Public Health Indicators

The Public Health Indicators were presented for the eleventh time today, Wednesday 16 September, in Egilsstaðir. The event was held in collaboration with Múlaþing and was live-streamed.

The Public Health Indicators 2026 provide many interesting insights into the nation's health, well-being, and related factors. Among the most prominent findings are the following:

• Financial difficulties: The proportion of people who said they had difficulty making ends meet fell significantly between 2024 and 2025, from just over 19% in 2024 to 15.5% in 2025 for the country as a whole. The proportion decreased in all healthcare districts, although the change was not significant in every district.

• Mental health: Across the country as a whole, the proportion of adults rating their mental health as fair or poor fell between 2024 and 2025, from just over 33% to 30%. However, year-on-year trends vary widely across healthcare districts. In some areas, the proportion increased, while in others it decreased; the Suðurnes region showed a significant decline. Among upper secondary school students, 43% rated their mental health as poor, and 29% said they were often or always lonely.

• Anxiety disorders in children: The proportion of children aged 6-17 who have had contact with primary healthcare and have a registered diagnosis of anxiety has increased since 2020, though to varying degrees across healthcare districts. At the same time, prescriptions for anxiety and depression medication for children of the same age have remained fairly stable or have slightly decreased. Differences also exist between healthcare districts.

• Vaccinations: Participation in the 4-year booster vaccination was 91% nationwide and 96% in East Iceland. Influenza vaccination among those aged 60 and over was just over 50%, still well below the 70% target.

• Social media: Among children in grades 4-5, 80% use social media, even though they have not reached the legal age to use it.

Further details on the presentation: Medical Director of Health María Heimisdóttir opened and closed the presentation. Other speakers included Dagmar Ýr Stefánsdóttir, Mayor of Múlaþing; Sigríður Haraldsd. Elínardóttir, Head of the Division of Health Information at the Directorate of Health; Dóra Guðrún Guðmundsdóttir, Head of the Division of Public Health at the Directorate of Health; Sigurbjörg Hvönn Kristjánsdóttir, Head of Education and Public Health; and Anna Alexandersdóttir, Head of Welfare at Múlaþing. Þórarna Gró Friðjónsdóttir, CEO of the East Iceland Healthcare Institution, moderated the meeting.

At the end of the meeting, the Mayor of Múlaþing and the Medical Director of Health signed a cooperation agreement between the municipality and the Directorate on a Health-Promoting Community.

Earlier in the day, stakeholders from Múlaþing and elsewhere in East Iceland met with representatives of the Directorate of Health. They reviewed the status of public health indicators in the area, the key strengths and challenges, and ways to improve.

Public health indicators by health district in Iceland 2025 were presented for the tenth time in Ísafjörður, September 29 2025.

Medical Director of Health María Heimisdóttir both opened and closed the meeting. She started by discussing the purpose of public health and finished by emphasizing that the indicators offer insight into the current situation and highlight the importance for professionals in the field to assess the data and take further action. She emphasized the value of cross-sectoral cooperation and dialogue within society and the significance of coming together, as was done today for the presentation of the Public Health Indicators.

Public health indicators concerning society, health, and diseases

Sigríður Haraldsd. Elínardóttir, head of the Health Information division, examined selected public health indicators. Among other findings, it was revealed that approximately 19% of the population faced financial difficulties in 2024, a figure that has remained relatively unchanged since 2023. Comparing healthcare districts, the highest proportion of people in financial difficulty is in the Suðurnes region, while the lowest is in East Iceland. Generally, the proportion is higher in rural areas than in the capital. Poverty has a negative impact on health and social status, underscoring the importance of providing support where needed. About a third of the population rates their mental health as fair or poor, similar to the previous year.

The Health Service Act emphasizes that healthcare services should be delivered locally and that primary healthcare typically serves as the initial point of contact within the health system. Regulations regarding primary healthcare centres stipulate that they must provide mental health services for both children and adults, encompassing assessment of problems, treatment planning, and psychological interventions. The emphasis is on addressing mild to moderate depression, anxiety, and trauma. In line with legislation and health policy objectives, health authorities have prioritized strengthening mental health services within primary care in recent years.

Judging by the number of primary care consultations where the initial diagnosis was a mental or behavioral disorder, there are clear signs that primary care has expanded its services for children and adolescents with mental health issues. These signs align with the fact that in 2017, psychological services began to be offered at primary healthcare centres, and since then, many mental health teams have started operating within primary care. The number of children's visits to primary care for cognitive and behavioral disorders has increased since 2017, particularly in rural districts.

Public health indicators concerning infectious disease prevention – vaccinations and antibiotic use

Guðrún Aspelund, Chief Epidemiologist, presented public health indicators related to infectious disease prevention and control. She highlighted that, according to regulations, all vaccinations in Iceland are recorded in a central vaccination register, and participation figures for general childhood vaccinations are published annually in June, both nationwide and by district. The aim is to monitor vaccination uptake and assess the risk of epidemics.

Participation in infant vaccinations is generally high. However, vaccination coverage is lowest for booster doses in several districts, including for diphtheria, tetanus, and pertussis (DTP), as well as for measles, mumps, and rubella (MMR).

The annual influenza vaccine is offered every autumn. The Chief Epidemiologist recommends that specific priority and risk groups receive priority for influenza vaccinations, which are provided to them free of charge. Participation in influenza vaccinations among older people increased during the COVID-19 period but has since declined. The aim is for at least 70% of older people to be vaccinated; however, participation in Iceland is currently around 40-50%.

Guðrún emphasized that prudent use of antibiotics is vital for lowering antibiotic resistance. Antibiotic prescriptions in Iceland in 2024 stayed similar to those in 2022 and 2023. Outside hospitals, approximately 94% of total antibiotic use occurred. General practitioners account for around one-third of the prescriptions, and just over 30% of the population receives an antibiotic prescription.

Icelanders use the most antibiotics in the Nordic countries, but at a rate comparable to that of EU/EEA countries. Antibiotic use in the Nordic countries has been lowest in Sweden for the past decade. Still, Iceland stands out in Europe for its low use of broad-spectrum antibiotics, which is a positive development.

