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Our Methodology
For our list, we looked at two indexes: the GHS index of 2021 and the health pillar of Legatum Prosperity index of 2023. The 2021 Global Health Security (GHS) Index assesses 195 countries’ preparedness for epidemics and pandemics across six categories. The global average score is 38.9, indicating weak international readiness despite COVID-19 efforts. Similarly, The Health pillar of the 2023 Legatum Prosperity Index assesses health outcomes, systems, risk factors, and mortality rates, highlighting the importance of physical and mental health and access to effective healthcare services for individual and national prosperity. Hence, we averaged the scores of GHS, and the health pillar’s from Legatum index and the final rankings in our list were adjusted according to the average we obtained of these scores.
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Here is our list of the 15 unhealthiest countries in Europe.
15. Belarus
Insider Monkey Score: 14.5
Belarus tops the list for being the unhealthiest country in Europe. Belarus also ranks high in both alcohol and tobacco consumption. The lifestyle choices of Belarusians, including diet and physical inactivity, contribute significantly to the country’s health challenges. In 2023, Belarus’ healthcare spending rose by 116% from the previous year, reaching a minimum standard of $408.70 per person, up from $351.50 in 2022. This increase, driven by the DRG model for result-based budgeting, allowed the reallocation of over $800,000 to cover inpatient care costs in Grodno.
14. Lithuania
Insider Monkey Score: 14
Lithuania has one of the highest alcohol consumption rates in the world. On average, Lithuanians consume 18.2 liters of alcohol per person annually, which places the country among the top consumers globally. In 2021, Lithuania spent 7.85% of GDP on health, up from 6% since 2008. In 2022, spending decreased slightly to 7.5% of GDP.
13. Bulgaria
Insider Monkey Score: 12
Unhealthy diets and low levels of physical activity contribute to health issues in Bulgaria. Although obesity rates in Bulgaria are below the EU average, they are still considerable, with 26.3% of adult women and 28.3% of adult men living with obesity. In 2023, Bulgaria’s draft healthcare budget exceeds $5 billion. The National Health Insurance Fund allocated $4.07 billion, including $248 million for primary care, $250 million for specialized care, $148 million for dental care, $1.843 billion for hospital care, $97 million for medical and diagnostic activities, $946 million for medicines and medical devices, and $500 million for access and health needs.
12. Romania
Insider Monkey Score: 9
Romania ranks among the top countries in Europe with unhealthy diets, which can lead to various health issues despite the lower obesity rate. In 2021, Romania’s health spending was $16.7 billion, or $2,385 per person, accounting for 5.69% of GDP, one of the lowest rates in the EU. The public sector predominantly provides healthcare, covering nearly all citizens, with 79.5% of spending publicly financed, similar to the EU average. However, Romania’s health system is underfunded, leading to common out-of-pocket expenses, especially for dental care and pharmaceuticals.
11. Bosnia and Herzegovina
Insider Monkey Score: 8.5
Noncommunicable diseases are the leading cause of death and disability in Bosnia and Herzegovina, accounting for approximately 80% of annual deaths. The most prevalent NCDs include heart disease, stroke, cancer, diabetes, and chronic respiratory diseases. In 2020, Bosnia and Herzegovina spent 9.7% of GDP on health, above both the regional and income group averages. Public health spending slightly increased from 6.7% in 2013 to 6.9% in 2020, while private spending, mostly on out-of-pocket payments, remained around 30%, double the EU average.
10. Moldova
Insider Monkey Score: 8
Moldova has a significant obesity problem, with an obesity rate of 20.6%. In 2024, Moldova’s health expenditure was 7.7% of GDP. Out-of-pocket spending was 29.4% of total health expenditure, and domestic government health spending was 14.6% of general government expenditure.
9. Azerbaijan
Insider Monkey Score: 8
Azerbaijan faces challenges related to malnutrition, with 35.1% of women aged 15 to 49 years affected by anemia. Additionally, 17.8% of children under five years of age are affected by stunting, and 14.1% are overweight. In 2021, Azerbaijan spent $839 million on healthcare, or 5.2% of the state budget and 1.5% of GDP, a 0.5% increase from 2020.
8. Russia
Insider Monkey Score: 8
Russia stands eighth among the unhealthiest countries in Europe. Russia has a significant obesity problem, with approximately 30.3% of adults classified as obese, a rate higher than many OECD countries. Noncommunicable diseases (NCDs) such as cardiovascular diseases and diabetes are prevalent in Russia, driven by factors like obesity, hypertension, and inadequate nutrition. The prevalence of hypertension among Russian adults aged 50 and older is estimated to be 69.2%, which is a major risk factor for cardiovascular diseases. In 2023, Russia’s healthcare spending was $138 billion, or 7% of GDP, with $919 per capita, a significant increase from 4.6% of GDP in 2020 due to the COVID-19 pandemic.
