Estonian Human Development Report

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1.5. Changes in the Estonian Human Development Index Since 1998, the Estonian Human Development Index has continually increased, although its ranking has not always improved, because our index growth has not been as rapid as other countries belonging to the same group (Figure 1.5.1.). The life expectancy at birth remains practically unchanged, while the education index (shown in percentages) has changed quite a lot. The main reason lies in the objective increase in the gross enrolment rate. However, since this index is an approximate assessment, which is affected by the assessment method and different sizes of the age groups, the fluctuations may not be objectively justified. GDP changed the most during the observation period, and apparently this indicator is the reason for the relatively large changes in the Estonian Human Development Index (HDI). The relatively high level at the beginning of the 1990s was caused by differing calculation rules and the lower level of all indicators throughout the world; at that time, Estonia has a higher ranking than at any subsequent time. The decline in the middle of the 1990s was related primarily to a decrease in GDP, while at the same time life expectancy and the education index were also at a low point. As far as future development is concerned, one can assume a small increase for Estonia during the next two years (in 2007 and 2008 based on increased GDP). However, in subsequent years, there will probably be a decline along with a decline in GDP, since life expectancy inevitably increases very slowly and tends to decline in years of economic downturn. In the education index, Estonia has practically no room to improve. With respect to Estonia, one can say that it has the greatest difference between the education index and the life expectancy index in the entire world: Estonians are relatively well educated, but they are in poor health, resulting in shorter life spans. It is clear that Estonia’s possible rise in the human development ranking is unavoidably related to an improvement in life expectancy, especially for men. Without this, we can expect a reversal, because life expectancy at birth in practically all developed countries is not only considerably higher than in Estonia, but it is also increasing faster – especially for men. The reasons for low life expectancy of Estonia’s population can be sought in our history and in our climate, and maybe even in our genes, but the example of our northern neighbours confirms that the state’s consistent policies to shape lifestyles and to place greater value on healthy lifestyles can improve this indicator considerably and guarantee the country a high ranking with respect to human development. Figure 1.5.1. Changes in the value and ranking of Estonian Human Development Index 100 80 60 40 20 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Rank 34 29 43 68 71 77 54 46 44 42 41 36 38 40 44 42 HDI 0.872 0.876 0.862 0.749 0.776 0.758 0.773 0.801 0.812 0.826 0.833 0.853 0.853 0.858 0.868 0.871 Sources: HDR 1995 – HDR 2008 0,9 0,85 0,8 0,75 0,7 0,65 Figure 1.5.2. Changes in the indicators that are the basis for the Eesti Human Development Index 100 20000 80 15000 60 10000 40 20 5000 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Life expectancy Education index GDP Sources: HDR 1995 – HDR 2008 0 | 30
CHAPTER 2 Health and quality of life 2.1. Introduction Health is one of the fundamental human rights and important to anyone’s development and well-being. The importance of health has been stressed in many agreements and charters, including the 2008 Tallinn Charter: “All the Member States of WHO in the European Region share the common value of the highest attainable standard of health as a fundamental human right; as such, each country shall strive to enhance the performance of its health systems 6 to achieve the goal of improved health on an equitable basis, ...” (Tallinn Charter 2008). The health ministers of the European Union have also emphasized the importance and central role of health systems in providing the residents of member states with a feeling of safety and increasing social cohesion and social justice, thereby promoting sustainable development. The health systems are characterized by generally recognized European values, such as universality, accessibility of quality services, fairness, and solidarity (EU common principles 2006). The connection between health and wealth is complicated and has been the subject of much research. While better health facilitates the growth of wealth at the level of the individual and society, wealth is also a factor in attaining better health. The connection is reciprocal, as a bad state of health affects people’s affluence, and poverty, in turn, does not allow them to attain their full potential for health. Empirical studies confirm that the good state of health of a country’s population is not only a natural byproduct of economic growth, but that the health of the population also influences economic development, competitiveness and productivity (CMS, 2001, Suhrcke M, 2007). This is also reflected in the recent agreement: “Beyond its intrinsic value, improved health contributes to social wellbeing through its impact on economic development, competitiveness and productivity. High-performing health systems contribute to economic development and wealth.” (WHO, 2008). This fact has a significant implication on policy making: health investments should be seriously considered with regard to promoting national economic development as they can have an influence on the achievement of countries’ economic policy goals. In other words, health and wealth amplify each other; well-functioning health systems contribute to both health and wealth, which, in turn, increase social well-being (J Figueras, 2008). On the basis of the information provided above, we can draw the conclusion that a significant connection exists between the state of health of a country’s population and its society’s potential for development. The necessity for increased health investments was also recognized by the European Commission in 2004, who issued a statement that health is a prerequisite for economic welfare as it leads to a longer, better and more productive life (European Commission & Parliament 2004). In the Tallinn Charter signed by the ministers of Member States of the WHO European Region in June 2008, the political leaders of European countries recognize, for the first time, the impact of well-functioning health systems on both the improvement of people’s health as well as economic growth. The leaders gathered in Tallinn were convinced that by investing in health, we also invest in human development, social well-being and prosperity (WHO, 2008). In general, the state of health of Estonian residents has improved in recent years. In 1990–2007 the average life expectancy of men increased by nearly three years and women’s life expectancy grew by nearly four years (Statistics Estonia 2008). Since this period also comprises years when the state of health of Estonian residents deteriorated rapidly, it is worth mentioning that the fast increase in life expectancy has taken place in the 21 st century. Compared to most European countries, however, Estonia is still lagging behind significantly in terms of the aggregate indicators reflecting the population’s state of health. Furthermore, the increase in average life expectancy in Estonia remains faster in the case of women, resulting in a situation where the average life expectancy of men was 11 years shorter in 2006 than that of women. Young people in Estonia are generally healthier now than ever before. Mortality rates indicate that children and young people aged up to 20, but especially children aged 0–5 have enjoyed a stable decrease in mortality for several decades, contrary to the working population. However, there are several causes for concern, including, for example, increasing mental stress, smoking at an early age, the tendency to abuse alcohol, insufficient physical activity, the spread of dangerous infectious diseases (primarily HIV and venereal diseases), and injuries and poisonings (HBSC 2005/2006). The following section provides a more detailed analysis of various indicators related to the health of Estonia’s population and our healthcare administration, with the aim of arriving at a better understanding of our development potential. 