Public health indicators concerning well-being and lifestyle

Dóra Guðrún Guðmundsdóttir, head of the Public Health Division, presented indicators related to well-being and lifestyle. Dóra mentioned a working group established by the Minister of Health on new public health challenges for young people, and that these challenges had been considered when selecting this year's indicators.

Smart device usage and quality time together

One of these indicators is the use of smart devices by children. It shows that the use of smart devices before sleep has increased in recent years and is now at 18% among 7th-grade students. There is some variation between healthcare districts, with the highest proportion in the Westfjords at 30%.

Spending time with parents is regarded as one of the most significant protective factors against children's risk-taking behavior. Over 87.5% of children in 4th-6th grade report that they do something enjoyable with their parents at least weekly.

Safety and violence

Violence and its prevention have been prominent concerns in society, with several indicators related to this issue. This year, questions were asked about trust and safety. Just over 30% of upper secondary school students say there is an adult at school they can trust. This figure is noticeably higher in West Iceland, at 43.3%, but it remains important to work on increasing this percentage across all districts.

Almost 96% of children in grades 7-10 feel safe at home, which is positive, but it is important to acknowledge the 4% who do not feel safe at home.

Approximately 90% of adolescents in grades 9-10 report feeling safe in their neighborhood or community, but the aim is, of course, for this figure to reach 100%. Bullying has also risen, with 11% of children in grades 6-7 saying they have been bullied, and it is crucial to systematically work towards eradicating it. One of the most notable public health indicators shows that 13% of upper secondary school students have been raped.

Drunkenness - Energy drinks – Soft drinks - Nicotine

Binge drinking among lower secondary school students has decreased, with only 3% reporting they have been drunk in the past 30 days. Energy drink consumption in upper secondary schools has increased recently, with approximately 31.2% of students in these schools saying they drink energy drinks five or more days a week. Furthermore, about a third of adults consume soft drinks daily or more often.

About a quarter of upper secondary school students have used nicotine pouches in the last 30 days, and 8.4% of adults use e-cigarettes.

Finally, women's stress levels have increased more in recent years compared to men's, with 31.6% of women now experiencing high stress, versus 22.7% of men.

The significance of public health measures for local government work

Sigríður Júlía Brynleifsdóttir, the mayor of Ísafjarðarbær, welcomed the attendees. At the end of the meeting, Margrét Geirsdóttir, Head of the Welfare Division, and Dagný Finnsbjörnsdóttir, Sports and Youth Representative and liaison for the Health Promoting Community in Ísafjarðarbær, discussed the practical use of public health indicators for the local community. Margrét mentioned the Health Promoting Municipality, the Act on the Well-being of Children, and child-friendly municipalities, which place certain obligations on municipalities to work on children's issues. She expressed serious concern about the indicator for financial difficulties and said it was crucial to take those results very seriously. She discussed new public health challenges for young people and the importance of creating a positive environment for children and youth in their local community, mentioning in this context the discussion about reopening a youth center. Dagný agreed with Margrét and spoke about the importance of updating prevention work, learning from what has been successful in tackling previous challenges, and continuing to develop a public health policy in co-operation with all sectors of society. They both discussed the significance of public health indicators and this meeting for the work ahead in promoting a health-promoting community and, consequently, well-being for all.

Lúðvík Þorgeirsson, CEO of the Westfjords Health Care Institute, chaired the meeting.

-Automatic translation

Regional Public Health Indicators 2024 were presented for the ninth time in Grindavík, 20. September 2024.

Address

Eggert S. Jónsson, director of recreation and culture in Grindavík, welcomed the guests and asked for good wishes from the mayor. He said there is optimism about the town's development, even though few people have permanent residence in Grindavík today. Before the evacuation in November 2023, the municipality emphasised sports and youth activities and senior citizens' work, such as extensive sports facilities and low leisure fees. Eggert expressed concern about the drop-out of Grindvík residents from leisure activities after moving to other municipalities, e.g. due to the financial situation, anxiety, transportation and other factors. The municipality must continue to support the people of Grindvík despite the situation.

Although the cohesion of the population is evident, repeated trauma takes its toll on physical and mental health. Following trauma, there is a greater risk of various health challenges. Therefore, it is important to take good care of all protective factors and provide the people of Grindvík with the necessary support. In the coming years, employees in the health care system and the front line of municipalities must be prepared to treat the people of Grindvík with multiple health problems. The people of Grindvík must continue to find a hold in the community and maintain the social power of peer support and togetherness. Even though the population is scattered around the country today, they are still „Grindvíkingar“.

When society strikes – public health indicators and trauma

Alma D. Möller, the Medical Director of Health, discussed public health indicators and how data in the Directorate of Health's registers can be used to monitor people's health and well-being during a crisis.

In connection with natural disasters in Reykjanes, real-time data from the prescription medicines register and the register of primary health care contacts have been used to monitor the mental and physical health of the residents of Reykjanes, most recently for the group living in Grindavík in mid-2023.

The results of that analysis indicate that the use of respiratory medicines has increased significantly among the residents of Grindavík and is now somewhat higher than the use nationwide. It appears that the use of respiratory medicines has increased more among women than men.

There also seems to have been an increase in anxiety and depression among residents of Grindavík since 2021 compared to residents elsewhere in the country. At the same time, natural disasters in recent months have resulted in more people being prescribed psychiatric medication than before. In general, the use of psychotropic medicines among residents in Grindavík is lower than among the rest of the population. Characteristically, however, there are two clear peaks in the use of sedatives and anxiolytics, in March 2021, when the first eruption of this series began, and again in November 2023, when the magma intrusion under Grindavík took place.

Events such as the one now sweeping over Reykjanes can have a noticeable impact on health and well-being. Experience from previous disasters has revealed two key preventive factors regarding long-term health consequences. On the one hand, strengthening the support network of those who suffer trauma and placing special emphasis on those with dependent children to reduce the stress symptoms of caregivers are important.

