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Chapter 9

A great deal of additional information on the European Union is available on the Internet.It can be accessed through the Europa server (http://europa.eu).

Luxembourg: Office for Official Publications of the European Communities, 2006

ISBN 92-79-01799-3ISSN 1681-9306

European Communities, 2006

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CONTENTSQ INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Statistical data at the regional level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Some highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Regional classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

More regional information needed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Regional interest group on the web . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Closure date for the yearbook data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Q 1. POPULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

A changing population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

and a shifting age structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

What will the future bring? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Methodological notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Q 2. REGIONAL GROSS DOMESTIC PRODUCT . . . . . . . . . . . . . . . . . . . . . . . . . 25What is regional gross domestic product? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Regional GDP in 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Major regional differences even within the countries themselves . . . . . . . . . . . . . . . . . 29

Catching-up process in the new Member States is not successful everywhere . . . . . . . . . . 31

Different trends even within the countries themselves . . . . . . . . . . . . . . . . . . . . . . . 33

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Purchasing power parities and international volume comparisons . . . . . . . . . . . . . . . . 35

Q 3. HOUSEHOLD ACCOUNTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Introduction: Measuring wealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Private household income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Results for 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Primary income and disposable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Income and social benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Not all the new Member States are catching up . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

The measurement unit for regional comparisons . . . . . . . . . . . . . . . . . . . . . . . . . 49

Q 4. REGIONAL LABOUR MARKET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Employment the 15-64 age group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Regions with high employment rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Regions with employment rates immediately below the highest level . . . . . . . . . . . . . 54

Regions with low employment rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Employment in Bulgaria and Romania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Employment the 55-64 age group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

High employment rates for persons aged 55 to 64 . . . . . . . . . . . . . . . . . . . . . . . 58

R e g i o n s : S t a t i s t i c a l y e a r b o o k 2 0 0 6 5

Low employment rates for persons aged 55 to 64 . . . . . . . . . . . . . . . . . . . . . . . 59

Employment rates for persons aged 55 to 64 in Bulgaria and Romania . . . . . . . . . . . 60

Unemployment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Q 5. LABOUR PRODUCTIVITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Marked differences in regional labour productivity . . . . . . . . . . . . . . . . . . . . . . . 67

Productivity growth rates: the new Member States are catching up . . . . . . . . . . . . . . . 70

Labour productivity in terms of hours worked . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74


Q 6. URBAN STATISTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77What is the Urban Audit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Spatial units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Urban competitiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Outputs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Inputs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Outlook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Q 7. SCIENCE, TECHNOLOGY AND INNOVATION . . . . . . . . . . . . . . . . . . . . . . . 91Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Human resources in science and technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Patents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

High-tech industries and knowledge-intensive services . . . . . . . . . . . . . . . . . . . . . . 101

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101


Q 8. STRUCTURAL BUSINESS STATISTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

Lowest business diversification in small tourist regions and capital regions . . . . . . . . . . . 107

Retail trade the main activity in more than half the regions . . . . . . . . . . . . . . . . . . . 109

Many regions are highly specialised in a specific activity . . . . . . . . . . . . . . . . . . . . . 110

High-tech intensive regions relatively evenly distributed across the Member States . . . . . . . 110

Large differences in average wage costs among the high-tech intensive regions . . . . . . . . . 111

Highest investment rate in high-tech activities in Brussels . . . . . . . . . . . . . . . . . . . . 114

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116


Q 9. HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Mortality in EU regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Ischaemic heart diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Accidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

R e g i o n s : S t a t i s t i c a l y e a r b o o k 2 0 0 66

Health Care resources in EU regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128


Q 10. TRANSPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Road network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Vehicle stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135

Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135

Maritime transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Aviation passengers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140


Q 11. AGRICULTURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147


Structure of the agricultural holdings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148

Environmental aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

Rural development statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154

The OECD concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

The Eurostat degree of urbanisation concept . . . . . . . . . . . . . . . . . . . . . . . . . . 156

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

Q EUROPEAN UNION: NUTS 2 regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

Q CANDIDATE COUNTRIES: Statistical regions at level 2 . . . . . . . . . . . . . . . . . . 165


Introduction


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Statistical data at theregional levelThe Structural Funds for the period 2007 to 2013were decided in December 2005. This decisionwas based on the objective regional statisticscompiled by Eurostat, thus highlighting the im-portance of our effort to produce a wide range ofcomparable regional information.

