Estonian Human Development Report
Estonian Human Development Report - Eesti Koostöö Kogu
Estonian Human Development Report - Eesti Koostöö Kogu
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almost exclusively sexual partners of male injecting drug<br />
addicts and that the HIV epidemic has not yet spread outside<br />
the risk groups (Drew et al. 2008).<br />
HIV has not yet had a significant effect on the comparative<br />
indicators of Estonia, but it is likely that the number of<br />
people who suffer from or have died of AIDS will increase<br />
significantly in the near future as the victims of the concentrated<br />
HIV epidemic 7 that started at the beginning of this<br />
century will reach the final phase of the illness. According<br />
to the worst scenario, the contribution of HIV to the burden<br />
of disease may equal that of cardiovascular diseases in<br />
a few years (Lai T, 2004), due to the fact that the <strong>Estonian</strong><br />
epidemic has predominantly affected very young people. In<br />
Estonia, people under 25 made up 61% of all newly registered<br />
HIV cases in 2004, 57% in 2005, 45% in 2006, and<br />
38.4% in 2007. The number of children to have contracted<br />
HIV from their mothers is 25 (Rüütle 2008).<br />
The incidence of tuberculosis became more frequent in<br />
Estonia during the 1990s. In 1997, 51 new cases of tuberculosis<br />
were diagnosed per 100,000 residents – an incidence<br />
rate ten times higher than that of the Nordic countries.<br />
The danger of the recurrence of a tuberculosis epidemic<br />
came into being in Estonia due to inadequate care and the<br />
use of incorrect treatment regimens, which were, in turn,<br />
caused by a decrease in vigilance regarding tuberculosis<br />
in the health care system and the society as a whole (TAI,<br />
2004). In 2006, there were 24.5 cases of tuberculosis diagnosed<br />
in Estonia per 100,000 residents (see Figure 2.4.7.)<br />
and by 2007 the number had grown to 29.8. In 2007, the<br />
tuberculosis incidence rate per 100,000 residents was lowest<br />
in Iceland (3) and highest in Lithuania (66.12) (Health<br />
Protection Inspectorate, 2008).<br />
Although the incidence of tuberculosis has fallen in<br />
recent years, multiresistant forms of tuberculosis still pose<br />
a serious problem. Along with the halt in the decrease of<br />
2007 infections, there has been a considerable increase in<br />
the frequency of HIV and tuberculosis coinfection.<br />
According to the Tuberculosis Registry, a tuberculosis<br />
patient was first diagnosed with HIV in Estonia in 1997.<br />
As of 2007, a total of 183 people with tuberculosis infections<br />
have been diagnosed with HIV. The tuberculosis<br />
patients who have contracted HIV have been 20–44 years<br />
old. The average age of a tuberculosis patient in Estonia is<br />
45, so the risk groups do not overlap significantly based on<br />
age (Rüütle 2008).<br />
Mental health<br />
According to data gathered by WHO, mental disorders are<br />
the most important cause of loss of healthy life years all<br />
over the world, constituting 37% of the burden of disease<br />
among adults (people aged 15 and older) (WHO, 2008).<br />
According to the WHO, 9% of West and South European<br />
adult men and 17% of adult women suffer from severe lifelong<br />
depression. Although depression is the most common<br />
cause of mental disorders among both women and<br />
men, the latter are characterized by a much more frequent<br />
use of addictive substances (alcohol and narcotics).<br />
During the past five years, there has been a constant<br />
increase in the number of mental and behavioural disorder<br />
cases in Estonia, especially among men (see Figure 2.4.8.).<br />
Figure 2.4.7. Tuberculosis incidence rate per 100,000 <strong>Estonian</strong><br />
residents in 1998–2006 (including home care cases)<br />
60<br />
50<br />
40<br />
30<br />
20<br />
1989<br />
First-time cases and<br />
recurrences<br />
First-time incidence<br />
Incl. repeated<br />
treatment cases<br />
1990<br />
1991<br />
1992<br />
1993<br />
1994<br />
1995<br />
1996<br />
1997<br />
Source: Health Protection Inspectorate<br />
Figure 2.4.8. Mental and behavioural disorders per<br />
100,000 residents in the case of women and men<br />
2200<br />
2100<br />
2000<br />
1900<br />
1800<br />
1700<br />
Men<br />
Women<br />
1998<br />
2000 2001 2002 2003 2005 2006 2007<br />
Source: Ministry of Social Affairs, 2007<br />
Among men, the most common mental problems are mental<br />
and behavioural disorders caused by the use of psychoactive<br />
substances (917 cases per 100,000 residents). The most<br />
frequent mental disorders in the case of women are stressrelated,<br />
neurotic, and somatoform disorders (871.4 cases<br />
per 100,000 residents) (Ministry of Social Affairs, 2007).<br />
Suicides are an important cause of premature death in<br />
Europe. In 2006, an average of 10.7 suicide-related deaths<br />
per 100,000 residents occurred in the European Union<br />
(Lithuania had the highest suicide-related mortality rate<br />
with 28.9 deaths per 100,000 residents, while Cyprus had<br />
the lowest rate with only 2.4 deaths per 100,000 residents)<br />
(WHO). In 2008, there were 18.4 suicide-related deaths<br />
per 100,000 residents in Estonia (30.9 deaths per 100,000<br />
residents among men and 7.7 deaths per 100,000 residents<br />
among women) (Statistics Estonia, 2008).<br />
Compared to adults, the use of addictive substances by<br />
young people has increased recently (for more on this subject,<br />
see the next subchapter). The most common mental<br />
disorders among children and young people are disorders<br />
related to psychological development, behavioural and<br />
emotional disorders originating from childhood (including<br />
communication disorders and fears), and stressrelated<br />
somatoform disorders (anxiety, adjustment disorders,<br />
mental retardation, etc.) (Saame, 2008).<br />
1999<br />
2000<br />
2001<br />
2002<br />
2003<br />
2004<br />
2005<br />
2006<br />
7<br />
Estonia is characterized by a concentrated HIV epidemic, where the percentage of injecting drug users infected with HIV is higher than 5%,<br />
but remains lower than 1% in the case of pregnant women (National Institute for Health <strong>Development</strong>, HIV-nakkus ja AIDS arvudes 2006).<br />
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