Public health indicators related to society, health and disease

Sigríður Haraldsd. Elínardóttir and Dóra Guðrún Guðmundsdóttir, heads of divisions at the Directorate of Health, reviewed selected public health indicators. It showed that proportionately more people are experiencing financial difficulties in 2023 compared to the last three years. When the health districts are compared proportionally, most people are experiencing financial difficulties in the Suðurnes region but fewest in the East. Poverty has a detrimental effect on health and social status, and it is important to ensure support where it is needed. The proportion of those who rate their mental and physical health as fair or poor is similar to last year, but the general situation continues to be that more people rate their health as fair or poor in rural areas compared to the capital area. There is some increase in the use of blood sugar-lowering medicines, which may indicate that type 2 diabetes is being diagnosed and treated to an increasing extent and that the incidence of the disease is increasing. It is also likely that the marketing of new medicines in the blood sugar-lowering class, Ozempic and Wegovy, explains part of the increase, but those medicines are also used to treat obesity. Participation in screening for breast cancer is increasing somewhat, and participation in screening for cervical cancer did not decrease between years as in previous years.

Public health indicators related to lifestyle and well-being

Both positive and negative trends can be found in measurements related to lifestyle and well-being. Most young people generally feel well, and proportionately, fewer young people in 7th grade experience anxiety than before in all districts. On the other hand, more young people feel lonely than before, and 16% of young people in 10th grade feel left out of place at school, which is worrying as it can negatively impact both health and well-being and society. The proportion is even higher in many parts of the country, with 22% in the West Fjords and 20% in Suðurnes. Regarding physical activity, only 18% of young people in 10th grade exercise according to recommendations, compared to 70% of adults, and only half of students in 4th grade walk or cycle to school. Also, only half of 7-year-olds take vitamin D. The vast majority of young people in 10th grade, or 95%, have not become intoxicated, but the use of nicotine pouches and energy drinks has increased among young people, and there is some variation between districts. However, the trend in alcohol consumption among adults is in the opposite direction, and now 23% of adults have a risky consumption pattern of alcohol, which is a concern as the consumption of alcohol can harm other than those who consume it and society as a whole.

Practical use of public health indicators in Sudurnes Hospital & Health Center (HSS)

Guðlaug Rakel Guðjónsdóttir, CEO of HSS, spoke about the practical use of public health indicators in the organisation of health services in the Suðurnes region. She emphasised how much trauma can affect societies. Although the events in Grindavík and the economic collapse of 2008 affected people's health in very different ways, certain similarities can be identified.

HSS has systematically used public health indicators in its policy formulation to bring the services closer to the residents. Among other things, a residents' meeting was called on how to react to the challenges highlighted by the indicators. Subsequently, measures have been taken, such as inviting women to breast screening at the institute's premises during the anniversary week in November. In the public health indicators, now published, it appears that the use of antidepressants among people under the age of 18 is above the national average, and work is now awaiting to address this challenge. Finally, Guðlaug Rakel mentions that a letter of intent has been signed to open a healthcare centre in Suðurnesjabær and that the opening of the healthcare facility in Vogar will be accelerated.

Gígja Gunnarsdóttir, project manager of Health Promoting Society at the Directorate of Health, chaired the meeting.

Regional Public Health Indicators 2023 were presented for the eighth time in Reykjavik, 14. September 2023.

Alma D. Möller, the Medical Director of Health, addressed the meeting and spoke of challenges in healthcare that are, among other things, increased demand, lack of staff and a more complex environment. To meet these challenges public health and prevention, aimed at maintaining and improving health and preventing diseases as far as possible, must be promoted. In this context, Alma discussed influencing factors on health and health promotion approaches that the Directorate of Health manages; Health-Promoting Community, Health-Promoting Preschool, Primary and Upper Secondary Schools, and Health-Promoting Workplaces. Alma also announced that PHI are now for the first time being published for the most populous municipalities in addition to health districts. All indicators ever published by the Directorate of Health have now been made available in an interactive dashboard.

Value of public health indicators for municipalities

Mayor Dagur B. Eggertsson discussed the value of PHI for the work of municipalities. The mayor mentioned that data collection such as PHI helped with goal setting and policy-making and thus contributed to a better society. He also touched on the importance of city planning on the well-being of residents and various determinants of health.

Dagur hopes that in the future it will be possible to combine data from various sources, including PHI, to analyze how various factors have a direct impact on life expectancy, quality of life and wellbeing. On behalf of the city, Dagur welcomed the fact that PHI were now being published for the largest municipalities in addition to health districts. He also mentioned the importance for the city of examining PHI in more detail by city district.

Public Health Indicators related to society, health and disease

Sigríður Haraldsd. Elínardóttir, head of Health Information, introduced indicators related to society as well as health and diseases. Education is the first of many social factors related to health and several studies have shown a positive relationship between education and health. Access to quality education equals opportunities in many ways and has a positive impact on health and quality of life. When one looks at the proportion of people who have completed a university education, there is a difference between men and women, health districts and municipalities. In 2022, nearly 28% of men in the country had completed a university degree, while a total of 43% of women had completed it. The proportion of university-educated men and women is highest in the capital area and well above the national average. The proportion is significantly below the national average in all the rural districts.

According to Sigríður, a significantly higher number of adults assessed their physical and mental health as being fair or poor in 2022 compared to the previous three years. Overall, significantly fewer people evaluate their physical health as fair or poor in the capital area compared to the whole country, but significantly more people in rural areas. There is less difference in health districts when it comes to mental health evaluation.

Antidepressant use declined slightly in the country between 2021 and 2022, the first time that a decline has been detected since the first PHI publication in 2016.

Sigríður explained that diabetes is one of the four major chronic diseases that cause the greatest burden of disease. It has been shown that a large portion of cases of type II diabetes can be prevented with diet and physical activity, but 85-90% of diabetics have type II diabetes. No data are available on the prevalence of diabetes in Icelandic populations but the use of medications with blood glucose lowering properties, other than insulin, used to treat type II diabetes, give clues to the incidence of the disease. Thus, the use of blood glucose-lowering drugs has increased in the country and almost all health districts, particularly in the last three years, indicating an increase in the incidence of the disease and related determinants.

Finally, Sigríður mentioned that in 2022, 7.4% of individuals reported that they had not consulted a doctor in the last 12 months because they could not afford it. The proportion is lowest in Vesturland, 2.8% and highest in Suðurnes, 10.3%.