This yearbook shows many aspects of this region-al data and suggests in the various chapters someof the analyses which can be made with them. Butwe also invite you the reader to yourself continuethe analyses of the regional data supplied in eachof the different themes presented here. We alsohope that this publication will make you keen tofurther investigate Eurostats statistical databases(available free of charge on the internet).

In keeping with the traditions of the Regionalyearbook, we try to renew the publication a littleeach year, but also to keep its structure basicallyunchanged. In this way, many subjects reappearfrom year to year, but the theme or focus of thesubject is always slightly different. This year weagain have one theme that is totally new for theRegional Yearbook, namely labour productiv-ity, which combines statistics on GDP withlabour market statistics in a very interesting way.This kind of cross-cutting of different statisti-cal domains could of course also be conductedwith other statistical themes, but we will forthe moment leave that to a future edition of theyearbook.

Some highlightsWe will not present here the content of all chap-ters of this Regional Yearbook. Here, however,are some hints to whet your appetite to read itcarefully:

The population chapter this year focuses onold and young dependency ratios in the com-ing decades, highlighting the drastic changesof society we will have to cope with.

The chapter on regional GDP centres its at-tention on growth rates between 1999 and2003, giving interesting insights into regionaldifferences.

The Urban Audit chapter concentrates on thecompetitiveness of cities, analysing variousfacets of benchmarking cities that competeagainst each other.

The chapter on the Structural Business Surveyfocuses on specialised regions in different in-dustrial and service activities. This highlightsthe heterogeneity of European regions interms of the production process and skills.

RegionalclassificationAll regional analysis in this yearbook is based onNUTS 2003. In the meantime, the ten new Mem-ber States have also been formally integrated intothe new regional classification in the form of anamendment to the NUTS Regulation. The textsof the Regulation and the amendment are avail-able on the CD-ROM as is the annex, whichlists the regions making up the nomenclature ineach country.

CoverageNo distinction is made in the yearbook betweenthe old Member States, the countries that becameMember States in 2004 and those due to joinin 2007 or 2008: wherever data are availablefor Bulgaria and Romania, these of course alsofeature in the maps and commentaries. In thecase of Turkey and Croatia, there are still toofew regional data to justify including them in theanalyses.

StructureIn each chapter, regional distributions are high-lighted by colour maps and graphs which arethen evaluated by expert authors in text com-mentaries. In keeping with the traditions of theyearbook, an effort has been made to focus onaspects not recently covered.


In order to assist the understanding of the maps,the data series used for the maps in the yearbookare provided as Excel files on the CD-ROM.

In the maps, the statistics are presented at NUTSlevel 2. A map giving the code numbers of theregions can be found in the sleeve of this publi-cation. At the end of the publication there is alist of all the NUTS-2 regions in the EuropeanUnion, together with a list of the level 2 sta-tistical regions in Bulgaria and Romania. Fulldetails of these national regional breakdowns,including lists of level 2 and level 3 regions andthe appropriate maps, may be consulted on theRAMON server.1

More regionalinformation needed?The public REGIO database on the Eurostat web-site contains more extensive time series (whichmay go back as far as 1970) and more detailedstatistics than those given in this yearbook, suchas population, death and birth by single years ofage, detailed results of the Community labour-force survey, etc. Moreover, there is coverage inREGIO of a number of indicators at NUTS level 3(such as area, population, births and deaths, grossdomestic product, unemployment rates). This isimportant because there are no fewer than eightEU Member States (Cyprus, Denmark, Estonia,Latvia, Lithuania, Luxembourg, Malta and Slov-enia) that do not have a level 2 breakdown.

For more detailed information on the contents ofthe REGIO database, please consult the Eurostatpublication European regional and urban statis-tics Reference Guide 2003, a copy of whichis available in PDF format on the accompanyingCD-ROM.

In addition, the reader is also invited to consultthe web version of the Portraits of the Regions,which give regional profiles of all individualregions across Europe.2 These regional topicalprofiles describe the geography and history of theregion, before going on to assess its strengths andweaknesses in terms of demographic, economicand cultural issues. Among the aspects examinedare the labour market, education, infrastructureand resources.

