Estonian Human Development Report
Estonian Human Development Report - Eesti Koostöö Kogu
Estonian Human Development Report - Eesti Koostöö Kogu
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healthy life years method consists in using epidemiological<br />
studies or databases instead of self-assessments in researching<br />
the spread of disease. As a subjective component, a socalled<br />
disability weight is assigned to every diagnosis, i.e. an<br />
assessment of the time spent living with a certain disease or<br />
disability that reflects the comparative social significance of<br />
various states of health (Lai T, 2004).<br />
According to the DALY method, we first calculate the<br />
number of years of life lost (YLL) due to premature death<br />
and the healthy life years lost due to disability (YLD). Subsequently,<br />
both indicators are summarized (Lai T, 2004):<br />
DALY = YLL + YLD<br />
The total health loss of the <strong>Estonian</strong> population in<br />
2000 was 341,164 years. This figure decreased somewhat<br />
during the next two years (340,968 in 2001 and 338,242<br />
in 2002). No significant dynamics occurred during this<br />
period with regard to social groups based on age and gender<br />
(see Table 2.4.2.).<br />
In 2002, the summarized loss of life years in Estonia<br />
according to the DALY method amounted to 338,224<br />
years – 170,736 in the case of men, and 167,506 years in the<br />
case of women (Lai T, 2004).<br />
Although men and women lose an approximately<br />
equal number of years in total, the loss of years is mainly<br />
the result of deaths in the case of men and illnesses in the<br />
case of women (see Table 2.4.3.). Of the entire burden of<br />
disease, 8% is borne by children and young people (aged<br />
0–19), 39% by pensioners (aged 65+), and over half of the<br />
burden is borne by the working age population (20–64)<br />
(58% in the case of men and 43.6% in the case of women).<br />
The three main groups of illnesses that cause loss of health<br />
(cardiovascular diseases, tumours, and external causes)<br />
make up 65% of the total burden of disease. HIV/AIDS is<br />
not yet represented in this list, although according to the<br />
burden of disease study conducted in Estonia, the loss of<br />
life years resulting from the contraction of AIDS may be<br />
as substantial in 2012 as the mortality rate related to cardiovascular<br />
diseases in 2002 (Lai T, 2004).<br />
Women’s burden of disease is twice as high as that of<br />
men in the field of muscle and joint diseases, while men’s<br />
loss of health is triple that of women with regard to external<br />
causes. The majority of women’s burden of disease is<br />
constituted by cardiovascular diseases (35%), tumours<br />
(22%), and muscle and joint diseases (8.5%).<br />
Table 2.4.1. Principal reasons of death among <strong>Estonian</strong><br />
and Finnish men aged 25–64 in 2005<br />
Estonia Finland<br />
Note: standardized mortality coefficients per 100,000 people<br />
Estonia/Finland ratio<br />
Tumours 204 104 2.0<br />
Circulatory system disease 358 136 2.63<br />
External causes related to<br />
injuries and poisonings<br />
280 129 2.17<br />
Source: European detailed mortality database (DMDB). Copenhagen,<br />
WHO Regional Office for Europe, updated in January 2009<br />
Table 2.4.2. Health loss in years due to mortality and<br />
morbidity in 2000–2002<br />
Men<br />
Women<br />
2000 2001 2002 2000 2001 2002<br />
Years of life lost (YLL) 108 458 112 483 111 573 89 954 88 585 86 781<br />
Years lost due to<br />
disability (YLD)<br />
Disability adjusted<br />
life years (DALY)<br />
59 620 59 026 59 163 82 072 80 872 80 725<br />
168 078 171 508 170 736 172 023 169 458 167 506<br />
Source: Lai T, Maakondlik haiguskoormus Eestis 2000–2003. Tallinn:<br />
Ministry of Social Affairs; 2006<br />
The largest differences between men and women in<br />
terms of loss of life years appear in age groups 5–19 and 20–<br />
44. In these age groups, men lose three times as many life<br />
years as women. Boys and young men experience accidents<br />
several times more frequently than girls; in this age group<br />
external causes are the main reason for the loss of life years<br />
in the case of 60% of men and 40% of women. The loss of life<br />
years is 2.3 times higher among <strong>Estonian</strong> men than among<br />
women before the age of 65 (72,642 and 32,002 years, respectively)<br />
and 61% of the life years are lost by working age men.<br />
Of <strong>Estonian</strong> men, 13% die before they reach the age of<br />
45, and 25% of lost life years can be attributed to this group.<br />
Meanwhile, although only 4% of women die before the age<br />
of 45, they make up 11% of the lost life years. In the case of<br />
men, external causes have a dominant role in causing loss<br />
of life years from birth until the age of 50, after which cardiovascular<br />
diseases assume a prominent role. Women are<br />
Table 2.4.3. Summarized loss of health (DALY) – men and women<br />
Men<br />
Women<br />
0–4 5–19 20–44 45–64 65+ Total 0–4 5–19 20–44 45–64 65+ Total<br />
Respiratory organ diseases 512 902 2067 4562 3360 11402 240 656 1773 2882 2748 8299<br />
Tumours 243 1057 2616 1164 14319 29889 393 1138 5637 13843 15872 36883<br />
Genitourinary organ diseases 17 64 254 701 1072 2108 22 235 1041 953 1179 3430<br />
Joint and muscle diseases 152 910 2260 2935 1512 7770 134 1064 3148 5903 4114 14363<br />
Other diseases and conditions 554 1364 2492 3386 3009 10804 843 1569 2640 3377 6726 15156<br />
Infectious diseases 54 272 1082 798 191 2398 54 206 583 227 184 1253<br />
Neurological diseases 2335 888 1425 1196 539 6427 2158 733 960 889 871 5610<br />
Psychiatric diseases 145 1176 2721 1823 616 6481 66 770 2567 2223 1638 7263<br />
Digestive organ diseases 61 107 1816 3163 1450 6598 46 151 1070 2005 1822 5093<br />
Cardiovascular diseases 59 317 5110 21701 26214 53402 51 344 2585 12044 43745 58769<br />
External causes 433 2831 14831 10503 2078 30676 254 917 3185 3758 1590 9705<br />
Deformities and birth-related<br />
conditions<br />
2042 465 178 46 11 2742 1017 394 209 47 17 1684<br />
Total 6627 10353 36852 62478 54425 170737 5278 8176 25397 48151 80504 167507<br />
% 3.9 6.1 21.6 36.6 31.9 3.2 4.9 15.2 28.7 48.1<br />
Source: Lai T, Kiivet R. (2004). Haiguskoormuse tõttu kaotatud eluaastad Eestis: seosed riskifaktoritega ja riskide vähendamise kulutõhusus. Ministry<br />
of Social Affairs, University of Tartu.<br />
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