
$253
$252
$210
$200
$100
$0
United
States
France
Canada Germany
Japan a
OECD
Median
United Australiac New
b
Kingdomb
Zealand
a
1999
1997
c 1998
b
Source: OECD Health Data 2002
38
Chart VI-4
Average Annual Growth Rate of Real Spending
per Capita on Pharmaceuticals Between 1990 and 2000
Percent
8.0
7.0
6.9
6.0
6.0
6.0
4.8
5.0
4.5
4.2
4.0
2.9
3.0
2.0
1.2
0.6
1.0
0.0
Australia a United
United
b
Kingdom States
Canada
OECD
Median
France
New
Germany c
b
Zealand
Japand
a
1990–1998
1990–1997
c 1992–2000
d 1990–1999
b
Source: OECD Health Data 2002
39
Chart VI-5
Public Financing of Pharmaceuticals as a Percentage of
Total Pharmaceutical Spending in 2000
80
71
69
70
65
64
63
63
60
53
50
36
40
30
18
20
10
0
New
Germany
Zealand a
France
United
Kingdom a
Japan b
OECD
Median
Australiac Canada
United
States
a
1997
1999
c 1998
b
Source: OECD Health Data 2002
40
VII. Spending on Physician Services24
and Health Care Workforce
•
•
•
•
Physician services were the second largest component of health care spending
after hospital services in three of the eight countries (Australia, Japan, and the
United States) in 2000 (see Appendix).
The percentage of health care spending on physician services ranged from
10 percent in Germany to 27 percent in Japan in 2000.
Between 1.0 percent (Germany) and 2.9 percent (United States) of GDP was
spent on physician services in 2000.
Per capita spending on physician services in 2000 ranged from $271 in
Germany to $1,041 in the United States.
41
Practicing Physicians25
• In all countries except Canada, the physician-to-population ratio increased
between 1990 and 2000.
• In the United Kingdom, there was one practicing physician per 556 people,
and in Germany, there was one practicing physician per 278 people in 2000.
• All countries had approximately the same number of physician visits per
capita except Japan, which had more than twice as many visits.
Practicing Nurses26
• In all countries except Australia and Canada, the nurse-to-population ratio
increased between 1990 and 2000.
• The number of nurses varied considerably across the countries. New Zealand
and Germany had a substantially higher number of practicing nurses per capita
than France in 2000.
• The number of nurses per acute care hospital bed remained steady or increased
between 1990 and 1999.
• Nurse staffing ratios for acute care in hospitals varied considerably across the
eight countries, suggesting different roles for nurses in each country.
42
Chart VII-1
Percentage of Total Health Care Spending
on Physician Services
40.0
30.0
36.1
1990
2000
27.1
23.1 22.5
20.0
15.3
13.7
13.4 13.6
14.9
14.9
12.8 12.5
9.9 9.9
10.0
0.0
Japan a
United
States
Canada
Australia b
France
Germany c
OECD
Median
United
Kingdom
a
1990–1999
1990–1998
c 1992–2000
b
Source: OECD Health Data 2002
43
Chart VII-2
Percentage of GDP Spent on Physician Services in 2000
3.0
2.9
2.0
2.0
1.2
1.2
1.2
1.0
1.0
0.0
United States
a
b
1999
1998
Japan a
Canada b
Australia
France
Germany
Source: OECD Health Data 2002
44
Chart VII-3
Per Capita Spending on Physician Services in 2000
Adjusted for Differences in the Cost of Living13
$1,200
$1,041
$1,000
$800
$600
$519
$347
$400
$296
$294
$271
Australiab
France
Germany
$200
$0
United States
a
b
1999
1998
Japan a
Canada
Source: OECD Health Data 2002
45
Chart VII-4
Number of Practicing Physicians per 1,000 Population
4.0
3.6
3.1
3.1
1990
3.3
2000
3.1
2.8
3.0
2.4
2.4
2.3
2.5
2.2
1.9
2.0
2.1 2.1
1.7
1.9
1.8
1.4
1.0
0.0
Germany a France
OECD
Median
United
States b
Australiac
New
Zealand
Canada
Japan
United
Kingdom
a
1992–2000
1990–1998
c 1991–1998
b
Source: OECD Health Data 2002
46
Chart VII-5
Annual Number of Physician Visits per Capita27
16.0
16.0
14.0
12.0
10.0
8.0
6.5
6.5
6.4
6.4
6.0
5.9
5.8
5.4
OECD
Medianb
United
States a
United
Kingdomd
4.0
2.0
0.0
Japan a
France a
Germany a Australiab
Canada c
a
1996
2000
c 1999
