The Burrow
May 3, 2023
A chronic illness is an ongoing health condition that can affect someone’s health and quality of life long-term. There are many different types of chronic illnesses. The Australian Institute of Health and Welfare (AIHW) notes that the most common conditions include asthma, arthritis, cancer, cardiovascular disease, diabetes, chronic kidney disease, mental health conditions, localised pain such as back pain, and osteoporosis, though there are others.1
Having a chronic illness or chronic disease means you may need regular visits to a doctor or specialist, medication and health equipment to help you live your life while managing the symptoms.
A chronic illness can also impact your ability to work, and in severe cases may lead to a terminal diagnosis, upending your life. This is where trauma insurance (also known as critical illness insurance) can help you and your loved ones with financial support while you work through this difficult time. It’s a type of life insurance that pays a lump sum if you suffer a specified serious injury or medical condition. It can be purchased on its own or part of a life insurance package, depending on the policy and the provider.
To get a glimpse of the impact chronic illnesses are having across the world, the life insurance experts at Compare the Market used 14 different data points to create an index of 50 countries to see how these nations are faring in relation to each other.
Here are the results.
The USA had the worst indexed chronic illness score out of all 50 countries we examined at 7.42/10. America fared poorly in many different areas. Specifically, the USA had the highest prevalence of asthma, with 11.25% of the country’s population having this condition. In addition, America had the highest prevalence of overweight adults, with 68% of those aged 18 and above being classified as overweight.
Other areas where America did poorly included cancer, prevalence of diabetes and chronic respiratory disease death rate. America had the fourth-highest incidence rate of cancer (362.2 cases per 100,000), the fifth-highest prevalence of diabetes among those aged 20-79 (10.7% of this age group) and the sixth-largest death rate from chronic respiratory disease (39 deaths per 100,000).
Close behind the USA was Bulgaria with a score of 7.17/10. Bulgaria had the highest prevalence of cigarette and tobacco smoking with 38% of those aged 15 and above smoking, and 95% of deaths were caused by non-communicable diseases (NCDs) – another term for chronic illnesses and chronic diseases. This was the highest amount across all countries.
Bulgaria also had the fifth-highest number of disability adjusted life years (DALYs) at 29,375.15 years per 100,000, which represents the number of years lost from illnesses, diseases, premature death and disability. Bulgaria also had the fifth-highest alcohol consumption per capita (11.2 litres per capita) and the sixth-highest digestive disease death rate (60.80 per 100,000).
Rounding out the three worst chronic illness scores was Hungary, with an index score of 6.74/10. Hungary fared poorly in several areas, specifically deaths from NCDs. Hungary had the second-highest portion of deaths caused by chronic diseases at 94% of all deaths.
Hungary was also in the top 10 worst scores for other metrics, such as smoking population (31%), cancer rate (338.2 per 100,000), cardiovascular death rate (266 per 100,000), digestive disease rate (65.68 per 100,000), and physical inactivity (39% of the adult population).
These figures were calculated by indexing 14 different metrics. Read more about how we calculated these figures here.
Peru had the best index score of 2.77/10. What helped Peru rank so well was the fact that the nation had the smallest population of smokers, with only 6.6% of Peruvians smoking. Other strong factors include having the third-smallest amount of deaths attributed to NCDs (73%), fourth-lowest cardiovascular death rate (73 per 100,000, the same as Australia) and the fifth-lowest diabetes population (4.8% of adults aged 20-79).
Tying with a score of 3.17/10 was South Korea and Japan. These Asian nations had the lowest DALYs per 100,000 (15,885.71 per 100,000 for Japan and 17,191.57 per 100,000 for South Korea). These two countries also had the lowest cardiovascular disease death rates at 64 per 100,000 for South Korea and 68 per 100,000 for Japan.
Focusing on South Korea, the nation had the seventh-lowest number of deaths attributed to NCDs (78%), eighth-smallest chronic respiratory disease death rate (17 per 100,000), and the fourth-lowest percentage of the population with a mental health or development disability disorder (10.88%).
Areas where Japan did well include the number of adults categorised as overweight – Japan has the second-smallest score after India at 27% – and the eleventh-lowest percentage of deaths attributed to NCDs at 85% of all deaths.
Japan also had the lowest percentage of mental health and development disability disorders in the population, with 10.58% of the population reportedly having a mental health condition (excluding substance abuse disorders).
However, in the past few decades Japan has had one of the highest suicide rates in the world. Despite this, the nation has had a reportedly low rate of mental health conditions such as anxiety, depression and developmental disabilities, which is all factored together into this one score. Furthermore, recent WHO data shows that Japan’s suicide rate has declined strongly year-on-year since 2013.2
In third place for positive chronic illness scores on our index was Iceland. Iceland scored 3.42/10 thanks to several factors. These include having the fifth-smallest population of smokers at 10.5%, third-lowest DALYs at 17,420.69 per 100,000, and the ninth-smallest percentage of 20-79 year old’s with diabetes at 5.5%.