Public Health Indicators related to well-being and lifestyle

Dóra Guðrún Guðmundsdóttir, head of Public Health, presented indicators related to wellbeing and lifestyles. She revealed that the happiness of adults is still declining, with the rate of very happy now being 55% and 61% in 2016. Happiness is important for society, a reduction of one point on a happiness scale (1-10) costs society over 2 million krónur per year for each individual. It is therefore important to consider how to increase happiness and well-being in society. One explanation for the decline in happiness may be found in increased loneliness, which has been growing steadily since measurements began in 2016. At that time, 11% of young people aged 18-34 experienced loneliness often or very often, compared to 18% in the last measurement in 2022.

Dora stated that the percentage of 10th-grade students who feel anxious daily is 23%. This is not a measurement of anxiety disorder, but the proportion of 10th graders who experience the feeling of anxiety almost daily. Even so, it is important to find out what causes it and how it can be reduced.

Positively, 86% of young people in 8-10th grade find it easy to get emotional support and help from their family. However, it is important to take into consideration the 14% who do not receive support from their family.

Only about half of six-year-old children take fish oil or vitamin D, which is similar to the proportion in recent years. It is important to remind parents/guardians to provide their children with a vitamin D supplement.

Over one-third of adults reported eating whole grain products daily or more often in 2022, but it is recommended to eat whole grain products twice a day (70 grams per day). There is a difference in whole grain consumption between health districts, with the highest ratio in Vestfirðir, 46.4%, and the lowest in Vesturland, 31.7%.

Roughly half of children in the 4th grade consumed soft drinks 1-2 times a week in 2022. Studies show that soft drink consumption is correlated with chronic diseases, weight gain and tooth decay. In Iceland, soft drinks and energy drinks are exempt from the standard value-added tax, which is contrary to all public health recommendations.

Over 20% of children in 10th grade practice daily physical activity. There are some differences between the health districts where Vestfjörður stands out with a percentage of 40%. About 66% of the students in the 7th grade walk or cycle to school. There is some difference between health regions where the proportion is higher in urban areas. The proportion of adults who practise little vigorous physical activity is 25% nationwide. More than half of adults say they are trying to lose weight, and this proportion has not changed much over the years.

In 2022, almost a quarter of Icelanders (24%) fell under the definition of the so-called harmful pattern of alcohol consumption, 27% of men and 21% of women. There has been a significant increase in harmful drinking between years, whether considered as a whole or when analyzed by age groups and gender. If this ratio is applied to the whole population, it can be assumed that around 33 thousand men and 25 thousand women had a harmful pattern of alcohol consumption in 2022. It is worth noting that according to the latest research, there are no known limits on the harmlessness of alcohol, and therefore it can be argued that all alcohol consumption is harmful.

About 15% of 10th-grade students have used nicotine pouches nationwide, but the proportion is much higher in some health districts. In Vesturland and Suðurland the ratio is 21% and in Austurland 25%. It is important to consider what causes this use and how it can be reduced. When the age group 18-34 is examined, the proportion increases to 23% nationwide. The proportion is highest in Norðurland og Austurland or 30%.

This year, a PHI on discrimination is published for the first time. It indicates that 13% of adults have experienced some form of discrimination. Women are also much more likely to suffer discrimination, 16% compared to 9% of men. The same gender difference can be seen when it comes to sexual violence, where 24% of women have experienced sexual violence compared to 9% of men. Striking results can also be found in a new indicator of sexual violence by peers, which reports that 11% of girls in grades 8-10 have experienced serious sexual abuse (oral sex or intercourse against the will) by another teenager.

Public Health Indicators and the Work of the Health-Promoting Community

Gígja Gunnarsdóttir discussed PHI in the work of the Health Promoting Community. She gave a short presentation on the work, which has the main goal of supporting municipalities, schools and workplaces in working systematically to create an environment and conditions that promote a healthy way of life, health and well-being for everyone. A web-based system of checklists has been developed to assist contacts and steering groups to analyze the situation, work on improvements and evaluate progress in terms of environment and conditions. PHI are used, together with various other indicators and data, to analyze the situation regarding lifestyle, health and wellbeing, etc. Gígja said it was a welcome step that PHI were now being published for the nine most populous municipalities for the first time. She explained why it was not possible to do the same for all the municipalities, although there was a desire to do so. Gígja reiterated that although comparisons with other regions could be useful, the most important thing was for each municipality to review the public health indicators and interpret the situation based on their local community's knowledge. The conditions can be so different between, and within, the municipalities. It is also necessary to ask oneself if the situation is acceptable even though it seems to be good/best in comparison to others.

The next move includes a further introduction for Health-Promoting Community contacts and sharing the indicators with the smaller municipalities as the data allows. We will continue to look for ways to strengthen the data and coordinate and integrate it so that the work is of the best use for the municipalities.

Harpa Þorsteinsdóttir, Public Health Project Manager at the City of Reykjavík, chaired the meeting.

-Automatic translation

Icelandic Public Health Indicators 2022 were presented for the seventh time in Akranes 13.6.2022.

Alma D. Möller, Medical Director of Health, addressed the meeting and discussed the challenges in healthcare: increased demand, lack of staff and a more complex environment. According to Alma, it is necessary to strengthen public health and prevention to maintain and improve people's health, prevent diseases and use the health system wisely. In this context, she talked about the determinants of health and the health-promoting approaches that the Directorate of Health manages: Health-Promoting Community, Health-Promoting Preschool, Primary School and Upper Secondary School, and Health-Promoting Workplace. She specifically touched on sleep and presented a new public health indicator: quality sleep in the 4th grade. This indicator shows that over 60% of pupils in the 4th grade get quality sleep. Alma also presented the status of sleep in the 8th-10th—class of primary school. Almost half of the teenagers don't get enough sleep.

Alma also discussed cancer screenings. As stated in the Directorate of Health's report on cancer screenings in 2021 (Icelandic), participation in the screenings was somewhat poorer in 2021 than in the previous two years. Difficulties at the beginning of 2021 undoubtedly play a role in explaining this. However, the implementation of screenings for both cervical and breast cancer has improved. In the future, the task is to strengthen the performance and improve women's attendance. The overall death rate from cancer continued to decline in 2017-2021, as it had done in the previous five-year periods.

