Estonian Human Development Report

A comparison with Finland shows that while the
Estonian mortality coefficient (in the 15–64 age group)
in 2000 was 641 (per 100,000 residents), the corresponding
Finnish coefficient was 307 (WHO DMDB 2009). In
the case of a 1.5% yearly decrease in adult mortality, it
would take Estonia 49 years to reach the level Finland had
attained by 2000. If our mortality rates dropped 3% on a
2.9. Summary
In 2006, Estonia ranked 93 rd in the world in terms of
life expectancy, with people in only 86 countries living
shorter lives than us. However, during the first years of the
21 st century, life expectancy in Estonia has increased very
quickly and the life expectancy of men and women has
grown by 2.6 and 4.1 years, respectively (Statistics Estonia).
This means that the increase in life expectancy has
been quicker than at any time during the last half century
and that Estonians live longer today than ever before.
A stagnation trend began in the life expectancy of the
populations of the entire Soviet Union, and also in all of
the other so-called socialist Eastern European countries
around the 1960s. Estonia was no exception. As a result,
in forty years the life expectancy of men has not changed
at all and the life expectancy of women has grown by only
two years (Katus 2009). In the 1960s, Estonian and Finnish
women had the same life expectancy, while our men’s
life expectancy was one year less than that of the men living
in what was one of the most backward Nordic countries
at the time. The difference has constantly increased
ever since (see Caselli 1995, Katus 2009).
In Estonia, the average life expectancy of 1980 was
surpassed only in 1996. We have worked hard to reach the
level that Europe’s wealthiest countries were at 20 years
ago and despite our great spurt during the past five years,
the other countries have kept increasing their lead over
Estonia throughout the time following our restoration of
independence. The development in women’s health has
been more stable; the difference between the life expectancy
of Estonian and Finnish women was nearly 5 years
in 2006. In the case of men, however, the difference was
already 9 years (WHO 2009). Why is that?
Overall, the shortness of Estonia’s average life expectancy
can be attributed to both the self-destructive health
behaviour of the population along with the environment
and values that promote such behaviour as well as the inefficient
health system that has not been capable of implementing
measures that improve health with the necessary
speed (Nolte & McKee 2004).
Empirical studies indicate that the good state of health
of a population is not only a natural by-product of economic
growth, but that the health of the population also
affects economic development. With an aim of a yearly 3%
decrease in mortality, we could reach Finland’s current
level by 2025 and the GDP per person could potentially
increase by 30% compared to a scenario where the mortality
rate remains at its present level (Suhrcke et al. 2006).
There is potential for the development of public health
in both the improvement of health behaviour as well as
the more extensive and effective operation of the health
system. While relatively good results have been achieved
yearly basis, we would reach Finland’s level by 2025. Figure
2.8.3. indicates, among other things, that the growth
of GDP per person halts or may be replaced with a downward
trend if Estonia’s adult mortality rate remains at
its current high level (the constant mortality scenario).
Thus, economic growth cannot last if the health of the
population does not keep up with economic success.
in improving the healthiness of the population’s diet, taking
into account our latitudinal position and purchasing
power, the rate of engagement in movement activities of
Estonian residents is still as insufficient as it was at the
beginning of the 1990s, despite the significant improvement
in opportunities. Moreover, risk behaviour, especially
among working age men, has not changed considerably,
as alcohol use is constantly growing and the
reduction in smoking is slow.
Estonia’s relative backwardness in comparison with
other European countries is smallest in the case of children’s
and young people’s health. It is true that Estonian
youth cannot be set up as an example for their health behaviour,
but during the last couple of years their rationality has
increased with regard to several aspects and there have been
changes for the better. Examples of such improvements
include the decrease in risky sexual behaviour and even a
halt in the increase of alcohol and tobacco use. However,
compared to other countries, Estonian children’s problems
include early experimentation with addictive substances
and more frequent cases of alcohol-induced intoxication.
Health behaviour can be affected directly through the
provision of relevant information and the creation of a
favourable environment. This also applies in the case of
Estonia. Practical examples include the improvement of
people’s diet through the increase in the availability of
vegetable cooking oil and fresh fruits and vegetables since
the 1990s, but also the improvement in the sexual practices
of young people as well as the changes in attitudes
towards smoking among both Estonia’s youth and adults.
In addition, regardless of the unjustifiably fast spread of
HIV, the occurrence of an epidemic among the general
public has been so far successfully avoided. According to
the latest analyses, this can be associated with the prevention
measures implemented (Drew et al. 2008).
There still exist considerable inequalities in Estonia
between men and women, between Estonia’s different
regions and between different ethnic groups or groups
based on income and education. Women’s mortality indicators
are still improving faster than those of men in all age
groups (Statistics Estonia 2009). The average life expectancy
of ethnic Estonian men is comparable to the European
average in the 1970s, while the life expectancy of non-
Estonian men is three years lower and thus comparable to
the average of the rest of the Europe in the 1950s (Sakkeus
2007). People with lower incomes and those who are ill
more frequently contribute more of their own resources to
health care (Habicht et al. 2006) and specialized medical
care is not equally available. In addition, there are manifold
differences between the use of, for example, hospital
care in different regions (Kunst et al. 2002).
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