d 1998
b
Source: OECD Health Data 2002
47
Chart VII-6
Number of Practicing Nurses per 1,000 Population26
10.0
9.3
1990
9.7
8.7
9.0
8.0
2000
9.3
8.3
8.5
8.1
8.1
7.8
7.2
8.1
7.6
7.0
7.0
7.5
6.5
6.0
6.0
5.4
5.3
5.0
4.0
3.0
2.0
1.0
0.0
New
Zealand
Germany a United
States b
Australiac England
Japand
Canada
OECD
Median
France
a
1993–2000
1990–1999
c 1991–1997
d 1990–1998
b
Sources: OECD Health Data 2002; U.K. Department of Health
48
Chart VII-7
Number of Nurses per Acute Care Hospital Bed28,29
1.4
1.4
1.3
1.3
1990
1.2
1.2
1999
1.2
1.1
1.0
0.8 0.8
0.8
0.8
0.6
0.6
0.5
0.5
0.4
0.4
0.2
0.0
Australiaa
a
b
United
States
1991–1999
1992–1999
England
OECD
Median
Germany b
France
New
Zealand
Canada
Sources: OECD Health Data 2002; U.K. Department of Health
49
VIII. Medical Procedures Involving
Sophisticated Technology
Access to Technology
• Japan had nearly three times as many magnetic resonance imaging (MRI) units
per capita as the United States and nearly 10 times as many as Canada, New
Zealand, and France in 2000.
• Japan had four times as many computer tomography (CT) scanners per capita
as Australia and over 10 times as many as Canada and the United Kingdom.
Utilization
• The number of coronary angioplasty procedures performed in the United
States was more than twice that reported in Germany and over seven times that
in England.
• The number of patients undergoing dialysis in Japan was nearly twice that in
the United States and 6 times that in the United Kingdom in 2000. Unlike the
other countries with active transplant programs, virtually all end-stage renal
disease (ESRD) treatment in Japan is delivered using dialysis.
50
Chart VIII-1
Magnetic Resonance Imaging (MRI) Units
per One Million Population in 200030
25.0
23.2
20.0
15.0
10.0
8.1
6.2
4.7
5.0
4.7
3.9
2.8
2.6
2.5
0.0
Japan a
United Germany b Australia
States a
OECD
Median
England
France a
New
Canada
c
Zealand
a
1999
1997
c 1998
b
Source: OECD Health Data 2002
51
Chart VIII-2
Computer Tomography (CT) Scanners
per One Million Population30
90
84
80
70
60
50
40
30
21
20
17
14
12
10
9
8
7
France a
New
Zealand d
Canadac
England e
10
0
Japan a
Australiab Germany c United
States a
OECD
Mediand
a
1999
1995
c 1997
d 2000
e 2001
b
Sources: OECD Health Data 2002; U.K. Department of Health
52
Chart VIII-3
Coronary Angioplasty Procedures per 100,000 Population31
400
388
350
300
250
200
166
150
103
81
100
66
51
50
0
United States a
Germany b
Australia a
Canadaa
New Zealand a
England c
a
1999
1997
c 2000
b
Sources: OECD Health Data 2002; U.K. Department of Health
53
Chart VIII-4
Number of Patients Undergoing Dialysis
per 100,000 Population in 200032
180
162
160
140
120
100
87
80
64
60
46
40
40
35
33
New
Zealand
Australia
27
20
0
Japan
a
b
1998
1999
United
States a
Germany
Canada b
OECD
Median
United
Kingdomb
Sources: OECD Health Data 2002; The Australia and
New Zealand Dialysis and Transplant Registry (www.anzdata.org.au).
54
IX. Health Status33
•
•
•
•
•
•
•
•
•
People were three times more likely to die of a heart attack in the United Kingdom and New
Zealand compared with Japan in 1999.
The diabetes mellitus mortality rate was the highest in the United States and nearly three times
higher than in the United Kingdom and Japan in 1999.
The breast cancer incidence rate was highest for U.S. women in 1999.
The mortality rate for breast cancer among women was much lower in Japan
than in the other countries in 1999.
Although the United Kingdom had the lowest incidence of breast cancer after Japan in 1999,
the U.K. breast cancer mortality rate was the highest.
The incidence rate of colon cancer was twice as high in the United States as in the United
Kingdom.
The colon cancer mortality rate was higher in New Zealand than in the other countries in 1999.
The incidence rates of lung cancer in the United States and Canada were nearly three times
higher than in Japan.