Public Health Indicators, society, health and diseases

Sigríður Haraldsd. Elínardóttir, Head of Health Information at the Directorate of Health, presented indicators related to society, health and diseases. According to Sigríður, significantly more adults rated their mental health as fair or poor in 2020 and 2021 compared to 2019. If 2020 is excluded, when access to primary health care was limited due to the COVID-19 pandemic, the number of visits to primary health care due to mental and behavioural disorders has increased steadily. Specialized mental health services have generally not been provided within primary health care. Still, in the last five years, this has grown under the government's goal that primary health care should be the first point of contact for individuals within health care. Visits to primary health care due to mental and behavioural disorders have increased the most in Westfjords and East Iceland.

Furthermore, Sigríður reported that diabetes is one of the four major chronic diseases that cause the most significant burden of disease. Approximately 10-15% of people with diabetes have type I diabetes, while the majority, or about 85-90%, have type II. In many cases, type II diabetes can be prevented with a healthy diet and exercise. There is no information on the prevalence of diabetes by health district in Iceland. The use of hypoglycemic drugs, other than insulin, however, provides evidence of the incidence of the disease. Thus, the use of hypoglycemic medications has increased in Iceland and all health districts, especially in the last two years, which indicates the increased frequency of the disease.

Public Health Indicators, well-being and lifestyle

Dóra Guðrún Guðmundsdóttir, Head of Public Health at the Directorate of Health, presented indicators related to well-being and lifestyle. In Dóra's talk, it was stated that the condition has generally worsened. The happiness of adults continues to decline, but the percentage of very happy people fell systematically between 2019 and 2020, when it fell below 60% for the first time. The rate of happy teenagers in the 10th grade has also never been lower and is now below 80%, a significant decrease from the last measurement in 2018. It is essential to pay close attention to this and look at what can be done to reverse this trend. The British government has calculated that a drop of one point on the happiness scale costs society 13,000 pounds per person per year or roughly 2 million ISK. The mental health of upper secondary school students remains the same between years, but less than half of secondary school students rate their mental health as good. Loneliness has grown steadily since 2016, but in 2021, almost 13% of adults said they felt lonely.

In general, there is no evidence of significant changes in the physical activity of children and young people in recent years. Among children in primary school, however, there is less active commuting to school and less participation in organized sports activities in the oldest age groups. The percentage of upper secondary school students who engage in vigorous physical activity is increasing. The proportion of adults who exercise little increased temporarily in 2020 but is falling again. The same applies to active commuting among adults; the change in 2020 is reversing.

Over 10% of adults said they ate vegetables and fruit five times a day in 2021, but this percentage was around 9% in 2020. As before, there are some differences between health districts, and the rate is lowest in Westfjords, only 4.3%, but highest in the capital area or 11.5%. Vegetables and fruits are an essential part of a healthy diet. Its consumption reduces the risk of cardiovascular disease, type II diabetes and various types of cancer and promotes a healthy body weight. Eating five servings of vegetables and fruit daily, or at least 500 grams, is recommended. Only half of six-year-old children took fish oil or vitamin D daily in 2021, a percentage similar to previous years.

The percentage of adults who drank soft drinks daily increased from 24% in 2020 to 26% in 2021. Also, 30% of high school students drank energy drinks four times a week or more in 2021. Excessive consumption of caffeine can harm the cardiovascular system, as well as the nervous system. Common side effects of excessive consumption include irregular heartbeat, insomnia, adverse impact on the fetus and possible anxiety. In Iceland, soft and energy drinks are exempt from the traditional value-added tax, which goes against all public health recommendations. Research shows a strong correlation between soft drink consumption and other unhealthy foods, as well as a correlation with chronic diseases.

Overall, there has been a reduction in the harmful use of alcohol among adults during the peak of the COVID-19 pandemic. However, it varies slightly between health districts; an increase can be seen in the Westfjords and the North in 2021. It can be assumed that the social restrictions during the pandemic affected alcohol consumption. This is especially true in 2020, but there was a slight increase in alcohol consumption in 2021, and now the situation has become similar to before COVID-19. It is also pleasing to see that most young people have never used illegal drugs. 81.4% of upper secondary school students in Iceland say they have never tried illicit drugs. The percentage is highest in the North, 86%.

Utilization of Public Health Indicators in the West

Alma, Sigríður and Dóra discussed the importance for communities to review the indicators for their health district, see what is good and where there are opportunities for improvement.

Jóhanna Fjóla Jóhannsdóttir, Director of the Western Health Institute, presented the usefulness of Public Health Indicators in the West. Public Health Indicators support policymaking and prioritise and monitor trends and changes over time. In that context, she also mentioned the Directorate of Health's health-promoting approaches and their good support in general health-promoting work.

In the end, Jóhanna Fjóla spoke about the good results, among other things, in tobacco control and reminded us of the importance of being alert to new challenges and paying close attention to prevention at all stages of life.

-Automatic translation

Public Health Indicators were presented for the sixth time in June 2021.

Public Health Indicators are a set of measures that give information on the health and well-being of the population. They are presented to provide an overview and make it easier for health services and local authorities to analyze the situation in their district so that they can work in a targeted way to improve the health and well-being of the residents.

Alma D. Möller, Medical Director of Health, addressed the meeting. In her speech, it was stated that health is not only an issue of the health service but of society as a whole. Lifestyle, education and financial security are thus no less critical when health is on the one hand. Alma also mentioned the United Nations' global goals, but there is a good correlation between them and the main influencing factors of health and well-being. Iceland has committed itself to work systematically on their implementation.

Dóra Guðrún Guðmundsdóttir, Head of Public Health at the Directorate of Health, reported on public health indicators, lifestyle and well-being. In Dóra's talk, it was stated that since the beginning of monitoring the happiness of adults, for the first time, there has been a significant decrease in the percentage of those who consider themselves very happy. The rate goes down in all districts except in Vestfjörður and Austurland. There was no significant difference in the frequency of adult stress between 2019 and 2020, and in most districts, the percentage of those who experienced a lot of stress was lower in 2020 than in 2019. There have been fluctuations in the measurements of loneliness. In Iceland, a lower percentage of adults experienced loneliness in the first wave of COVID-19, but it increased in the summer of 2020, as in recent years.