Regional interestgroup on the webEurostats regional statistics team maintains apublicly accessible interest group on the web(CIRCA site) with many useful links and docu-ments.3

Among other resources, you will find:

a list of all regional coordination officers inthe Member States, the candidate countriesand the EFTA countries;

the latest edition of the Regional and UrbanReference Guide;

PowerPoint presentations of Eurostats workconcerning regional and urban statistics;

the regional classification NUTS for the Mem-ber States and the regional classification of thecandidate countries.

Closure date for theyearbook dataThe cut-off date for this issue was the 15th of May2006.

1 See http://europa.eu.int/comm/eurostat/ramon/index.cfm?TargetUrl=DSP_PUB_WELC

2 See http://forum.europa.eu.int/irc/dsis/regportraits/info/data/en/index.htm

3 Seehttp://forum.europa.eu.int/Public/irc/dsis/regstat/infor-mation

Health 9.


IntroductionSocio-health regions are defined in very differ-ent ways from one regional, provincial or localgovernment to another, and from one MemberState to another. As regional governments havebecome more important in Europe, the role ofthe regions as units for the political and adminis-trative management of health issues has also de-veloped. For example, in Spain, where regionalgovernments have acquired a great deal of auton-omy, one practical effect is that they manage theentire health budget. The situation is very similarin Belgium. Since 1996, Frances healthcare re-form introduced to put healthcare planning ona regional footing has allowed hospitals to beresponsible for allocating the budget. Healthcaremanagement is also being drastically reorganisedin the United Kingdom, with NHS trusts havingvarying levels of responsibility. In other MemberStates such as the Netherlands and Sweden, themunicipalities are responsible for healthcare.

Hence one difficulty with statistics on health andon medical/health/hospital services at regionallevel stems from the fact that local-governmentboundaries, and thus the regional breakdownwhich is of interest to health authorities in theMember States, do not always coincide with theNUTS, and cross-referencing problems may there-fore arise when comparing regional statistics.

Currently, two different types of health statisticsare available at regional level, mostly for NUTSlevel 2. Firstly there are data on mortality byunderlying cause, where the illnesses or diseasesin question are defined according to an interna-tional classification and where data are collectedusing comparable methods. This chapter focuseson patterns of premature mortality (i.e. on mor-tality of the population aged between 0 and 64

years) for selected causes. The second type ofdata available at regional level concerns healthcare; here the regional distribution of hospitaldischarges and of dentists is examined.

Mortality in EUregionsMortality patterns differ significantly accord-ing to age and sex, and also vary considerablybetween regions. Many factors determine mor-tality patterns intrinsic factors such as age andsex, extrinsic factors such as biological or socialcollective factors, living or working conditions,and individual factors such as lifestyle, smoking,alcohol consumption, driving behaviour, andsexual behaviour.

As a general rule, mortality is higher among menthan women in all age groups. Although there aresigns that the mortality gap is narrowing in somemember states, the difference nevertheless war-rants looking at women and men separately.

Looking at the overall mortality in EU-25 in2003, diseases of the circulatory system accountfor 41% of all deaths and are thus the majorcause (45% for women and 37% for men). Thesepathologies affect the population at advancedages over 80% of deaths due to cardiovasculardiseases occur among people aged 70 years andolder. Malignant neoplasms, i.e. cancers, followas the second most frequent cause, accounting for25% of all deaths in EU-25 (or 22% for womenand 29% for men). Malignant neoplasms mostlyaffect elderly people, as almost 60% of all deathsdue to cancer involve persons aged 70 years andolder. At the same time, for premature deaths, i.e.


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deaths under the age of 65, malignant neoplasms account for 36% and so represent the main cause (men under 65: 31%, women under 65: 45%). External causes also have a substantial impact on deaths below 65. For this age group, 15% of deaths are due to external causes (men: 18%, women: 10%) while for all ages it is only 5% (men: 6%, women: 4%).

Ischaemic heart diseases

Ischaemic heart diseases comprise Angina pec-toris, acute myocardial infarction and other acute and chronic ischaemic heart diseases. For EU-25, ischaemic heart diseases account for 16% of all deaths and for 11% of deaths under the age of 65. This corresponds to nearly half of all deaths re-lated to all diseases of the circulatory system oc-curring under 65. Substantial differences can be observed between men and women only 6% of women die from ischaemic heart diseases before the age of 65 in contrast to 13% of men.