6 According to the definition provided by the World Health Organization (WHO), health services are a set of all public and private organizations, institutions and resources devoted primarily to improving, maintaining and restoring health. Health systems include services aimed both at private individuals and the public, as well as activities for influencing the policies and arrangements of other fields in order for the latter to take into account social, environmental and economic health factors (WHO 2008). 31 |
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Page 3 and 4: Estonian Human Development Report T
Page 5: 4.2. Ethnic differentiations in sat
Page 9: Preface This year, the Estonian Hum
Page 12 and 13: CHAPTER 1 Estonian Human Developmen
Page 14 and 15: Figure 1.1.3. Life expectancy in co
Page 16 and 17: Figure 1.2.2. Life expectancy at bi
Page 18 and 19: to reality. The greatest inaccuracy
Page 20 and 21: Figure 1.2.9. Internal migration ev
Page 22 and 23: 12. Marksoo, A. 1992. “Dynamics o
Page 24 and 25: Table 1.3.1. PISA 2006 study result
Page 26 and 27: Table 1.3.2. Number of students in
Page 28 and 29: 1.4. The gross domestic product and
Page 30 and 31: Figure 1.4.3. Estonian GDP (right a
Page 34 and 35: 2.2. Health of Estonian residents i
Page 36 and 37: Table 2.2.4. Differences in life ex
Page 38 and 39: Figure 2.4.1. Healthy life years of
Page 40 and 41: Figure 2.4.4. Various accidents, tr
Page 42 and 43: 2.5. Lifestyle and behaviour as a s
Page 44 and 45: Figure 2.5.5. Smoking in Estonia in
Page 46 and 47: Figure 2.6.1. Overview of the compo
Page 48 and 49: Table 2.6.2. Use of specialized med
Page 50 and 51: dren. The majority of services are
Page 52 and 53: Figure 2.8.2. How much a health dis
Page 54 and 55: 2.10. Policy recommendations aimed
Page 56 and 57: CHAPTER 3 Quality of life and life
Page 58 and 59: Table 3.2.1. Characteristics of liv
Page 60 and 61: Table 3.2.4. An assessment of the e
Page 62 and 63: Figure 3.2.4. Difference in the job
Page 64 and 65: Table 3.2.6. Agreement with stateme
Page 66 and 67: Figure 3.3.1. Satisfaction with lif
Page 68 and 69: Figure 3.3.4. Percentage of people
Page 70 and 71: Figure 3.4.1. Types of quality of l
Page 72 and 73: Figure 3.5.1. Percentage of teenage
Page 74 and 75: Figure 3.5.4. Percentage of respond
Page 76 and 77: Arieh A., Conti C., Kutsar D., Nicg
Page 78 and 79: Figure 3.6.2. Subjective quality of
Page 80 and 81: Pieper, A. Sixsmith, Care related q
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Figure 3.7.1. The placement of Euro
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Figure 4.2.1. Life satisfaction by
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Table 4.2.1. Factors forming genera
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Annexes Annex 4.2.1. Socio-demograp
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Figure 4.3.1. Changes in the assess
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Figure 4.3.4. Attitudes of the Esto
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olds considered themselves to be pa
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Table 4.4.3. Agreement of the Russi
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Table 4.5.2. The prospects of non-E
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Figure 4.5.4. Certainty of Estonian
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mote equal opportunities. At the (e
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CHAPTER 5 Quality of life in a cons
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Figure 5.2.1. GDP and AIC per capit
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Figure 5.2.3. Distribution of consu
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Figure 5.2.4. Indexes of environmen
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Table 5.3.1. Comparison of countrie
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Figure 5.3.3. Comparison of types o
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Table 5.3.5. Connections between po
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Table 5.4.1. Who and what are the f
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Table 5.4.3. Young people’s asses
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Figure 5.4.6. Time spent on the con
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Table 5.4.6. The perception of prob
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5.6. Summary To briefly summarize t
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Table 6.2.1. Objective and subjecti
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Figure 6.2.4. Relationship between
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Figure 6.2.7. Difference between th
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Figure 6.3.1. GDP, government secto
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Figure 6.3.3. Employed 15-74-year-o
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Figure 6.3.8. Percentage of social
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References 1. Aaviksoo, A., G. Paat
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Figure 6.4.1. Labour market flexibi
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Figure 6.4.3. Creations of jobs ind
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Figure 6.4.5. Public expenditures o
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Figure 6.4.6. Ratio of the particip
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6.5. Cities as development engines
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Table 6.5.2. Existence of developme
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have been underfinanced or are not
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Table 7.1. Factors that favour and
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Table 7.2. Potential economic devel
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Authors Chapter 1 Ene-Margit Tiit,
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Margit Keller (PhD) is a Senior Res
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Special prizes Estonian Human Devel
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Estonian Human Development Report H
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Estonian Human Development Report H
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Estonian Human Development Report T
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Honorable mentions Estonian Human D
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Estonian Human Development Report P
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Estonian Human Development Report A
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Estonian Human Development Report T
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Estonian Human Development Report

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