Measurements of sleeping fluctuate somewhat between months. In general, there has been a decrease in the number of adults who sleep too little, but unfortunately, the trend has not been the same among children. In 2019, 26.6% of adults slept too little compared to 24.7% in 2020. This percentage was 43.1% for children in 2019 and 43.6% in 2020. It's not a big increase but still a negative trend. It is worth noting that most children in the East get enough sleep, but the East is closer to having a correctly set clock compared to its position on the Earth. In addition, the start of school is later in the East than in other parts of the country, at least in one large school. Dóra encouraged school administrators in the country to look with an open mind at delaying the start of school, especially at the youth level. Almost half of secondary school students consider their mental health good or very good, but the highest percentage is in Vestfjörður and Suðurnes.

The number of adults who engage in little or no or moderate physical activity has increased since 2019. Roughly half of the high school students say they engage in strenuous exercise three times a week or more, and about 16% of students in the 10th grade of primary school exercise in accordance with exercise recommendations, i.e. 60 minutes or more every day.

Just under 10% of adults said they ate fruit and vegetables five times a day in 2020, but this percentage was 11% in 2019. Vegetables and fruit are an essential part of a healthy diet. Its consumption reduces the risk of cardiovascular disease, type 2 diabetes and various types of cancer and promotes a healthy body weight. Eating five servings of vegetables and fruit per day or at least 500 grams in total is recommended. There is also an increase in the consumption of soft drinks by adults between years, and about 20% of secondary school students drink soft drinks four times a week or more. In Iceland, soft drinks are exempt from value-added tax, so it can be said that it is a tax discount, which increases access to the product, which goes against all public health recommendations.

There have been no significant changes in binge drinking among 10th-grade students in recent years. The percentage of adults who fall under the definition of having a risky consumption pattern of alcohol has decreased in recent years. The percentage of adults who smoke daily is also decreasing, now 7.3% in Iceland.

Sigríður Haraldsd. Elínardóttir, Head of Health Information at the Directorate of Health, discussed Public Health Indicators, society, health and disease. Sigríður drew attention to the fact that population growth has slowed down relatively in the country, especially in the health districts where the population growth was the highest in recent years. Overall, significantly fewer had difficulty making ends meet in 2020 than in 2019. However, this difference was only significant in the capital area and the North.

The percentage of adult Icelanders who rate their health as fair or poor has grown in recent years. The percentage was significantly higher in 2020 than in 2019 in three health districts, in the capital area, Suðurnes and Norðurland. The percentage of adults who rate their mental health as fair or poor has also grown in recent years. The percentage was significantly higher in 2020 than in 2019 in three health districts, in the capital area, Suðurnes and Suðurland.

There has been a significant decrease in the prescription of antibiotics for children under five years of age every year since 2016. The most significant reduction in these prescriptions occurred between 2019 and 2020, which is undoubtedly related to the pandemic of COVID-19, restrictions on gatherings and increased emphasis on infection control.

There was little change in participation in cervical cancer screenings between 2019 and 2020 despite restrictions in health care due to the COVID-19 epidemic. Participation in breast cancer screening increased slightly between 2019 and 2020, and a significant increase could be seen in participation in the capital area and the south.

Arrivals at primary health care were significantly fewer in 2020 than in 2019 in all health districts, but in the previous years, they had increased significantly yearly. The restrictions that had to be placed on people's communication to slow the spread of COVID-19 greatly impacted how healthcare services were provided. As the number of visits to primary health care decreased, electronic communications and calls to primary health care centres increased enormously.

Finally, Gylfi Ólafsson, CEO of the Vestfjörður Health Institute, talked about using Public Health Indicators in the local area. Gylfi said significant progress has been made in collections and the use of data in recent years, and the value of data will increase significantly with time. He said that the Icelandic Public Health Indicators were a good example, as they contribute to better decision-making in local communities, prioritization of projects and follow-up. Gylfi also requested some electronic data portal where all public health indicators would be published in an accessible way.

Gígja Gunnarsdóttir, the Project Manager of Health-Promoting Communities at the Directorate of Health, moderated the meeting.

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New Public Health Indicators were presented at Hotel Selfoss, Árborg, on June 23, 2020. This is the fifth time that the Icelandic Public Health Indicators are published.

Public Health Indicators are a set of measures that provide information on the health and well-being of the population. They are presented to give an overview and make it easier for health services and local authorities to analyze the situation in their district so that they can work in a targeted way to improve the health and well-being of the residents.

When choosing public health indicators, the focus is mainly on the factors that affect health and well-being, which include opportunities for health promotion and prevention. The focus is also on those aspects of the burden of disease that are important for each district's health service to be aware of and respond to.

Gísli Halldór Halldórsson, mayor of the municipality of Árborg, addressed the meeting. He discussed the importance of good key indicators and the challenges of using them for direct action. Medical Director of Health, Alma D. Möller, spoke about solidarity and cooperation in Iceland during COVID-19.

Dóra Guðrún Guðmundsdóttir, Head of Public Health at the Directorate of Health, reported on Public Health Indicators and lifestyle. In Dóra's talk, it was stated that Icelanders are happy; over 60% of the country's population consider themselves very happy, and in 2019 the percentage was the highest in the South. The rate of those who often feel lonely has increased in certain districts but decreased in others. Thus, almost 15% of the inhabitants of Austurland often experienced loneliness in 2019, compared to more than 10% in the whole country. Overall, younger people seem more lonely than older people, but about 22% of those aged 18-25 said they felt lonely in 2019. The percentage of those who sleep too little also varies by health district; about 35% of adults and 46% of teenagers in Suðurnes sleep too little, compared to 24% of adults and 42% of teenagers in East Iceland.

It is worrying how many students do not feel good at school and how many boys have been abused. About 14% of students in 5.-7. class wants to leave school, and this percentage is 21% in the East. Almost 30% of boys in 5.-7. class in Iceland and 35% of boys in East Iceland were exposed to violence at school last winter.

Icelanders have long held the Nordic record for consumption of soft drinks. A further increase in daily soft drink consumption is a cause for concern. In 2019, about 20% of adults and children in grades 5-7. class drank soft drinks daily. Furthermore, only about 11% of adults meet the recommendations of the Directorate of Health for the consumption of five servings of fruit and vegetables per day.

