Health of Hungarians: worsens or improves?

Published: 04. February 2020
Category: Medicine
Author: Zoltán Rihmer

In an Editorial (April 21, p 1549),[1] Viktor Orbán, currently third-time reelected prime minister of Hungary, was suggested as not delivering health for his nation. Since this opinion is based on certain health-care indicators, I should like to supplement with additional data. The Editors state that “Under Orbán’s leadership, the number of new cases of HIV/AIDS has more than doubled in a decade, rising from 1·0 per 100 000 in 2005 to 2·7 per 100 000 in 2015.” Since the population of Hungary is about 10 million, these figures represent 107 new cases in 2005, and 271 new cases in 2015.2 However, a major problem with this statement is that Prime Minister Orbán has been in government since 2010 rather than 2005. The period from 2002 to 2010 falls under three previous socialist governments, a fact that is relevant to the interpretation of the data. In 2005, the number of recognised new cases of HIV infection was 107, whereas 182 new cases were registered in 2010, and 271 new cases were registered in 2015, showing that the increase during the pre-Orbán period was greater (70%) than between 2010 and 2015 (49%).

However, to look only at the yearly number of newly recognised HIV cases does not reveal much about the quality of health care because this figure also reflects the rising number of people who voluntarily get tested for HIV annually. A more detailed analysis of the available data shows that, although the cumulative number of people with HIV increased gradually from 1638 cases in 2010 to 2747 cases in 2015, the annual number of patients dying from AIDS remained the same (ten deaths in 2010 and 11 deaths in 2015),[2] which indicates improved care of patients with AIDS after 2010.

Leaving these rather small numbers aside, and turning now to the mortality statistics of the most common disorders of the highest importance to public health, the data show that, although mortality from ischaemic heart disease and malignancies did not change, the number of deaths from acute myocardial infarction, stroke, liver diseases, suicide, and neonatal mortality markedly decreased between 2010 and 2015 (by 23–31%), a favourable change that should not be ignored. Additionally, life expectancy at birth also increased by 1·5 years during this short period of time (table).[3]

Number of deaths and life expectancy at birth in Hungary in 2010 and 2016

That “life expectancy in Hungary is nearly 5 years below the EU average” is also true, but this traditionally low figure has been continuously increasing from 1960 (68·1 years) to 2016 (76·2 years).[4]

The Editors [1] also state that “life expectancy is also lower than all of Hungary’s immediate neighbours with the exception of Romania”. This statement is not precise because, in addition to Romania, life expectancy is similarly low in Ukraine (72·5 years) and Serbia (75·7 years), which are also immediate neighbours of Hungary.[5,6] Of course, despite the fact that the mortality statistics of the most common disorders and some other health indicators improved in Hungary during the Orbán government, the present situation is far from ideal, and the health-care system urgently needs better financial support, especially if we consider the improving economy of Hungary. However, it is not the prime minister but, rather, the underfunded and overloaded healthcare system that has been delivering better health and longer life for Hungarians since 2010, even if only in small steps.

The autor of this text, Zoltán Rihmer (rihmer.z@kronet.hu) declared no competing interests.
Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, H-1083 Budapest, Hungary; and National Institute of Psychiatry and Addictions, Budapest, Hungary

[1] The Lancet. Orban not delivering health for Hungary. Lancet 2018; 391: 1549.
[2] AIDS Segély Alapítvány. Magyarországi HIV/AIDS statisztika. http://www.aidsinfo.hu/statisztika_magyar_t (accessed May 1, 2018).
[3] Central Statistical Agency. Deaths according to most frequent causes (1990-). http://www.ksh.hu/docs/hun/xstadat/xstadat_eves/i_wnh001.html (accessed May 1, 2018).
[4] Country Economy. Hungary – life expectancy at birth. https://countryeconomy.com/demography/life-expectancy/hungary (accessed May 1, 2018).
[5] Country Economy. Serbia – life expectancy at birth. https://countryeconomy.com/demography/life-expectancy/serbia (accessed May 1, 2018).
[6] Country Economy. Ukraine – life expectancy at birth. https://countryeconomy.com/demography/life-expectancy/ukraine (accessed May 1, 2018).
This article first appeared in The Lancet (www.thelancet.com), Vol 392, September 15, 2018, p. 917-918.

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