Australia sits in the middle of this 50-nation index at 25th place. In some areas Australia is ‘the lucky country’, such as being the eighth-largest population with good social support (93.81%), tenth-smallest population of smokers (12.4%), and having the fourth-lowest cardiovascular disease death rate at 73 per 100,000 people, to name a few highlights.
These good scores were balanced out by some negative ones, however. Australia had the highest cancer rate at 452.4 cases per 100,000 people and the largest population suffering from ill mental health at 19.35%.
Compare the Market’s Head of Life Insurance and Income Protection, Lana Hambilton, notes there are some serious health issues unfortunately common in Australia.
“This is not one of the times where 1st place is positive. It’s concerning to see Australia has both the largest population suffering from mental illness, as well as the highest cancer rate, as both are serious issues that can be traumatic for patients and their families. Heart attacks and cardiovascular health in Australia is another area of focus, although it’s interesting to see that many countries have a much higher rate of cardiovascular disease than Australia,” says Ms Hambilton.
The table below is a truncated table that shows data for different chronic illnesses and the overall index score. You can view the full data table with additional figures that were used to calculate the index scores here.
| Rank | Country | Cancer cases per 100,000 | Asthma prevalence | Chronic respiratory disease deaths per 100,000 | CVD deaths per 100,000 | Diabetes prevalence | Mental health condition prevalence | Digestive diseases deaths per 100,000 | Index score |
| 1 | United States | 362.2 | 11.25% | 39 | 128 | 10.7% | 16.93% | 36.40 | 7.42 |
| 2 | Bulgaria | 247.1 | 3.87% | 38 | 394 | 7.4% | 11.14% | 60.80 | 7.17 |
| 3 | Hungary | 338.2 | 3.56% | 33 | 266 | 7.0% | 11.31% | 65.68 | 6.74 |
| 4 | Portugal | 261.8 | 9.97% | 23 | 97 | 9.1% | 18.45% | 42.87 | 6.34 |
| 5 | United Kingdom | 319.9 | 10.07% | 28 | 85 | 6.3% | 15.13% | 46.36 | 6.26 |
| 6 | Romania | 263.1 | 4.47% | 23 | 310 | 6.5% | 11.10% | 85.61 | 6.08 |
| 7 | Türkiye | 231.5 | 5.38% | 32 | 173 | 14.5% | 14.40% | 11.88 | 5.95 |
| 8 | Germany | 313.2 | 4.55% | 23 | 107 | 6.9% | 15.00% | 50.34 | 5.82 |
| 9 | Lithuania | 293.4 | 2.92% | 10 | 284 | 5.8% | 13.25% | 82.12 | 5.80 |
| 10 | Argentina | 218.2 | 7.54% | 56 | 153 | 5.4% | 13.60% | 32.56 | 5.73 |
| 11 | Ireland | 372.8 | 7.56% | 32 | 93 | 3.0% | 17.61% | 20.7 | 5.71 |
| 12 | Poland | 267.3 | 5.88% | 20 | 189 | 6.8% | 10.60% | 49.52 | 5.64 |
| 13 | Latvia | 301.5 | 3.44% | 10 | 313 | 5.9% | 12.62% | 67.13 | 5.62 |
| 14 | Brazil | 215.4 | 5.13% | 37 | 157 | 8.8% | 16.72% | 30.46 | 5.58 |
| 15 | Greece | 264.7 | 5.79% | 24 | 121 | 6.4% | 17.05% | 32.89 | 5.56 |
| 16 | New Zealand | 422.9 | 7.00% | 24 | 95 | 6.2% | 19.04% | 19.51 | 5.52 |
| 17 | Croatia | 290.8 | 4.32% | 19 | 188 | 4.8% | 11.69% | 47.73 | 5.46 |
| 18 | Chile | 180.9 | 5.64% | 27 | 96 | 10.8% | 15.20% | 45.22 | 5.38 |
| 19 | Czech Republic | 292.6 | 3.29% | 21 | 182 | 7.1% | 11.14% | 50.07 | 5.31 |
| 20 | Spain | 277.2 | 4.95% | 27 | 77 | 10.3% | 18.32% | 47.69 | 5.22 |
| 21 | Estonia | 278.5 | 2.24% | 9 | 206 | 6.5% | 12.19% | 70.09 | 5.10 |
| 22 | Italy | 292.6 | 4.33% | 19 | 95 | 6.4% | 15.03% | 37.99 | 5.09 |
| 23 | Australia | 452.4 | 9.66% | 23 | 73 | 6.4% | 19.35% | 26.77 | 5.04 |
| 24 | Mexico | 140.4 | 2.95% | 31 | 150 | 16.9% | 12.26% | 53.86 | 4.98 |
| 25 | Belgium | 349.2 | 5.07% | 27 | 89 | 3.6% | 14.96% | 41.49 | 4.97 |
| 26 | France | 341.9 | 7.22% | 17 | 69 | 5.3% | 16.63% | 34.37 | 4.77 |
| 27 | Austria | 255.7 | 5.72% | 20 | 123 | 4.6% | 15.82% | 35.35 | 4.71 |
| 28 | Slovak Republic | 296.8 | 3.13% | 13 | 160 | 5.8% | 11.21% | 57.38 | 4.70 |
| 29 | Canada | 348.0 | 5.32% | 22 | 79 | 7.7% | 14.95% | 32.23 | 4.69 |
