SLOVAKIA CASE STUDY
Martin RUSNAK, MD, PhD
Foundation for Prevention of Civilization Diseases
Bratislava
Slovakia
May, 1994
Problems inherited from past:
legacy of deteriorating health;
geographical and social inequality;
industrial decay, environmental damage;
deep distrust of central planning and paternalism.
surface area / population / nuptiality / divorces / natality / mortality / natural population increase
infant mortality / LE males / LE females / mortality by cause / LE & PYLL
blood pressure / treated hypertension / obesity / hyperlipidemia / risk index
alcohol / smoking, alcohol, drugs / cigarettes
hospitals / physicians / budget
SLOVAK REPUBLIC - SURFACE AREA
| SLOVAKIA | AUSTRIA | HUNGARY | |
| Surface Area (km2) | 49 036 | 83 849 | 93 030 |
POPULATION
| SLOVAK REPUBLIC | AUSTRIA | HUNGARY | |
| Population (Mill.) | 5.3 | 7.71 | 10.55 |
NUPTIALITY
| SLOVAKIA | AUSTRIA | HUNGARY | ||
| Marriages per 1000 inhabitants | 1950197019801990 | 11.37.97.97.6 | 9.37.16.15.9 | 11.49.37.56.4 |
DIVORCES
| SLOVAKIA | AUSTRIA | HUNGARY | ||
Divorces per 1 000 inhabitants |
1950197019801990 | 0.520.761.331.67 | 1.521.391.762.11 | 1.212.212.592.40 |
NATALITY
| SLOVAKIA | AUSTRIA | HUNGARY | ||
| Live birthsper 1 000 inhabitants | 1950197019801990 | 28.817.819.115.1 | 15.615.112.111.6 | 20.914.713.911.8 |

MORTALITY
| SLOVAKIA | AUSTRIA | HUNGARY | ||
MORTALITY |
1950197019801990 | 11.59.310.210.3 | 12.413.312.310.7 | 11.411.613.613.7 |
NATURAL INCREASE of POPULATION
| SLOVAKIA | AUSTRIA | HUNGARY | ||
| Natural increaseof population | 1950197019801990 | 17.38.58.94.8 | 3.21.8-0.20.9 | 9.53.10.3-1.9 |
INFANT MORTALITY
| SLOVAKIA | AUSTRIA | HUNGARY | ||
| Infant mortality | 1950197019801990 | 103.325.720.912.0 | 66.125.914.37.8 | 85.735.923.214.8 |
EXPECTATION of LIFE at BIRTH
MALES
| SLOVAKIA | AUSTRIA | HUNGARY | ||
| Expectation of life at birthmale | 1950197019801990 | 59.066.766.866.6 | 61.966.569.072.6 | 58.766.365.565.1 |

EXPECTATION OF LIFE AT BIRTH
FEMALE
| Years | SLOVAKIA | AUSTRIA | HUNGARY | |
| Expectation oflife at birthfemale | 1950197019801990 | 62.472.974.275.4 | 67.073.476.179.2 | 63.272.172.773.8 |

MORTALITY RATE BY CAUSES OF DEATH
(No. of deaths per 100 000 inhabitants)
| CAUSE of | COUNTRY | |||
| DEATH | SLOVAKIA | AUSTRIA | HUNGARY | EUROPE |
| Cardiovascular | 520.6 | 400.0 | 624.5 | 414.6 |
| Malignancies | 200.5 | 199.0 | 260 | 200 |
| Respiratory diseases | 77.4 | 36.8 | 58.2 | 25.9 |
| Poisoning and injuries | 76 | 23 | 40 | 13.6 |
| Diseases of GIT | 51.6 | 45.6 | 80 | 38.7 |

LIFEEXPECTANCY and PYLL by SEX
MALES |
FEMALES |
|||
| MAX | MIN | MAX | MIN | |
| LE0 | 69.3 | 63.9 | 76.9 | 73.5 |
| PYLL CARDIO | 36.7 | 11.6 | 32.8 | 6.9 |
| PYLL ONCO | 73.3 | 11.6 | 171.9 | 22.7 |

