As Minister of Health, I am very pleased to launch the second edition of ‘Health in Review: An International Comparative Analysis of Bermuda Health System Indicators’.
Health in Review is a comprehensive look at how Bermuda is doing compared to other high income countries globally. These are the member countries of the Organisation for Economic Co-operation and Development (OECD) including the U.S., Canada, Portugal, Switzerland and Singapore.
The trends highlighted in the report include: health status, social determinants of health, the health workforce, healthcare activities, quality, access, and health expenditure and financing. Additional information is also provided on the demographic and economic context within which the health system operates.
The findings of the Health in Review report will assist the Ministry of Health with policy development and programme planning as we monitor and improve the health of Bermuda’s residents. The data found in Health in Review can also be of benefit to other parts of Government, private businesses, NGOs, students, researchers and the media. The updates from the first, 2011 edition will prove insightful to anyone with an eye on the performance of Bermuda’s health system.
Overall, there are some indicators of which we can be very proud, but also some where we perform poorest of the 44 countries measured. Let me give you some key highlights of the findings.
Life expectancy at birth on average across OECD countries reached 80.6 years, but Bermuda has a higher life expectancy of 81.1 years, which is higher than the U.S., Germany, and the U.K., but lower than Canada, France and Portugal. For comparison, the United States has a life expectancy of 78.8 years.
Bermuda’s female life expectancy at birth is 84.9 and male life expectancy at birth is 77.3. As has been noted previously, Bermuda spends more on healthcare per capita than Portugal, Canada and the U.K., but we don’t live as long. There are many reasons for this, but it’s clear that we can and should do better.
Nevertheless, we are doing well on smoking – only 10% of the population smoke daily, one of the lowest rates in the OECD. This is great news comparatively, though, of course, we strive to reduce this even further.
Heart disease mortality is decreasing in Bermuda, as is mortality from stroke. Our length of stay in the hospital post-heart attack is five days, down from 10 in 2007.
In Bermuda 13% of the population has diabetes which is the second highest rate in the OECD…only Mexico has a higher prevalence. Hospital admissions for diabetes are decreasing, which implies that those with the condition are getting better care, but the admission rate is still higher than the OECD average.
Transport accident rates among males are nearly three times the OECD average. Unfortunately, we see this playing out in the headlines all too often. In brighter news, female transport accident mortality rates are the lowest in the OECD. On average, in Bermuda over 85% of transport accidents were motorcycle related.
Similarly, there is a sobering scenario with deaths due to homicides, where the overall average mortality in Bermuda is five times the OECD average, mainly due to the increased mortality among males.
This means that when our men die early, and this is defined as before the age of 70, most are dying early because of external causes like road traffic accidents or homicide.
Bermuda has the worst obesity and overweight percentage of all OECD countries. Let me say that again: Bermuda has the worst result. There are 70% of women and 79% of men either overweight or obese. We are creating a national strategy to deal with this public health crisis and will hold a symposium on halting the rise in Diabetes and Obesity in mid-January 2018.
Although it varies, on average Bermuda has a diabetes-related major lower extremity amputation rate around twice as high as the OECD average (22% vs. 10%). We are only exceeded by Israel, Slovenia and Malta.
One in 12 babies born in Bermuda weigh less than 5.5 lbs (low birth weight) which is higher than the OECD average of 1 in 15.
Fertility rates have not met replacement levels (2.1) in the past decade. With a total fertility rate of 1.44 in 2015, Bermuda is below the OECD average of 1.68 and among the lowest fertility rates of the comparison countries.
The population decreased between 2010 and 2016 (64,129 to 61,695). There are more women than men. As the population ages and the birth rate stagnates, this has implications on dependency ratios, and therefore will have an economic impact, not least on the costs of healthcare.
In conclusion, what was striking to me is that, as in other countries, men’s health needs to be improved. Men are dying more often from certain conditions than women, dying younger from external causes like transport accidents or homicide, and have a lower life expectancy. This is something of concern to all of us. Today’s Men’s Health Screening and Bermuda Cancer and Health’s Movember activities to promote men’s health are very timely.
I encourage you to look at Health in Review… it is the most comprehensive report on Bermuda’s health and healthcare, and it is invaluable because it benchmarks us against other countries so we can really know how we’re doing.