The index gives Spain an overall score of 92.8 out of 100, and its rise in the last two years has been vertiginous. In 2017, our country occupied the sixth position in this table. Today already heads the list, ahead of nations such as Iceland, Japan and Switzerland. The Bloomberg classification evaluates 169 economies around the world, based on factors that contribute to overall health, such as physical activity, the health system, food, life expectancy or access to drinking water. Obesity, smoking or alcohol consumption are aspects that are also taken into account in the development of the study, and that subtract points.

The report highlights two key aspects in which Spain borders on excellence. On the one hand, a Primary Care that is “essentially provided by public providers, specialized family doctors and nurses, who provide preventive services to children, women and the elderly, and acute and chronic care”. And, on the other hand, the ” Mediterranean diet , supplemented with extra virgin olive oil or nuts”, which favors cardiovascular health. It is clear that these data are good, but is there room for improvement? We think so.

The healthiest country … with one of the highest rates of obesity
Spain is the second country in the European Union (EU) with the highest rate of obesityamong its adult population, only behind the United Kingdom. The forecast of the Organization for Economic Cooperation and Development (OECD) is that, by 2030, more than 20% of Spaniards (one in five) will be obese, compared to the current 16.5%. The problem acquires special gravity with minors. According to the World Health Organization (WHO), around 40% of children are already overweight or obese. “The trend of increasing obesity is global, if you turn out to be one of the countries where you grow less quickly, you can become the one-eyed in the country of the blind,” warns dietitian-nutritionist Eduard Baladia. Do not forget, in addition, the extra cost of almost 2,000 million euros that is for the National Health System to care for people suffering from this disease,IMIM ).

A National Health System with long waiting lists and few beds
A total of 584,018 patients were on the waiting list to be operated on in the National Health System (SNS) during the first semester of 2018, according to the last report of waiting listspublished by the Ministry of Health. Of them, 12.2% had more than six months to go through the operating room. In Spain, the average waiting time for a non-urgent operation in public health is 93 days. This is one of the main complaints of patients who go to Spanish public hospitals, but it is not the only one. According to the latest data published by Eurostat in 2017, our country had 297.9 beds per 100,000 inhabitants at the end of 2015. The figure is far from the average 514.54 beds in Europe. Between 2000 and 2014, the number of hospital beds per capita decreased steadily by 20%.

The Mediterranean diet, to the downside
The experts have already confirmed a change in our eating habits. “The social and economic changes of recent decades and the introduction of new lifestyles have changed the eating habits of the Spanish population, producing a significant decrease in household consumption of the products included in the Mediterranean diet,” acknowledges the Ministry of Agriculture, Fishing and Food. For the dietitian-nutritionist Eduard Baladia, the key is to turn Spain “into a country where healthy eating options are the most accessible”. To achieve this, says this expert, we must “stop thinking about individual responsibility when it comes to feeding, and focus on community responsibility:

So, are we the ones that last longer or the ones that last best?
Spain has the highest life expectancy in the entire EU, with an average of 82.9 years. And the forecasts suggest that, in 2040, the figure can reach 85.8 years, surpassing even Japan, the longest living country in the world. Baladia argues that in this equation, and taking into account a broad definition of health, solitude also enters . “We must work a lot on the prevention of diseases, but also the loneliness of the elderly and in extending the life perceived as useful in their eyes, because most believe that it does not work anymore.” Yes or yes we must talk about changes in all systems for that to happen, “he says.

The higher the life expectancy, the more number of chronic diseases
Life expectancy increases and our elders face old age in better health conditions than decades ago. “But having a low birth rate, the population pyramid is reversing, there are more older people than young people, and this directly affects a higher prevalence of chronic diseases, especially if they are related to age,” advances Eduard Baladia.

The latest Cronos Report states that these diseases affect more than 19 million people (almost 11 million are women), especially from the age of 55, and cause more than 300,000 deaths per year. Some chronic health problems have increased considerably: in the last two decades hypertension went from affecting 11.2% of the adult population to 18.5%; the diabetes , from 4.1% to 7%; and high cholesterol , from 8.2% to 16.4%. In childhood, the prevalent chronic diseases are allergy (10.0%) and asthma(5.2%). In addition, these ailments “have an impact on an increase in the cost of health services and families: we live longer and live with a disease that requires care and pharmacological treatments,” the report recalls.

And what are the consequences of pollution in large cities?
Up to 93,000 people have died in the last decade in Spain due to air pollution, according to recent data from the National Institute of Statistics and the Ministry of the Environment. Or what is the same, 3% of the annual mortality in our country is due to this issue. In addition, 35% of the Spanish population breathes polluted air and cities such as Madrid registered more than 20 episodes of high pollution in 2017. In fact, Brussels has opened a case against Spain for the chronic failure of nitrogen dioxide levels, over everything in Madrid and Barcelona. It also kills noise pollution: noise causes 1,700 births with low weight, and 17% of children are born premature due to this problem.