Male/female mortality ratios compare the dif-ferences in mortality between women and men. They are calculated by dividing the age-standard-ised death rate (SDR) for men in a given region and for a specific cause by the corresponding SDR for women (for SDR see also below in the methodological notes). Values higher than 1 in-dicate excess male mortality, while values lower than 1 mean excess female mortality.

Looking at all ages, the male/female mortality ratios for ischaemic heart diseases show a male excess mortality in all regions but the variation within EU-25 is relatively small, ranging from 1.2 in the French Guyane to 3.0 in Comunidad Foral de Navarra (Spain). However, for prema-ture mortality, i.e. SDRs for the ages 0 to 64, considerably higher male excess mortality can be found throughout Europe. Even the regions with the lowest male excess mortality before the age of 65 report values of around 2.5, and values higher than 8.0 are reached in the following five Euro-pean regions: Castilla y Len and Comunidad Foral de Navarra (Spain), Bretagne and Poitou-Charentes (France) and land (Finland).

The regional pattern for this indicator is not very evident but some regional particularities can be observed. In the southern European regions as well as throughout France and the southern regions of Germany, a high male excess mortality can be ob-served, with few exceptions in Portugal (Alentejo, and also Algarve, Centro (P) and Lisboa) and in Italy (Basilicata, Campania and Sicilia). Regions

with a low male excess mortality can be found in a diagonal across Europe from United Kingdom through Belgium and the Netherlands and some of the neighbouring German regions (Dsseldorf, Kln and Koblenz) over to the Czech Republic and Austria. In the east, most Hungarian regions together with all Romanian and several Bulgarian regions present a joint area of relatively low male excess mortality. In the north, it is in Denmark and Sweden where smaller differences can be seen between men and women while Finland and the Baltic countries show a high male excess mortal-ity for ischaemic heart diseases.

Accidents

Before the age of 65, deaths due to external causes play a significant role (see above), and ac-cidents account for almost 60% of deaths from external causes. This figure refers to all types of accidents, i.e. transport accidents, falls and other accidents such as drowning, fire, accidental poi-soning all types of circumstances that may well be preventable. The risk of men below the age of 65 falling victim to a fatal accident is twice as high as for women in EU-25 in 2003, 10% of deaths among men younger than 65 were due to an accident, compared to only 5% among women in that age-group.

The regional distribution of premature mortality of men expressed in Standardised Death Rates (SDRs, see below methodological notes) shows a very clear pattern for European risk areas. The highest SDRs for accidents are reported for a more or less coherent area in the east, stretching from Finland and the Baltic countries in the very north via Poland, the Czech Republic and regions in Austria and through Hungary, Romania, and Bulgaria all the way down to Greece. High mor-tality due to accidents is generally the result of transport accidents for men in EU-25, just over half of all deaths due to accidents are caused by transport accidents.

In the west, almost all regions in France and Spain show high SDRs, though not at the same level as the regions in the east. The regions with lower mortality in these two countries are Alsace, Lorraine, Nord - Pas-de-Calais and le-de-France (which comprises Paris) in France and Cantabria, Pas Vasco, Comunidad de Madrid and Canarias in Spain. The safer countries are the United Kingdom, Sweden, Denmark and the Netherlands, where all regions report SDRs be-low 30.6 (per 100 000 inhabitants). Most regions


in Germany and in Italy are also low-risk regionsfor accident mortality, with a few exceptions(SDRs higher than 35 in Brandenburg Nordost,Brandenburg Sdwest and Mecklenburg-Vor-pommern in Germany and higher than 30 in Pie-monte, Valle dAosta/Valle dAoste, ProvinciaAutonoma Bolzano/Bozen, Emilia-Romagna andMolise in Italy).

For women, premature mortality due to acci-dents is generally far lower, with SDRs ranging

between less than 5 per 100 000 inhabitants inMalta and the Netherlands, and more than 30in Estonia and Latvia. For men in the same agegroup the lowest rate reported is 14.1 (the Neth-erlands), and in the Baltic countries the rates arearound 135 and above.