| 30 | Luxembourg | 291.9 | 7.46% | 23 | 95 | 5.9% | 14.91% | 28.29 | 4.63 |
| 31 | South Africa | 209.5 | 4.27% | 49 | 226 | 10.8% | 12.01% | 19.90 | 4.55 |
| 32 | Colombia | 182.3 | 3.68% | 35 | 130 | 8.3% | 12.05% | 23.94 | 4.39 |
| 33 | Costa Rica | 188.7 | 5.89% | 21 | 93 | 8.8% | 13.01% | 28.12 | 4.34 |
| 34 | Denmark | 351.1 | 5.29% | 35 | 84 | 5.3% | 14.10% | 38.02 | 4.30 |
| 35 | Finland | 271.2 | 6.70% | 12 | 115 | 6.1% | 14.96% | 45.03 | 4.15 |
| 35 | Slovenia | 309.0 | 4.96% | 13 | 126 | 5.8% | 11.63% | 44.39 | 4.15 |
| 36 | Indonesia | 141.1 | 3.58% | 55 | 345 | 10.6% | 10.68% | 5.74 | 4.12 |
| 37 | China | 204.8 | 2.11% | 57 | 236 | 10.6% | 11.31% | 0.11 | 4.08 |
| 38 | India | 97.1 | 2.75% | 113 | 239 | 9.6% | 13.73% | 1.15 | 3.93 |
| 39 | Switzerland | 317.6 | 7.29% | 16 | 81 | 4.6% | 17.07% | 29.66 | 3.91 |
| 40 | Norway | 327.5 | 7.36% | 26 | 77 | 3.6% | 15.98% | 22.33 | 3.87 |
| 41 | Netherlands | -* | 7.66% | 26 | 79 | 4.5% | 16.60% | 27.85 | 3.78 |
| 42 | Israel | 240.7 | 5.37% | 21 | 69 | 8.5% | 14.48% | 16.47 | 3.61 |
| 43 | Sweden | 288.6 | 8.24% | 19 | 99 | 5.0% | 15.33% | 27.14 | 3.45 |
| 44 | Iceland | 265.1 | 7.90% | 21 | 95 | 5.5% | 14.60% | 21.34 | 3.42 |
| 45 | South Korea | 242.7 | -* | 17 | 64 | 6.8% | 10.88% | 24.73 | 3.17 |
| 45 | Japan | 285.1 | 4.22% | 21 | 68 | 6.6% | 10.58% | 43.47 | 3.17 |
| 46 | Peru | 176.3 | 4.56% | 18 | 73 | 4.8% | 13.82% | 27.60 | 2.77 |
A chronic health condition can have an impact on a trauma insurance policy, Ms Hambilton explains.
“If you have a pre-existing condition some insurance providers may not cover claims relating to that specific condition. Alternatively, they may offer the option to lodge a claim related to an event caused by the condition, at an additional cost,” says Hambilton.
“Cancer, however, is a bit different. Life insurance can typically pay a claim if you are diagnosed with a terminal illness and given less than 24 months to live, which can include cancer. If you already have cancer, insurers might add exclusions to your policy where you will be covered for other illnesses and diseases, but not a pre-existing condition. A family history of cancer may also mean your life insurance premiums are a bit more expensive.”
“Trauma Insurance (a type of life insurance) could assist you in the event of a specified critical illness diagnosis, like cancer or a heart attack, it can also support in the instance of a serious injury that occurs after the policy start date. It’s important to keep in mind that cover may be subject to conditions, such as a premium loading or an exclusion. Trauma cover provides a lump sum payment that could assist with medical costs, therapy, living expenses or even changes to your house to adjust to this condition.”
To compile this index, Compare the Market sourced data for 14 different metrics across 50 different countries, analysing different chronic illness statistics and statistics for associated risk factors. Countries were given a score for each individual metric out of 10, with 10 representing a the worst score and 0 representing the best score for that metric. All other countries (i.e. not the best or the worst scoring for that metric) were given a normalised score between 0 and 10 for each metric. After this step, all 50 countries were indexed by calculating an equally weighted average from all 14 metrics, providing a final score out of 10.
The specific datasets and how these datapoints were scored are as follows:
* Some countries did not have data available for some metrics. Where this was the case, an average score from all other countries that did have data was used for the purpose of calculating the index score.
1 Chronic disease. Australian Institute of Health and Welfare, Australian Government. 2023.
2 Age-standardized suicide rate. Western Pacific Health Data Platform, World Health Organization. 2021.