Overall, the French are in good health...

• Life expectancy is high: 85 years for women and 78.9 years for men, and the gender gap is narrowing, as in other European countries.

• All-cause mortality continues to decline across all age groups, for both men and women. This reduction in mortality applies to most chronic diseases: cancers, cardiovascular diseases, respiratory diseases, diabetes…

• The decline in premature mortality observed over the past 15 years continues, and preventable mortality linked to risky behaviors continues to fall, particularly among men.

... but the burden of premature deaths remains significant, and morbidity from chronic diseases is not declining

• Nearly one in five deaths is premature (death before age 65).

• Premature mortality is twice as high among men as among women.

• Mortality that could be prevented by reducing risky behaviors accounts for 30% of this premature mortality; it is more than three times higher among men than among women.

• The incidence of chronic diseases is not declining, and the prevalence, already high, is rising sharply, particularly due to the aging population and increased life expectancy.

From a very young age, social and regional health inequalities are pronounced

• Social health inequalities are present at all stages of life, starting with pregnancy: key health indicators (life expectancy, perceived health, incidence and mortality of chronic diseases, etc.) thus show social gradients. The life expectancy of male managers at age 35 is 49 years, which is 6.4 years longer than that of male manual workers.

• Health determinants such as nutrition, physical activity, and tobacco use also follow social gradients. For example, children of manual laborers consistently suffer more from being overweight and poor oral health than children of managers.

• Working conditions have a significant impact on health; risks (exposure to carcinogens, factors contributing to physical strain) are unevenly distributed across socio-occupational categories. Manual workers and employees are particularly at risk.

• Regional health inequalities are largely explained by differences in demographic and social structures from one region to another. Certain environmental exposures or an unequal distribution of healthcare services are also factors contributing to regional disparities.

• Significant variations in mortality and morbidity rates are also observed between regions. For example, strokes and chronic obstructive pulmonary disease are more common in Hauts-de-France than in the Auvergne-Rhône-Alpes region.

"Although their situations are not uniform, the overseas departments and regions (DROM) are generally characterized by higher birth rates, younger mothers, and poorer socioeconomic conditions due to high unemployment. Many indicators, particularly those related to perinatal health, are less favorable there than in mainland France." Sylvie Rey, public health project manager, Drees.

Health-risk behaviors persist

• Smoking remains too prevalent. Among women, the proportion of smokers has remained stable since the 1970s. Among men, while tobacco use has declined significantly over the same period, it remains higher than that of women.

• Contrary to trends in daily consumption, heavy episodic drinking (HED) is on the rise. Between 2010 and 2014, the percentage of people who had at least one Binge Drinking Episode ^(BDE)1 in the year rose from 36% to 38% among those aged 18–75, and from 52% to 57% among those aged 18–25.

• Half of all adults are now overweight, and among them, one in six is obese. Consumption of fruits and vegetables and physical activity remain insufficient.

• Sexually transmitted infections are on the rise: between 2012 and 2014, the number of diagnoses increased by 12% for Chlamydia infections and by 25% for gonorrhea.

Adverse trends among women under 65

• Among women, the incidence of lung cancer and the hospitalization rate for COPD exacerbations are rising particularly sharply (+136% in hospitalizations for COPD exacerbations between 2000 and 2014).

• The reduction in premature mortality is a positive trend, but it is smaller among women (-15%) than among men (-23%) over the 2000–2013 period.

"One of the main causes of these adverse trends is well known: tobacco, the consumption of which among women has not decreased over the past 40 years. Nearly a quarter of women smoke daily, so reducing smoking remains a major public health priority." Michel Vernay, epidemiologist, Santé publique France

Key points of the 2017 edition

• First edition co-led by DRES and Santé publique France

• First collaboration with the National Federation of Regional Health Observatories (Fnors)

• Introduction of new fact sheets: childhood cancer, occupational health

• Improved description of social and regional health inequalities

• 18 regional profiles to complement the regional data presented throughout the report

More information:

• /Publications-and-tools/Reports-and-summaries/Populations-and-health/The-state-of-health-of-the-population-in-France

• http://drees.social-sante.gouv.fr/etudes-et-statistiques/publications/recueils-ouvrages-et-rapports/recueils-annuels/l-etat-de-sante-de-la-population/article/l-etat-de-sante-de-la-population-en-france-rapport-2017