AGE AND SEX DISTRIBUTION OF BLOOD PRESSURE
CINDI, BANSKA BYSTRICA, 1993
| DIASTOLIC BP > 90 mmHg | AGE | ||||
| 15 to 24 | 25 to 34 | 35 to 44 | 45 to 54 | 55 to 64 | |
| Male [%] | 4.3 | 4.2 | 22.6 | 32.2 | 54 |
| Female [%] | 0 | 7 | 12 | 32.5 | 24.5 |
AGE AND SEX DISTRIBUTION OF TREATED HYPERTENSION
CINDI, BANSKA BYSTRICA, 1993
| TREATEDHYPERTENSION | AGE | ||||
| 15 to 24 | 25 to 34 | 35 to 44 | 45 to 54 | 55 to 64 | |
| Male [%] | 0 | 4.1 | 7.5 | 8.5 | 20.8 |
| Female [%] | 0 | 1.8 | 2 | 19.5 | 22.6 |
AGE AND SEX DISTRIBUTION OF OBESITY
CINDI, BANSKA BYSTRICA, 1993
| BMI | AGE | ||||
| 15 to 24 | 25 to 34 | 35 to 44 | 45 to 54 | 55 to 64 | |
| Male [%]BMI>30 | 4.3 | 8.3 | 15.1 | 16.9 | 45.8 |
| Female [%]BMI>29 | 3 | 8.8 | 24 | 28.6 | 30.2 |
PREVALENCE OF HYPERLIPIDEMIA
550 subjects, 15 to 64 years old
CINDI, BANSKA BYSTRICA, 1993
RISK FACTOR |
VALUE |
PREVALENCE [%] |
| Total cholesterol | > 5.2 mmol/l | 65.3 |
| Total cholesterol | > 6.2 mmol/l | 28.8 |
| Triglycerides | > 1.9 mmol/l | 30.3 |
AGE AND SEX DISTRIBUTION OF RISK INDEX
CINDI, BANSKA BYSTRICA, 1993
| TOTAL/HDLCHOLESTEROL | AGE | ||||
| 15 to 24 | 25 to 34 | 35 to 44 | 45 to 54 | 55 to 64 | |
| Male | 0.7 | 3 | 22 | 20 | 15 |
| Female | 2 | 3 | 15 | 21 | 11 |

YEARLY CONSUMPTION OF ALCOHOL
PER CAPITA in LITERS
| COUNTRY | Total | Wine | Beer | Spirits |
| SLOVAKIA | 10.4 | 15.9 | 95.6 | 14.2 |
| AUSTRIA | 10.1 | 35.2 | 119.3 | 1.45 |
| HUNGARY | 10.7 | 20 | 103 | 4.8 |
| EUROPE | 6.9 | 22.4 | 52.6 | 2.1 |
SMOKING, ALCOHOL AND DRUG ABUSE IN YOUTH
(in %)
| SMOKES OCCASSIONALLY | SMOKES REGULARLY | DRINKS ALCOHOL | TASTED MARIJUANA | |
| BOYS | 28.8 | 16.3 | 20.2 | 15.2 |
| GIRLS | 25.8 | 11.6 | 11.6 | 10 |
ANNUAL CONSUMPTION OF CIGARETTES
PER PERSON
| COUNTRY | SLOVAKIA | AUSTRIA | HUNGARY | EUROPE |
| # of cigarettes | 1691.5 | 1862 | 2549.3 | 1561.8 |

HOSPITAL RESOURCES AND AVERAGE LENGTH OF STAY
COUNTRY |
INPATIENT BEDS PER 1000 PEOPLE | INPATIENT DAYS PER CAPITA | AVERAGE LENGTH OF STAY (DAYS) |
| SLOVAKIA | 9.1 | 2.03 | 12.7 |
| AUSTRIA | 10.7 | 3.3 | 12.9 |
| HUNGARY | 9.6 | ||
| EUROPE | 9.4 |
# of PHYSICIANS per 100 000 PEOPLE
| SLOVAKIA | AUSTRIA | HUNGARY | EUROPE | |
| # | 322.3 | 270.6 | 298.1 | 305 |
DEVELOPMENT OF HEALTH CARE BUDGET
(billions US $)
| YEAR | 1991 | 1992 | 1993 | 1994 |
| billions US $ | 0.55 | 0.58 | 0.55 | 0.48 |
| US $ per capita | 103.8 | 109.4 | 103.8 | 90.6 |
