The OECD Health at a Glance report serves, every two years, as a compass to understand trends, progress, and setbacks in health. In 2025, the publication highlights post-pandemic recovery, but also reveals deep fractures that demand urgent attention—especially in mental health, as I have noted in previous columns.

1. Life Expectancy: Are We Living Longer, Are We Living Better?

Average life expectancy across OECD countries increased again after the impact of the pandemic, reaching 81.1 years in 2023. However, 13 countries have yet to recover pre-pandemic levels. Chile, for example, shows a faster recovery than Mexico and Brazil, but still faces challenges in terms of healthy life years.

Yet the most troubling finding is that living longer does not necessarily mean living better. Women, as I emphasized in another column, although they live longer than men, accumulate more years with functional limitations and a higher burden of mental illness, especially after the age of 60. In France and Spain, the life expectancy gap between women and men exceeds five years, but women spend more time with disability or dependency. In Brazil and Mexico, the gap is smaller, but the pattern persists: greater female longevity accompanied by a higher burden of disease.

2. Mental Health: The New Frontier of Public Health

If there is one chapter that deserves special attention in the 2025 report, it is mental health. The data are compelling:

52% of 15-year-old adolescents in OECD countries report multiple mental health complaints (anxiety, insomnia, sadness, recurrent pain), a significant increase compared to 2014.

• The pandemic intensified the prevalence of depressive and anxiety symptoms, particularly among young women. In countries such as the United Kingdom and Canada, adolescent mental health services have seen an increase in demand of more than 30% since 2020.
• In Latin America, Chile stands out for its school-based mental health protection system, but still faces barriers to access and persistent stigma. Mexico and Brazil show significant gaps in coverage and specialized human resources.
• Among older adults, the situation is also concerning. Women over 60 live longer but accumulate a greater burden of mental illness and functional limitations. Loneliness and social isolation are growing risk factors, associated with higher rates of depression and cognitive decline. In countries such as Germany and Japan, companionship and prevention programs have shown positive results, but in most OECD countries, investment in mental health remains insufficient.

Socioeconomic inequalities exacerbate the problem: low-income individuals are 2.5 times more likely to report unmet mental health needs. In Greece, Canada, and Finland, more than 8% of the population reports unmet needs due to cost, distance, or waiting times.

3. Health Expenditure and Prevention: An Investment in Retreat

Average health spending in the OECD reached 9.3% of GDP in 2024, above pre-COVID levels. However, the report warns that higher spending does not necessarily guarantee better outcomes—consistent with what I have argued in previous columns: eight countries achieve better preventable mortality indicators with lower relative spending, highlighting the importance of efficiency.

The most concerning trend is the decline in preventive spending, which I have also highlighted previously. In 2024, only 3% of total health expenditure was allocated to prevention—a step backward compared to prior years. This leaves systems vulnerable to future health crises. In countries such as Sweden and Denmark, preventive investment exceeds 5%, with visible results in reducing chronic diseases and premature mortality. By contrast, Mexico and Brazil allocate less than 2% to prevention, resulting in higher rates of obesity, diabetes, and cardiovascular diseases.

4. Chronic Diseases and Preventable Mortality

More than 80% of primary care patients over 45 live with at least one chronic condition; half of them with two or more. High levels of avoidable mortality persist: more than 3 million premature deaths could have been prevented or treated in 2023, with cardiovascular diseases and cancer as the leading causes.

In Chile, cardiovascular mortality has declined over the past decade, but remains the leading cause of death. In Mexico, diabetes and obesity continue to rise, while Brazil faces challenges in controlling cancer and respiratory diseases.

5. Human Resources and Coverage: Strengths and Vulnerabilities

The health sector represents one in every nine jobs in the OECD, yet there is a strong dependence on foreign-trained physicians (20% in 2023), revealing structural vulnerabilities. In countries such as Australia and Canada, more than 30% of physicians are foreign-trained, while in Chile and Mexico the figure is around 10%.

Most countries maintain universal or near-universal coverage, but real access challenges persist. In Greece, Canada, and Finland, more than 8% of the population reports unmet needs due to cost, distance, or waiting times. In Brazil, public coverage is broad, but quality and access vary significantly across regions.

6. Risk Factors and Lifestyles

Nineteen percent of adults in the OECD are obese and 14.8% smoke daily, increasing pressure on health systems and economies. In Mexico, obesity rates exceed 30%, while in Chile and Brazil they are around 25%. Exposure to environmental pollution and low levels of physical activity remain significant challenges across several countries.

OECD Recommendations: What Should Be Done?

The report not only diagnoses the situation but also proposes concrete actions:

1. Strengthen mental health prevention:

• Integrate mental health services into primary care.
• Invest in school-based programs and awareness campaigns.
• Train more specialized professionals and reduce social stigma.

2. Increase preventive spending:

• Prioritize investment in prevention and health promotion, especially for chronic diseases and risk factors.
• Implement fiscal and regulatory policies to reduce consumption of tobacco, alcohol, and ultra-processed foods.

3. Reduce inequalities and improve access:

• Ensure effective coverage for vulnerable groups by removing barriers related to cost, distance, and waiting times.
• Develop targeted strategies for women, older adults, and low-income populations.

4. Improve the efficiency of health spending:

• Assess and replicate best practices from countries achieving better outcomes with lower spending.
• Promote innovation and digitalization to optimize processes and resources.

5. Monitor psychological well-being as a key indicator:

• Incorporate mental health and well-being metrics into health information systems.
• Foster research and data exchange among countries.

Final Reflection

Reaching my 50th column in El Economista is an opportunity to look both backward and forward. The Health at a Glance 2025 report reminds us that health challenges are complex and constantly evolving, but also that there are clear pathways forward. Mental health emerges as the new frontier, prevention as the smartest investment, and equity as a non-negotiable principle.

I hope to have contributed, through this platform, to public debate and to the development of more just and effective policies. The challenge remains: to live longer—but above all, to live better.