As for men, the standardised mortality for wom-en due to accidents is relatively high in regionsin the East of Europe, stretching from Finlandto Greece. Low risk areas for women are mainly

AORES P

0 100

MADEIRA P

0 25CANARIAS E

0 100GUADELOUPE

F 0 25MARTINIQUE

F 0 20RUNION

F 0 20GUYANE

F 0 100

0 100 500 km

> 5.14.2 5.13.7 4.2


9H

EA

LT

H

concentrated in the southern part of the UnitedKingdom, in the Netherlands, Germany and thesouth of Italy. But Malta, the Comunidad deMadrid, Vorarlberg (Austria), land (Finland)as well as 4 regions in the south-east of Swedenalso have outstanding low accident related SDRsfor women.

Regarding the male/female mortality ratios foraccidents, male excess mortality is particularlymarked in Poland, Slovenia and Malta with val-

ues above 5. At the regional level, the largestdivergence of accident-related mortality forwomen and men is reported for Guadeloupeand Martinique (France), Ciudad Autnomade Ceuta (Spain), Valle dAosta/Valle dAosteand Provincia Autonoma Trento (Italy), RegioAutnoma da Madeira (Portugal), land (Fin-land) and Lubelskie (Poland) in these regionsvalues higher than 6 for male excess mortalityare observed.

AORES P

0 100

MADEIRA P

0 25CANARIAS E

0 100GUADELOUPE

F 0 25MARTINIQUE

F 0 20RUNION

F 0 20GUYANE

F 0 100

0 100 500 km

> 46.430.6 46.420.3 30.6


Health care resourcesin EU regionsHospital discharges

Hospitalisation statistics give a broad picture of

the health care treatment of the population, and

also of general health. Around 15 640 persons per

100 000 population were discharged from hospi-tals in EU-25 in 2003. However, even betweencountries, there is a wide range for this indicator,from less than 7 000 in Cyprus and Malta to over26 000 in Finland and Austria. These differencesmay partly reflect the differences in the organisa-tion of health care services.

Regional data for hospital discharges of in-pa-tients have only quite recently become available,and not all countries are yet in the position to

AORES P

0 100

MADEIRA P

0 25CANARIAS E

0 100GUADELOUPE

F 0 25MARTINIQUE

F 0 20RUNION

F 0 20GUYANE

F 0 100

0 100 500 km

> 11.58.1 11.56.1 8.1


9H

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provide hospital discharges data at sub-nationallevel. Amongst the countries with sub-nationaldata, the Czech Republic, Greece and Italy showthe greatest variation within the country for thenumber of hospital discharges per 100 000 in-habitants. In the Czech Republic, in the capitalregion comprising Prague, almost twice (1.8) asmany persons are discharged from hospitals as inStedn echy, which geographically surroundsthe region Praha. In Austria, hospital dischargeswithin the country vary by a factor of 1.5, andbetween Wien and the surrounding Niederster-reich, it is only by a factor of 1.3. Within coun-tries, it is often capital regions or relatively smallregions including a big city which have high dis-charge rates: Praha (30 676), Bremen (28 284),and the Saarland (24 363) in Germany, Athens(19 799) in Greece. However, this is not verysurprising since hospitals tend to be concentratedin cities and agglomerations. While the hospitals

are located in the cities, their catchment area ismuch wider, and people living in the neighbour-ing regions may also use the health care facilitiesoffered in the cities. However, relatively highhospital discharge rates can also be observed insome sparsely populated regions such as Meck-lenburg-Vorpommern (Germany) and Limousin(France), (22 068 and 19 391 respectively) whichmay partly be explained by the effects of migra-tion and ageing.

Dentists

For EU-25, the density rate of dentists, i.e. theiraverage number per 100 000 inhabitants, isaround 60. At the regional level, considerablevariations in this indicator can be observed, andmap 9.4 shows a clear picture of where the provi-sion of dental services is concentrated. Across allregions, the density rates range from less than 20

Hsbqi!:/2;!Iptqjubm!ejtdibshft!.Sbuf!qfs!211!111!joibcjubout-!!3114!.!OVUT!3

PrahaStredni Cechy

BE

CZ

DK

DE**

EE

EL***

ES

FR

IE

IT**

CY

10 0008 000

* 2004 data

LV**

LT

HU**

NL

AT

PL

PT

FI**

RO**

SE

UK

SK

LU

MT*

SI**

BG

12 000 14 000 16 000 18 000 20 000 22 000 24 000 26 000 28 000 30 000 32 000

Baden-Wrttemberg Bremen

Castilla-La Mancha

Illes Balears

Runion CorseSouthernand Eastern Border, Midland and Western

6 000

Burgenland Krnten

England Scotland

StereaEllada

Attiki

Piemonte Abruzzo

** 2002 data *** 1999 data

land It-Suomi

National average

Zeveroiztochen Yugozapaden


in a number of Polish, Romanian and Portugueseregions (however, data for the latter refer only todentists practising in hospitals and clinics andtherefore underreport the situation) up to rateshigher than 100. Eight regions situated in Bel-gium, Bulgaria, the Czech Republic, Germany,and Greece report these highest density rates,