7. Armenia
Insider Monkey Score: 8
Armenia ranks poorly in terms of blood glucose levels, which indicates a high risk of diabetes among its population. Armenia has an obesity rate of 19.5% which is one of the factors that makes the country unhealthy. In 2017, Armenia spent 1.4% of GDP on public health, below both the regional average of 4.9% and its income group’s average of 4%. In 2019, per capita health expenditure was $1,616, higher than the upper middle-income average but lower than the regional average. Armenia also had one of the highest out-of-pocket spending ratios, with 81.4% in 2021.
6. Macedonia
Insider Monkey Score: 8
North Macedonia has a notable prevalence of obesity, with 23.9% of adult women and 25.1% of adult men classified as obese. This is slightly below the regional average for women but above the average for men. Obesity is a significant risk factor for various non-communicable diseases (NCDs), including diabetes, which affects 7.1% of adult women and 8.4% of adult men in the country. Skopje, the capital city, is frequently listed among the most polluted cities in Europe. In 2018, the levels of PM10 particles exceeded EU limits for 202 days. The World Health Organization estimates that air pollution contributes to around 4,000 premature deaths annually in North Macedonia, with significant economic costs ranging from €570 to €1,470 million.
5. Albania
Insider Monkey Score: 8
Albania stands fifth among the unhealthiest countries in Europe. Albania has an obesity rate of approximately 24.7%. In 2022, Albania’s public healthcare spending was 63.8 billion lek, or 2.98% of GDP, the lowest percentage since 2017. Despite this, funding for essential services like primary care and drug reimbursement has remained unchanged, with drug reimbursement making up only 1.6% of the 2024 budget.
4. Serbia
Insider Monkey Score: 5.5
Serbia has a notable prevalence of obesity, with 23.9% of adult women and 23.6% of adult men living with obesity. Serbia shows limited progress towards achieving diet-related NCD targets. Diabetes affects 7.0% of adult women and 8.2% of adult men. The prevalence of overweight children under five years of age is 10.9%, indicating early onset of weight-related health issues. While Serbia is on course to meet several global nutrition targets, challenges remain. For instance, 22.8% of women aged 15 to 49 are affected by anemia, and 5.4% of children under five are stunted, which is higher than the European average. In 2021, Serbia spent 10% of its GDP on health, which is above its income group’s average but below its regional average, amounting to $919 per capita.
3. Ukraine
Insider Monkey Score: 4
In Ukraine, 27.5% of adult women and 24.5% of adult men are classified as obese. This rate is higher than the regional average for women but slightly lower for men. In terms of children, 26.5% of those under five are overweight, which is significantly higher than the European average of 4.5%. Ukraine faces issues with malnutrition, particularly among children. Stunting affects 22.9% of children under five, and 8.2% suffer from wasting. Additionally, 17.7% of women of reproductive age are affected by anemia. In 2024, Ukraine’s health spending is projected to reach UAH 239 billion, an increase of UAH 31 billion from 2023. This budget includes UAH 16 billion for the healthcare guarantee program, UAH 1 billion for hospital construction, and funds for a pilot dental prostheses program for veterans.
2. Georgia
Insider Monkey Score: 3.5
Georgia stands among the unhealthiest countries in Europe. Georgia has a significant obesity rate, with approximately 37% of its population classified as obese. Georgia’s FY 2025 budget allocates $7.3 billion to the Departments of Behavioral Health and Developmental Disabilities, Community Health, and Public Health, representing about 20% of state spending. Of this, $6.6 billion (90%) comes from General Fund appropriations, with the remaining $740 million from sources like Tobacco Settlement Funds. This represents an 11% increase, or $666 million, over the FY 2024 budget.
1. Montenegro
Insider Monkey Score: 1
Montenegro has a significant obesity problem, with an obesity rate of 25.6% as of recent data and tops the list for being the unhealthiest country in Europe. The economic impact of overweight and obesity in Montenegro was estimated to be approximately US$173.05 million in 2019, which equates to US$276 per capita and 3.1% of the country’s GDP. Alcohol consumption is also notably high, with Montenegrins consuming an average of 12.8 liters of alcohol annually, which is significantly above the global average of 7 liters per person. Non-communicable diseases (NCDs) account for 95% of all deaths in Montenegro.
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Disclosure. None: The 15 Unhealthiest Countries in Europe is originally published on Insider Monkey.
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Publish date : 2024-09-28 06:06:00
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