Estonian Human Development Report

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 |