Malta has third lowest death rate from preventable diseases

But deaths from diabetes and ischaemic heart disease higher than in EU average with Malta’s high obesity rate

Mortality from preventable causes in Malta is the third lowest in the European Union, an OECD report on the state of health in European Union shows.

Mortality rates from lung cancer, accidents, chronic lower respiratory diseases and alcohol-related diseases are far lower than the EU average.

But the mortality rate from diabetes is the third highest in the EU.

And mortality rates from treatable causes – those that should not have occurred in the presence of timely and effective health care – have fallen by 15 % in Malta since 2011, and are now the same as the EU average.

Preventable causes of mortality per 100,000 population
Cyprus 104 France 134 Poland 222
Italy 104 Portugal 138 Bulgaria 226
Malta 111 Greece 139 Croatia 239
Spain 113 Belgium 146 Slovakia 241
Iceland 115 Denmark 152 Estonia 253
Sweden 118 Germany 156 Lithuania 293
Norway 120 Finland 159 Romania 306
Netherlands 129 EU-27 160 Latvia 326
Luxembourg 130 Slovenia 175 Hungary 326
Ireland 132 Czechia 195

The overall decline in treatable mortality reflects “improvements in health system performance, with increased availability of key services, innovative medicines and medical technologies”, the report states.

Ischaemic heart disease is the leading cause of treatable mortality in Malta, and death rates remain significantly above the EU average.

Relatively high mortality rates from diabetes and ischaemic heart disease are partly attributable to the high prevalence of overweight and obesity among Malta’s population.

In the 2021 budget, funding was committed to support educational campaigns to address eating disorders and obesity among minors - €11 million were committed to promote a new culture of physical activity by refurbishing and developing sport venues and facilities.

According to the report, life expectancy gains in Malta since 2000 have been driven by a decline in premature deaths from leading causes – notably, cardiovascular diseases and cancers.

Life expectancy at birth in Malta stands at 82.6 years in 2020 – the second highest in the EU and two years higher than the EU average. Overall, the gap in life expectancy between men and women is lower than the EU average, with women living on average 3.8 years longer than men, compared to the EU average of 5.6 years.

From 2000 to 2018, age-standardised mortality rates per 100 000 population from cardiovascular diseases fell by more than 50%, and for all cancers by 14%.

Cardiovascular diseases nevertheless remained the leading cause of death in 2018, accounting for 34% of all deaths, followed by cancer (28%).

In terms of individual causes of disease, ischaemic heart disease was the leading cause of mortality in 2018, accounting for 17% of all deaths, followed by stroke.

Deaths attributable to diabetes (50.8 per 100 000 population) were the third highest in the EU, which is partly linked to Malta’s high prevalence of obesity.

Hospital admission rates in Malta for asthma and chronic obstructive pulmonary disease (COPD), chronic heart failure and diabetes are all higher than in many other EU countries.

Drop in cancer deaths

When it comes to specific cancers, mortality rates for breast cancer are higher than the EU average, but for colorectal cancer are the same as the EU average.

An estimated 2,400 people in Malta were diagnosed with cancer in 2020. The main cancer sites among men are prostate (26%), lung (16%) and colorectal (13%), while among women breast cancer is the leading cancer (36%), followed by colorectal (11%) and uterus (7%).

Malta also recorded a substantial increase in five-year survival rates for lung, breast and prostate cancers between 2000-04 and 2010-14, reflecting earlier diagnosis and more effective treatment.

The survival rate for lung cancer is now the same as the EU average, while survival rates for breast and prostate cancers are higher.

The five-year survival rate for colon cancer has been stable over the past decade and remains slightly below the EU average. The survival rate for cervical cancer is also slightly below the EU average.

Attendance rates for breast cancer screening have increased by more than 20 percentage points since 2010, but more than 30% of women in the target group did not attend routine mammography appointments in 2019.

In 2016, a national cervical cancer screening programme for women aged 25-35 was launched. Programme data for 2018 indicate that only 22% of eligible people had attended cervical cancer screening in the prior two years, but national survey data indicate that uptake may be as high as 62 %, suggesting that people are opting to undertake screening in the private sector.

Healthcare shortages

The number of doctors and nurses has also been rising steadily over the past decade.

Malta now has a higher number of doctors per capita (4.1 per 1 000 population) than the EU average (3.9), and a number of nurses (7.9 per 1 000 population) just below the EU average (8.4).

Moreover, the number of medical graduates more than trebled from 2008 to 2018, and the number of nursing graduates almost doubled.

However, recruitment and retention of GPs has proved challenging; the share of GPs within the physician workforce has declined since 2009, and at 20.5% in 2019 remained below the EU average of 26. %.

Malta also has a shortage of nursing staff in hospitals, and is increasingly reliant on recruiting foreign trained nurses notably from India, Pakistan and the Philippines.  Shortage of nurses is attributed to the migration of these foreign-trained nurses to the United Kingdom and other countries that offer more competitive working conditions.