Ukraine currently faces a number of major public health issues and is considered to be in a demographic crisis because of its high death rate and low birth rate (the current Ukrainian birth rate is 11 births/1,000 population, and the death rate is 16.3 deaths/1,000 population). A factor contributing to the high death rate is a high mortality rate among working-age males from preventable causes such as alcohol poisoning and smoking. In 2008, the country's population was one of the fastest declining in the world at −5% growth. The UN warned that Ukraine's population could fall by as much as 10 million by 2050 if trends did not improve. In addition, obesity, systemic high blood pressure and the HIV endemic are all major challenges facing the Ukrainian healthcare system.