Only 14% of children in 5.-7. class exercise in accordance with the office's recommendations (at least 60 minutes per day), even though 2/3 of all children in the country participate in organized sports activities. In 2019, roughly 11% of adults did not exercise vigorously during the week.

Overall, risky drinking among adults has decreased slightly in the country, but in 2019, almost a quarter of the population fell under the definition of dangerous consumption of alcohol. The monthly drinking of tenth-grade students has increased slightly. It is pleasing to see that the daily smoking of adults and the use of e-cigarettes by young people are still decreasing. However, there has been a considerable increase in oral tobacco use, especially in the capital area and in Suðurnes. The increase is most significant among young women.

Sigríður Haraldsd. Elínardóttir, the Head of Health Information at the Directorate of Health, discussed Public Health Indicators concerning society, health and diseases. Sigríður drew attention to the fact that the population of Suðurnes and Suðurland has increased relatively more in recent years than the population of other health districts. Rapid population growth provides challenges and opportunities that must be considered in public health work. One of the United Nations' global goals for 2030 touches on this issue, stating that a solid, local infrastructure must be developed to support economic development and prosperity.

A lower percentage of people found it difficult to make ends meet in 2019 than in previous years, and the rate has fallen the most in the South. Over the past 15 years, the risk of dying prematurely, before age 70, from NCDs has decreased, but to varying degrees by health district. The United Nations' global goals aim to reduce the number of premature mortality from NCDs by a third through preventive measures and treatment.

The prescribing of antibiotics to children under five has continued to decline. However, there are still considerable differences in the frequency of prescriptions between health districts. It is highest in the capital area and Suðurnes but is decreasing in both districts. The frequency is lowest in East Iceland.

In Iceland, participation in screening for cervical cancer remains the same as in 2018. However, participation in breast cancer screening increased slightly for the first time in several years, and this applies to all districts.

New Public Health Indicator reports filled adult teeth at age 13. The average number of decayed and filled adult teeth (dental caries index, DFT) in twelve-year-old children is an international dental health measure. Global goals aim to reduce the caries rate of twelve-year-old children below one. Since almost all twelve- and thirteen-year-old children are actively monitored by family dentists in Iceland, the Filled Teeth Index (FT) of thirteen-year-old children indicates the Tooth Decay Index (DFT) and thus also of the dental health of children in Iceland. This index is now just over 1.5 in Iceland and has decreased since 2015. There is considerable variation between health districts in the number of children's filled adult teeth.

Another new indicator reports older people's polypharmacy, i.e., the percentage of those taking more than five medicines simultaneously. In 2019, around 56% of people aged 75 and over fell under this definition, and the rate has changed little in recent years. The ratio is close to the average of several OECD countries.

The number of visits to primary health care per population continues to increase overall. The most significant increase is in the capital area, where a new financing system was put into use in 2017. The financing system aims to promote primary health care as patients' first point of contact. At the same time, visits to self-employed specialists have slightly decreased, and the number of visits per population still varies significantly between health districts. Most of the arrivals per resident were in the capital area, where this service is most available.

Finally,  Díana Óskarsdóttir, director of the Southern Health Institute, discussed the organization's public health policy. Diana told, among other things, about the mental health team that started working at HSU at the end of 2019 and about lifestyle receptions where people are taught to take responsibility for their health.

Braga Bjarnason, head of the leisure and culture at the municipality of Árborg and contact person for the health-promoting community, moderated the meeting.

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New Public Health Indicators by health districts were presented at Hljómahöllin in Reykjanesbær on June 6, 2019. This is the fourth time the Directorate of Health's Public Health Indicators are published.

Public Health Indicators are a set of measures that provide information on the health and well-being of the population. They are presented to give an overview and make it easier for health services and local authorities to analyze the situation in their district so that they can work in a targeted way to improve the health and well-being of the residents.

When choosing Public Health Indicators, the focus is mainly on the determinants of health and well-being that include opportunities for health promotion and prevention. An effort is made to select those aspects of the burden of disease that are important for each district's health service to be aware of and respond to.

Birgir Jakobsson, Assistant to the Minister of Health, addressed the meeting. Medical Director of Health, Alma D. Möller, explained why the office compiles and publishes Public Health Indicators annually.

Dóra Guðrún Guðmundsdóttir, Head of the Division of Determinants of Health at the Directorate of Health, reported on Public Health Indicators and lifestyle. Dóra's talk stated that Icelanders are very happy, and about 60% of the country's population consider themselves very happy. There has been a positive trend in the last few years in the percentage of those who choose active commuting, but about 60% of students in 8th-10th class bike or walk to school, and over 20% of adults bike or walk three times a week or more.

It was also stated that there has been a decrease in the percentage of secondary school students who have become drunk once or more in the last 30 days, but there is some variation between health districts. The percentage of people who smoke daily continues to shrink and is now 8.6%.

The main challenges regarding lifestyle are too little sleep, using energy drinks, stress, and the mental well-being of young people. Almost 30% of adults and over 70% of secondary school students don't get enough sleep. At the same time, there has been a considerable increase in the daily consumption of energy drinks among secondary school students, with the percentage going from 21.7% in 2016 to 54.6% in 2018. In addition, the adult consumption of soft drinks has increased. Dóra reported that research shows that students' experience of how teachers like them affects their well-being and academic performance. It is therefore worthy of consideration that only 55.7% of students in grades 8.-10. feel that the teachers like them. Research has also shown that teenagers' and parents' time spent together is a protective factor for risky behaviour.

Sigríður Haraldsdóttir, Head of the Division of Health Information at the Directorate of Health, discussed Public Health Indicators related to health and diseases. Sigríður noted that the frequency of antibiotic prescriptions for children under five has decreased in the country. The frequency has reduced the most in the health districts where it was highest. However, there is still a significant difference in the frequency of prescriptions between health districts, which is highest in the capital area. Participation in screening for cervical cancer and breast cancer has decreased in recent years, but participation remained the same between 2017 and 2018. However, participation in screening for cancer still varies considerably between health districts. The frequency of hip and knee replacement surgeries has increased following an effort to shorten the waiting list. The age-standardized frequency of these surgical procedures is highest in the North and the East. Overall, visits to primary health care have increased over the last two years. The most significant increase is in the capital area, where a new financing system was put into use in 2017, which has, among other things, the goal of promoting primary health care as the first point of contact for patients. At the same time, there has been a slight decrease in visits to self-employed physicians, but the number of visits per population varies greatly between health districts. Most visits are in the capital area, where this service is most available.

