Definition of chronic disease

According to the World Health Organization:

Chronic diseases are diseases of long duration and generally slow progression. Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in Europe, representing 77% of the total disease burden and 86% of all deaths. These diseases are linked by common risk factors, underlying determinants and opportunities for intervention

Prevalence & impact

Each year cardiovascular disease (CVD) causes 3.9 million deaths in Europe and over 1.8 million deaths in the EU. CVD accounts for 45% of all deaths in Europe and 37% of all deaths in the EU. In 2015, more than 85 million people in Europe were living with CVD and almost 49 million people were living with CVD in the EU[1].

[1] European Cardiovascular Disease Statistics 2017. EHN

In 2015, 1.3 million people died from cancer in the EU, more than one quarter (25.4 %) of the total number of deaths[1]. Europe comprises only one eighth of the total world population but has around one quarter of the global total of cancer cases with some 3.7 million new patients per year[2]. Lung, breast, stomach, liver, colon and breast cancer cause the most cancer deaths annually. Lung cancer accounted for more than one fifth of all cancer-related deaths in the EU in 2015[3].

[1] https://ec.europa.eu/eurostat/statistics-explained/index.php/Cancer_statistics
[2] http://www.euro.who.int/en/health-topics/noncommunicable-diseases/cancer/data-and-statistics
[3] https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Cancer_statistics_-_specific_cancers

One in eight deaths in the EU are due to respiratory diseases, 600,000 people die every year in the EU from respiratory disease [1]. More than half of all the deaths from respiratory disease are due to diseases caused by smoking, such as lung cancer or Chronic Obstructive Pulmonary Disease (COPD)[2]. Moderate and severe COPD is prevalent in 5-10% of the EU adult population aged over 40 years[3].

[1] ERS White Book https://www.erswhitebook.org/chapters/the-burden-of-lung-disease/
[2]https://www.europeanlung.org/assets/files/publications/lung_health_in_europe_facts_and_figures_web.pdf
[3] https://www.europeanlung.org/assets/files/publications/lung_health_in_europe_facts_and_figures_web.pdf

58 million people are living with diabetes and 36 million more are at risk of developing the condition in Europe. Each year 477, 000 people die of diabetes-related complications and our health systems spend EUR 143 billion on direct costs of the disease[1].

[1] IDF Europe – Integrating diabetes evidence into practice: challenges and opportunities to bridge the gaps

10% of the population is affected by chronic kidney disease (CKD)[1]. About 70 million Europeans have lost some of their kidney function[2] and one in 3 Europeans is at an increased risk of developing CKD[3]. Increased incidence of CKD is linked with several other chronic diseases and behaviours, including diabetes mellitus, hypertension, smoking, ageing, and obesity.

[1]ERA-EDTA http://www.era-edta2015.org/press/1_150526_18.00_Press%20Release_CKD_Challenge.pdf
[2] http://www.era-edta2015.org/press/1_150526_18.00_Press%20Release_CKD_Challenge.pdf
[3] EKHA recommendations for sustainable kidney care http://ekha.eu/wp-content/uploads/2016/01/EKHA-Recs-for-Sustainable-Kidney-Care-25.08.2015.pdf

29 million people in the EU suffer from a chronic liver condition[1]. Hepatocellular carcinoma (constituting 70-90% of cases of primary liver cancer) is the fifth most common cause of cancer in Europe[2]. WHO estimate that liver cancer is responsible for around 47,000 deaths per year in the EU.

[1] EASL. The burden of liver disease in Europe. http://www.easl.eu/medias/EASLimg/Discover/EU/54ae845caec619f_file.pdf
[2] http://www.easl.eu/medias/EASLimg/Discover/EU/54ae845caec619f_file.pdf

Almost 30% of the total EU population, or 1 in 3 Europeans, live with chronic allergy[1] and one in four children under 10 years old is affected by an allergic disease. 70 million children and adults have asthma, 17 million live with a food allergy, and close to 100 million live with allergic rhinitis[2].

[1] Calderon et al. (2012, October), EAACI: A European Declaration on Immunotherapy. Designing the future of allergen specific immunotherapy. Clinical and Translational Allergy 2012, 2:20 http://www.ctajournal.com/content/2/1/20
[2] EAACI, (2016, March), Tackling the Allergy Crisis in Europe – Concerted Policy Action Needed, Advocacy Manifesto, revised version, retrieved from http://www.eaaci.org/images/ media/EAACI_Manifesto_brochure_ Interactive.pdf

The prevalence of hypertension is 60% higher in Europe compared with the United States and Canada[1]. Over 150 million people had hypertension in central and eastern Europe in 2015[2]. The prevalence in children and adolescents is increasing. Hypertension remains the major preventable cause of cardiovascular disease (CVD) and all-cause death in Europe[3].

[1]https://www.researchgate.net/publication/10761170_Hypertension_Prevalence_and_Blood_Pressure_Levels_in_6_European_Countries_Canada_and_the_United_States
[2] 2018 ESC/ESH Guidelines for the management of arterial hypertension
[3] 2018 ESC/ESH Guidelines for the management of arterial hypertension

An estimated 83 million people in the EU are being affected by a type of mental health issue[1]. At least 45% of people with psychological challenges also develop chronic physical conditions, while those who live with one or more long-term physical illnesses are 2 to 3 times more likely to experience problems in mental health[2].

[1] http://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/data-and-resources
[2] https://mhe-sme.org/wp-content/uploads/2017/11/Joint-statement_on_mental_health-final_pdf_with_endorsements_etc.pdf

EU policy response

The Council invited Member States and the European Commission to identify options to optimize the response to chronic diseases, exchange good practices, and integrate, where possible, chronic diseases as a priority in current and future European action.

More information here.

The reflection process resulted in a report identifying two main priority areas for EU action:

  • prevention and health promotion
  • disease management, with an emphasis on patient empowerment

It also recognised that Europe should be steering the response to chronic diseases.

A major EU chronic disease summit was held in April 2014, concluding on the need to strengthen political leadership to address chronic diseases, in particular on the prevention side.

More information here.

The Steering Group is composed of government representatives and became a formal expert group of the European Commission in July 2018. It provides advice and expertise to the Commission and aims to foster exchanges of relevant experience, policies and practices between Member States.

More information here.

The European Union and Member States adopted the SDGs in September 2015, and committed to their implementation into national and European policy. These include Goal 3 target 4 on reducing premature mortality from NCDs by one third by 2030. Many other goals and targets are interlinked with chronic diseases, including on tobacco use, reducing poverty and inequalities, economic growth etc.

The Joint Actions aim to promote the implementation of policies and practices that have been demonstrated to be successful in chronic disease prevention and management. CHRODIS+ focuses on sustainability, health promotion, multimorbidity, quality of care and employment. ECDA is a collaborating partner in the Work Package 8 on chronic disease and employment.

More information here.

Other EU joint actions relevant to chronic diseases have been carried out such as the Joint action on Tobacco Control (JATC), on Reducing Alcohol Related Harm (JA-RARHA), on Nutrition and Physical Activity (JA-NPA).

The Portal acts as a repository of good practices in health promotion, diseases prevention and management of chronic diseases, collected in the fields of nutrition, physical activity, mental health, health inequalities, reducing alcohol related harm and integrated care. It aims to support efforts to disseminate and transfer best practices across the EU to progress prevention.

More information here.