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1. Main trends in the health conditions of young people

2. Main concepts

Main trends in the health conditions of young people

Since gaining independence in 1991, the Republic of North Macedonia has made notable progress in transforming its health care system during the broader transition from a socialist to a market-oriented economy. Considerable reforms have been implemented in the organization, financing, and delivery of health care services, leading to the establishment of a mixed system that integrates both public and private providers. Although overall health care expenditure has increased in absolute terms over the past decades, it has gradually declined as a share of the national GDP, while private health expenditure remains comparatively high.

Despite these challenges, the overall health of the population has steadily improved. Life expectancy has increased, and mortality rates among both adults and children have approached the levels observed in other post-communist EU member states. However, the country continues to face significant health risks associated with unhealthy behaviors, including poor nutrition, smoking, alcohol consumption, and physical inactivity, which remain leading contributors to premature mortality and chronic diseases.

When it comes to young people, systematic data collection on their health conditions — particularly regarding behavioral and lifestyle-related factors — is still limited. Nonetheless, several national and international studies conducted over the past years provide valuable insights into the physical and mental health of young people in North Macedonia, highlighting issues such as stress, risky behaviors, and barriers to accessing health services.

Main concepts

Health in North Macedonia is defined in accordance with the World Health Organization’s definition — as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. It is shaped by a range of external determinants, including environmental, social, and economic conditions, as well as by individual lifestyle choices and policies across other societal sectors.

The national health system is also aligned with the WHO’s definition, encompassing all actors, institutions, and activities whose primary goal is to promote, restore, or maintain the health of citizens. Within this framework, organized health services — that is, the health care system — represent just one component of a broader network of influences that contribute to maintaining good health, supporting recovery from illness, and improving quality of life for those living with chronic conditions.