The lung cancer mortality rate was highest in the United States in 1999.
55
Chart IX-1
Age-Standardized Mortality Rates for Acute Myocardial
Infarction per 100,000 Population in 1999
80
75
75
65
70
63
63
61
60
60
50
40
29
30
25
20
10
0
United
Kingdom
a
b
New
Australia
a
Zealand
1998
1997
Canada b
OECD
Median
Germany
United
States a
France a
Japan
Source: OECD Health Data 2002
56
Chart IX-2
Age-Standardized Mortality Rates for Diabetes Mellitus
per 100,000 Population in 199934
20
20
18
16
16
16
13
13
12
10
8
8
7
4
0
United
States a
a
b
New
Canada b Germany Australia
a
Zealand
1998
1997
OECD
Median
France a
United
Kingdom
Japan
Source: OECD Health Data 2002
57
Chart IX-3
Incidence Rates for Breast Cancer
per 100,000 Females in 1999
139
140
120
110
104
100
83
81
80
80
80
78
60
40
30
20
0
United
States
Germanya
Canada
Australia a
New
a
Zealand
Franceb
OECD
Median
United
Kingdom c
Japand
a
1998
1995
c 1997
d 1996
b
Source: OECD Health Data 2002
58
Chart IX-4
Age-Standardized Mortality Rates for Breast Cancer
per 100,000 Females in 1999
30
29
29
27
26
25
25
24
24
22
20
15
10
10
5
0
United
Kingdom
a
b
New
Zealand
1997
1998
Canada a Germany
France b
OECD
Median
United Australia
States b
Japan
Source: OECD Health Data 2002
59
Chart IX-5
Incidence Rates for Colon Cancer per 100,000 Population
60
54
50
50
45
42
40
40
40
33
27
30
20
10
0
United
States a
Canada b
New
Zealand
Germany c
c
OECD
Median a
Australia c
France d
United
Kingdom b
a
1999
1997
c 1998
d 1995
b
Source: OECD Health Data 2002
60
Chart IX-6
Age-Standardized Mortality Rates for Colon Cancer
per 100,000 Population in 1999
30
28
24
25
21
20
20
20
19
United
Kingdom
France
19
18
18
15
10
5
0
New
Germany
a
Zealand
a
b
1998
1997
Australia
OECD
Median
a
Japan
Canada b
United
States a
Source: OECD Health Data 2002
61
Chart IX-7
Incidence Rates for Lung Cancer per 100,000 Population
70
64
63
60
45
50
40
35
30
32
28
28
25
22
20
10
0
United
States
a
Canada b Germany c United
OECD
Australia c New
c
a
b
Kingdom Median
Zealand
France d
Japan d
a
1999
1997
c 1998
d 1995
b
Source: OECD Health Data 2002
62
Chart IX-8
Age-Standardized Mortality Rates for Lung Cancer
per 100,000 Population in 1999
60
52
48
50
43
37
40
36
34
33
33
28
30
20
10
0
United
States a
a
b
Canada
1998
1997
b
United
Kingdom
OECD
Median
New
a
Zealand
France a Australia
Germany
Japan
Source: OECD Health Data 2002
63
X. Nonmedical Determinants of Health
Tobacco Consumption
• The prevalence of smoking decreased between 1990 and 2000 in all the
countries except Germany.
• The percentage of people who reported being daily smokers was the highest in
Japan and the lowest in the United States in 2000.
• The United States had relatively low smoking rates in 1990 and 2000 but the
highest lung cancer mortality rate in 1998.
Obesity
• Over 20 percent of the population in the United States and Australia was obese
(body mass index greater than 30) in 1999.
64
Chart X-1
Percentage of Adults Who Reported Being Daily Smokers35
40
35
37
1990
34
29
30
30
27
30
27
27
29
28
25
25
28
26
24 25
20
20
2000
20
19
Germany c Australiad Canada
United
States
15
10
5
0
Japan a
France b
United
Kingdom
OECD
Median
New
Zealand
a
1990–1999
1990–2001
c 1992–1999
d 1989–2001
b
Source: OECD Health Data 2002
65
Chart X-2
Obesity (BMI > 30) Prevalence36
Percent
30
26
25
21
19
20
17
15
15
12
11
10
10
5
3
0
United
States a
Australia a Englandb
New
c
Zealand
Canadad Germany a OECD
Mediane
France e
Japane
a
1999
1998
c 1997
d 2001
e 2000
b
Sources: OECD Health Data 2002; U.K. Department of Health
66
67