and not very surprisingly, the capital regionsof all five countries are in this group: Brussels,Sofia, Prague, Berlin and Athens. Similarly, inmost other countries for which regional data areavailable it is again the capital region where thehighest concentration of dentists within the coun-try can be found.

AORES P

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0 100GUADELOUPE

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F 0 20RUNION

F 0 20GUYANE

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> 73.655.9 73.641.0 55.9


9H

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ConclusionThe currently available regional indicators forhealth already provide a first insight into simi-larities and particularities that exist throughoutEurope. However, in analysing the data it hasto be kept in mind that the differences observedare also influenced by the organisation of healthcare systems and by socio-cultural factors.Examples of the latter are the reporting ofparticular causes of death such as suicide or al-

cohol-related deaths and their link to culturallydetermined consumption patterns. Health careresources are influenced by the organisation ofthe systems at national and regional level, and inthe medium term figures on health care capaci-ties should be complemented by information ontheir effectiveness.

The main focus of Eurostats work in the area ofhealth statistics lies on the further improvement ofthe quality and comparability of the data, and onthe further extension of the regional coverage.

Methodological notesCauses of Death (COD) statistics are based on informationderived from the medical death certificate. COD statisticsrecord the underlying cause of death, i.e. the disease orinjury which initiated the train of morbid events leadingdirectly to death, or the circumstances of the accident orviolence which produced the fatal injury. This definitionhas been adopted by the World Health Assembly.

In addition to absolute numbers, crude death rates andstandardised death rates for COD are provided at nationaland regional level. Regional level data are provided in theform of three-year averages. The crude death rate describesmortality in relation to the total population. It is expressedper 100 000 inhabitants, being calculated as the numberof deaths recorded in the population for a given perioddivided by the population in the same period and thenmultiplied by 100 000. Crude death rates are calculatedfor 5-year age groups. At this level of detail, comparisonsbetween countries and regions are meaningful. The crudedeath rate for the total population (all ages) by sex and age,however, is a weighted average of the age-specific mortal-ity rates. The weighting factor is the age distribution of thepopulation whose mortality is being observed. Thus, thepopulation structure strongly influences this indicator forbroad age classes. In a relatively old population, there willbe more deaths than in a young one because mortality ishigher in higher age groups. For comparisons, the age effectcan be taken into account by using a standard population.The standardised death rate (SDR) is a weighted averageof age-specific mortality rates. The weighting factor isthe age distribution of a standard reference population.The standard reference population used is the standardEuropean population as defined by the World Health Or-ganisation (WHO). Standardised death rates are expressedper 100 000 inhabitants and calculated for the age group0-64 (premature death) and for the total of ages. Causesof death are classified by the 65 causes on the Europeanshortlist of causes of death. This shortlist is based on theInternational Statistical Classification of Diseases and

Related Health Problems (ICD), a classification developedand maintained by the WHO.

Eurostat collects regional-level statistics on health carestaff (numbers of doctors, dentist and of other healthprofessions) and on hospital beds (the latter are not shownin this publication but available in Eurostats statisticaldatabases). Regional data on hospital discharges of in-patients have recently become available, though not yetfor all countries. In addition to absolute numbers, densityrates are provided for health care statistics. Density ratesare used to describe the availability of these resources orthe frequency of services rendered, expressed per 100 000inhabitants. They are calculated by dividing the absolutenumber of health care resources available or services ren-dered in a given period by the respective population in thesame period and then multiplied by 100 000.

Data on dentists should refer to those immediately serv-ing patients, i.e. dentists who have direct contact with pa-tients as consumers of health care services. In the contextof comparing health care services across Member States,Eurostat considers that this is the concept which best de-scribes the availability of health care resources. However,Member States use different concepts when they report thenumber of health care professionals both for nationalpurposes and for international comparison. Therefore forsome countries the data might refer to dentists licensed topractice (i.e. successfully graduated dentists irrespectivewhether they see patients or not) or they might includedentists who work in their profession but do not see pa-tients (i.e. they work in research, administration etc.).

