Health conditions and health services
Publications
From 1853 until 1961, information on public health was published in the annual issue of NOS Sundhedstilstanden og Medicinalforholdene (Medical Statistical Report). In 1962 the name of this publication was changed to Helsestatistikk (Health Statistics). In addition to this summary, Statistics Norway also issues a number of special publications on public health, mortality rates and health services.
Health surveys
In the surveys carried out by Statistics Norway in 1968, 1975 and 1985, health problems were evaluated on the basis of data relating to illness, its incidence and specific consequences. Emphasis was also placed on analyzing the population's use of health services.
There was little difference between the percent- ages of persons among the total population who were ill in 1975 and in 1985, with 47 and 49 per cent, respectively suffering from illness on one particular day in the autumn. In 1968 the comparable figure was 41 per cent.
Most of those who were ill suffered from chronic illnesses.
In 1968 the most common types of chronic diseases were those of the musculo-skeletal system and of the eye and ear. In both 1975 and 1985 musculo-skeletal disease and cardiovascular disease were the most common ones.
Infectious diseases
Mandatory reporting of epidemic diseases was established by the Health Act of 1860. The Medical Practitioners Act of 1927 required practising doctors to submit monthly reports on observed cases of certain diseases to the public health officer.
As time passes, many of the infectious diseases under observation increase and decrease without any regular pattern, e.g. hepatitis A and most forms of meningitis. The incidence of tuberculosis, which sank from almost 8 000 cases per year to less than 1 000 from 1925 to 1961, has remained relatively constant for the past 15 years with 200 cases reported in 1976 and 130 cases in 1990. (See figure 4.1.)
With the exception of herpes genitalis and chlamydia, venereal diseases have decreased steadily since 1975. In the early 1980s, however, HIV ap-peared. Since the first reported case of this disease in 1984, about 1 000 persons have become infected.
Thanks to intensive vaccination, the incidence of most children's diseases (including whooping cough, mumps and rubella) has been drastically reduced. In 1975 more than 2 000 cases of whooping cough were registered, compared with only 140 in 1991. Measles are almost eradicated from Norway.
New cases of cancer
Since 1952 all new cases of cancer have been reported to the Cancer Registry of Norway. From the early 1950s until the late 1980s, there was a two-fold increase in the number of new cases of cancer per 100 000 inhabitants.
The increase in illness due to cancer can be attributed in part to the greater longevity of the population.
The risk of cancer is about 20 per cent higher for men than for women, taking all forms of cancer into consideration. (Cancer Registry of Norway 1976-1985.)
Causes of death
Statistics on causes of death have been compiled since 1853 and information on the deceased person's age and sex have been included since 1867. Up until 1927 the statistics were compiled by the Directorate of Health on the basis of summaries sent in by doctors. Since 1928 statistics on the causes of death have been compiled on the basis of individual notifications of death submitted to Statistics Norway by public health officers.
In the 19th century the high mortality rate among young people was mainly due to epidemic diseases. (See figure 4.2.) Tuberculosis was a predominant cause of death well into the 20th century. Since the Second World War the main causes of death have been cardiovascular disease and malignant neoplasms. (See figure 4.3.)
From 1950 to 1970 deaths from malignant neoplasms among women decreased slightly in all age groups. Since the middle of the 1970s there has been a slight increase, however, particularly in the higher age groups. For men, deaths from malignant neoplasms increased in all groups above 50 years of age in the period after 1950, markedly so in the oldest age groups. It was death from lung cancer which showed the greatest increase among men. In recent decades there has also been an increase in death from lung cancer among women, but significantly less so than for men.
Health services
The best long-term view of the resources devoted to the health sector is presented by the number of physicians. In 1860 there were 4 800 inhabitants to each qualified physician. In 1992 this figure had been reduced to 300 inhabitants; in other words there were 16 times as many people per physician in 1860 as in 1992.
Over the past 20 years there has been a considerable increase in the number of physicians. The same is true of most other personnel groups in the health sector, including nursing and care services. In 1972, 100 000 people were employed in the health sector. In 1992, there were more than 200 000 people working in this sector, i.e. more than 10 per cent of the total employed population. (See figure 4.4.) There has been a particularly marked increase in nursing and special care personnel. The number of nurses almost doubled in the 12-year period from 1976 to 1988, while the number of auxiliary nurses more than doubled during the same period. The number of persons receiving nursing care in their own homes increased by 2 ½ times during the 15-year period from 1976 to 1991.
The number of beds in somatic and psychiatric hospitals increased significantly from the first year of registration (1930) until about 1970. Since then, however, a drastic reduction has taken place; the number of hospital places was halved during the period from 1969 to 1991. At the same time there was a slight increase in the number of patients treated in hospital.