Kjartan Már Kjartansson, mayor of Reykjanesbær, told how Reykjanesbær uses Public Health Indicators as an incentive to improve the health and well-being of the residents. He also talked about the cooperation between local authorities in Suðurnes and Heilbrigðisstofnun Suðurnesja on actions related to public health. Finally, Aldís Hafsteinsdóttir, Chairman of the Union of Icelandic Municipalities, discussed how the union works with the Directorate of Health to implement Healt-Promoting Communities.

Attendance at the meeting was good. The meeting was moderated by Markús Ingólfur Eiríksson, Director of Heilbrigðisstofnun Suðurnesja.

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Public Health Indicators 2018 were presented in Fljótsdalshérað on Wednesday, June 6.

The Public Health Indicators, now published for the third time, are a set of measures that provide information on the health and well-being of the nation. They are presented to give an overview and make it easier for municipalities and health services to analyze the situation in each health district.

When choosing Public Health Indicators, attention is directed, among other things, to those determinants of health and well-being that include opportunities for health promotion and prevention.

Lifestyle, health, and well-being of the nation

Alma D. Möller, Medical Director of Health, talked about why the Directorate of Health publishes Public Health Indicators, then Dóra Guðrún Guðmundsdóttir, Head of the Division of Determinants of Health at the Directorate of Health, talked about Public Health Indicators and lifestyle.

It was stated in Dóra Guðrún's talk that the happiness of Icelanders is similar this year to last year, but about 61% of Icelanders consider themselves very happy. It was also stated that there is a considerable difference between soft drink consumption and active commuting between health districts. About 10% of young people in classes 8.-10. are often lonely and feel bad at school, and about 60% of young people and 70% of adults get enough sleep. It was also stated that over 20% of students in 10th grade have smoked electronic cigarettes in the last month.

Next in line was Sigríður Haraldsdóttir, Head of the Division of Health Information at the Directorate of Health. She discussed public health indicators related to health and diseases. She stated, among other things, that there has been a reduction in antibiotic prescriptions for young children nationwide and in almost all health districts.

Sigríður also reported that the frequency of hip replacement surgeries has been increasing, a positive effect of the government's efforts to reduce the waiting for these surgical procedures. Also, the use of antidepressants is rising in the country, but not as much as in recent years.

Health-promoting East is growing

Eva Jónudóttir, prevention officer in Seyðisfjörður, talked about the work of health-promoting communities in Seyðisfjörður, Fljótsdalshérað, and Fjarðabyggð. A lot has been achieved since the municipalities started working according to this approach, and it is pleasing how good the cooperation between the municipalities has been. Pétur Heimisson, Medical Director at Heilbrigðisstofnun Austurlands, talked about how they use Public Health Indicators in their work, and Sigurbjörg Hvönn Þrastardóttir, Assistant Principal of Egilsstaðaskóli spoke about the health promotion work in the school, which has been leading in health-promoting primary schools.

The meeting was moderated by Björg Björnsdóttir, municipal representative in Fljótsdalshérað, and Björn Ingimarsson, mayor of Fljótsdalshérað, addressed the meeting.

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Public Health Indicators 2017 were presented on June 12 at Menningarhúsið Hof in Akureyri. 

Public Health Indicators, now published for the second time, are a collection of indicators that provide information on the health and well-being of the nation. They are presented to give an overview and make it easier for municipalities and health services to analyze the situation in different health districts. The same Public Health Indicators will not continuously be published, as data can be such a nature that information needs to be collected over a more extended period to see changes in a small community. Furthermore, there are not always significant changes from year to year.

At the presentation, Birgir Jakobsson, Medical Director of Health, discussed why Public Health Indicators are collected and published. Dóra Guðrún Guðmundsdóttir, Head of Division, the Determinants of Health at the Directorate of Health, talked about public health indicators and lifestyle, and Sigríður Haraldsdóttir, Head of Division, Health Information at the Directorate of Health discussed public health indicators and health and diseases. Then, Kristinn J. Reimarsson, Director at Akureyri town, spoke about Public Health Indicators and the health-promoting community in Akureyri, and Guðný Friðriksdóttir, Director of Nursing at Heilbrigðisstofnun Norðurlands, explained how the health service can use the indicators. The presentation ended with a panel discussion led by the Medical Director of Health.

This winter, the Directorate of Health has organized numerous workshops in connection with the Health-Promotion Community and Health-Promoting Schools. There, Public Health Indicators are used, among other things, to identify priorities and support schools and municipalities that want to create conditions that promote healthy lifestyles, health, and well-being of all residents. Health and well-being can vary depending on factors that cannot be changed but also factors that can be influenced. These include lifestyle, communication with family and friends, and living conditions such as education, employment, housing, health, and social services. 

A lot of work is behind choosing Public Health Indicators, and the office hopes they will be helpful both in policy-making and work in general. When selecting, the focus is primarily on the determinants of health and well-being that include opportunities for health promotion and prevention. It is essential to remember that each region has its strengths and challenges.

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• Slides - Presentation of Public Health Indicators 2016 (Icelandic)

Here, you can access the talks at the Safnahúsið (House of Collections) meeting on June 6, 2016.

• Address - Kristján Þór Júlíusson, Minister of Health (Icelandic)

• Why Public Health Indicators? - Birgir Jakobsson, Medical Director of Health (Icelandic)

• Public Health Indicators and Lifestyle - Dóra Guðrún Guðmundsdóttir, Head of Division, Public Health, Directorate of Health (Icelandic)

• Public Health Indicators and health and diseases - Sigríður Haraldsdóttir, Head of Division, Health Information, Directorate of Health (Icelandic)

• Public Health Indicators in Reykjavík  - Dagur B. Eggertsson, mayor of Reykjavík (Icelandic)