A discharge from a hospital or another health care facil-ity occurs at any time when a patient leaves because ofmedically authorised discharge, transfer, departure againstmedical advice, or death. The number of discharges is themost commonly used measure of the utilisation of hospitalservices, in preference to admissions. This is because it isat the time of discharge that information is gathered forhospital abstracts for in-patient care.

129R e g i o n s : S t a t i s t i c a l y e a r b o o k 2 0 0 6


EUROPEAN UNION: NUTS 2 regionsBE10 Rgion de Bruxelles-

Capitale/BrusselsHoofdstedelijk Gewest

BE21 Prov. AntwerpenBE22 Prov. Limburg (BE)BE23 Prov. Oost-VlaanderenBE24 Prov. Vlaams-BrabantBE25 Prov. West-VlaanderenBE31 Prov. Brabant WallonBE32 Prov. HainautBE33 Prov. LigeBE34 Prov. Luxembourg

(BE)BE35 Prov. NamurCZ01 PrahaCZ02 Stedn echyCZ03 JihozpadCZ04 SeverozpadCZ05 SeverovchodCZ06 JihovchodCZ07 Stedn MoravaCZ08 MoravskoslezskoDK00 DanmarkDE11 StuttgartDE12 KarlsruheDE13 FreiburgDE14 TbingenDE21 OberbayernDE22 NiederbayernDE23 OberpfalzDE24 OberfrankenDE25 MittelfrankenDE26 UnterfrankenDE27 SchwabenDE30 BerlinDE41 Brandenburg

NordostDE42 Brandenburg

SdwestDE50 BremenDE60 HamburgDE71 DarmstadtDE72 GieenDE73 KasselDE80 Mecklenburg-

VorpommernDE91 BraunschweigDE92 HannoverDE93 LneburgDE94 Weser-EmsDEA1 DsseldorfDEA2 KlnDEA3 MnsterDEA4 DetmoldDEA5 ArnsbergDEB1 KoblenzDEB2 TrierDEB3 Rheinhessen-Pfalz

DEC0 SaarlandDED1 ChemnitzDED2 DresdenDED3 LeipzigDEE1 DessauDEE2 HalleDEE3 MagdeburgDEF0 Schleswig-HolsteinDEG0 ThringenEE00 EestiGR11 Anatoliki Makedonia,

ThrakiGR12 Kentriki MakedoniaGR13 Dytiki MakedoniaGR14 ThessaliaGR21 IpeirosGR22 Ionia NisiaGR23 Dytiki ElladaGR24 Sterea ElladaGR25 PeloponnisosGR30 AttikiGR41 Voreio AigaioGR42 Notio AigaioGR43 KritiES11 GaliciaES12 Principado de AsturiasES13 CantabriaES21 Pas VascoES22 Comunidad Foral de

NavarraES23 La RiojaES24 AragnES30 Comunidad de

MadridES41 Castilla y LenES42 Castilla-La ManchaES43 ExtremaduraES51 CataluaES52 Comunidad

ValencianaES53 Illes BalearsES61 AndalucaES62 Regin de MurciaES63 Ciudad Autnoma de

CeutaES64 Ciudad Autnoma de

MelillaES70 CanariasFR10 le-de-FranceFR21 Champagne-ArdenneFR22 PicardieFR23 Haute-NormandieFR24 CentreFR25 Basse-NormandieFR26 BourgogneFR30 Nord - Pas-de-CalaisFR41 LorraineFR42 Alsace

FR43 Franche-ComtFR51 Pays de la LoireFR52 BretagneFR53 Poitou-CharentesFR61 AquitaineFR62 Midi-PyrnesFR63 LimousinFR71 Rhne-AlpesFR72 AuvergneFR81 Languedoc-RoussillonFR82 Provence-Alpes-Cte

dAzurFR83 CorseFR91 GuadeloupeFR92 MartiniqueFR93 GuyaneFR94 RunionIE01 Border, Midland and

WesternIE02 Southern and EasternITC1 PiemonteITC2 Valle dAosta/Valle

dAosteITC3 LiguriaITC4 LombardiaITD1 Provincia Autonoma

Bolzano/BozenITD2 Provincia Autonoma

TrentoITD3 VenetoITD4 Friuli-Venezia GiuliaITD5 Emilia-RomagnaITE1 ToscanaITE2 UmbriaITE3 MarcheITE4 LazioITF1 AbruzzoITF2 MoliseITF3 CampaniaITF4 PugliaITF5 BasilicataITF6 CalabriaITG1 SiciliaITG2 SardegnaCY00 Kypros/KbrsLV00 LatvijaLT00 LietuvaLU00 Luxembourg (Grand-

Duch)HU10 Kzp-MagyarorszgHU21 Kzp-DunntlHU22 Nyugat-DunntlHU23 Dl-DunntlHU31 szak-MagyarorszgHU32 szak-AlfldHU33 Dl-AlfldMT00 MaltaNL11 Groningen

AN

NE

X


NL12 FrieslandNL13 DrentheNL21 OverijsselNL22 GelderlandNL23 FlevolandNL31 UtrechtNL32 Noord-HollandNL33 Zuid-HollandNL34 ZeelandNL41 Noord-BrabantNL42 Limburg (NL)AT11 BurgenlandAT12 NiedersterreichAT13 WienAT21 KrntenAT22 SteiermarkAT31 ObersterreichAT32 SalzburgAT33 Tirol AT34 VorarlbergPL11 dzkiePL12 MazowieckiePL21 MaopolskiePL22 lskiePL31 LubelskiePL32 PodkarpackiePL33 witokrzyskiePL34 PodlaskiePL41 WielkopolskiePL42 ZachodniopomorskiePL43 LubuskiePL51 DolnolskiePL52 OpolskiePL61 Kujawsko-PomorskiePL62 Warmisko-MazurskiePL63 PomorskiePT11 NortePT15 AlgarvePT16 Centro (PT)PT17 LisboaPT18 Alentejo

PT20 Regio Autnoma dos Aores

PT30 Regio Autnoma da Madeira

SI00 SlovenijaSK01 Bratislavsk krajSK02 Zpadn SlovenskoSK03 Stredn SlovenskoSK04 Vchodn SlovenskoFI13 It-SuomiFI18 Etel-SuomiFI19 Lnsi-SuomiFI1A Pohjois-SuomiFI20 landSE01 StockholmSE02 stra MellansverigeSE04 SydsverigeSE06 Norra MellansverigeSE07 Mellersta NorrlandSE08 vre NorrlandSE09 Smland med arnaSE0A VstsverigeUKC1 Tees Valley and

DurhamUKC2 Northumberland and

Tyne and WearUKD1 CumbriaUKD2 CheshireUKD3 Greater ManchesterUKD4 LancashireUKD5 MerseysideUKE1 East Riding and North

LincolnshireUKE2 North YorkshireUKE3 South YorkshireUKE4 West YorkshireUKF1 Derbyshire and

NottinghamshireUKF2 Leicestershire,

Rutland and Northamptonshire

UKF3 LincolnshireUKG1 Herefordshire,

Worcestershire and Warwickshire

UKG2 Shropshire and Staffordshire

UKG3 West MidlandsUKH1 East AngliaUKH2 Bedfordshire and HertfordshireUKH3 EssexUKI1 Inner LondonUKI2 Outer LondonUKJ1 Berkshire,

Buckinghamshire and Oxfordshire

UKJ2 Surrey, East and West Sussex

UKJ3 Hampshire and Isle of Wight

UKJ4 KentUKK1 Gloucestershire,

Wiltshire and North Somerset

UKK2 Dorset and SomersetUKK3 Cornwall and Isles of

ScillyUKK4 DevonUKL1 West Wales and the

ValleysUKL2 East WalesUKM1 North Eastern

ScotlandUKM2 Eastern ScotlandUKM3 South Western

ScotlandUKM4 Highlands and IslandsUKN0 Northern Ireland


CANDIDATE COUNTRIES: Statistical regions at level 2

BG11 SeverozapadenBG12 Severen tsentralenBG13 SeveroiztochenBG21 YugozapadenBG22 Yuzhen tsentralenBG23 YugoiztochenRO01 Nord-EstRO02 Sud-EstRO03 SudRO04 Sud-VestRO05 VestRO06 Nord-VestRO07 CentruRO08 Bucureti

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