Estonian Human Development Report

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2.10. Policy recommendations aimed at improving quality of life related to the health of the Estonian population An important key to developing people’s health and improving it, if necessary, is their own behaviour. However, health-related quality of life can also be improved by creating favourable conditions for making healthy choices and by adding capital through involving responsible private enterprises. A good example of this, in addition to constructing sports facilities, is simply creating the conditions for physical movement in the form of light traffic roads, well-lit paths, parks, etc. It is very important to support the physical environment with active publicity and the activation of business and social organizations. Estonia has a number of good examples that should be presented to a wider public. This would allow us to achieve the desired results more quickly through learning from each other and engaging in cooperation. The best level for merging various fields and interests is the community which, in many cases, can mean the local government, the village or the city district. An important achievement that should be reinforced is the creation of local health networks between various parties who wish to coordinate their activities in a health-conscious manner. The propensity of people to emulate life around them makes leadership and the creation of examples very important. At the national level, for example, much has been achieved with the technically simple but ethically multifaceted decision to limit smoking in public spaces, which is supported by the overwhelming majority of residents and most smokers themselves. In addition to the changes in the physical environment, such decisions send important signals that help people make voluntary changes in their behaviour. Fighting against the use of tobacco is also a good example of international cooperation supported by the WHO Framework Convention on Tobacco Control. Dealing with the HIV epidemic will continue to be a topical issue in Estonia. On the one hand, increasingly more attention must be devoted to patients who have reached the AIDS phase, meaning an increase in the treatment burden, but also the necessity of increasing our ethical level to attain the capacity for unbiased relations with fellow-Estonians diagnosed with this disease. Since Estonia continues to be the European country with the fastest growing HIV infection rate, preventive activities must be continued as strongly or even more forcefully than before in order to ensure that the positive trend achieved in recent years persists. Among other preventive measures, the efforts of the local governments in Tallinn and Ida-Viru County in solving the health problem specific to them deserve recognition and encouragement as well as to be set up as an example for other local governments. Health services paid for by public funds in order to improve people’s quality of life should be universally and freely available to all members of the target group, not only those who are most accessible. This should be especially closely monitored in the case of people who are worse off economically, since poorer members of the society may have very many risks competing with their health-related choices. In this case, the professional approach means finding solutions aimed at specific target groups rather than the middle ground. This type of judicious policy requires a significant investment in analysis focusing on everything from the causes to the effects. Previous economic recessions have shown that Estonian residents are very sensitive to changes in the economic environment and that it is usually the most vulnerable social groups that are in danger of deterioration in their state of health. In order to guarantee the successful and sustainable development of society it would be important to guarantee basic first contact medical care to the entire population, regardless of their social status (including their insurance status). Taking into account the particularities of the funding of the Estonian health care system and its reliance on just half of the population, compensatory measures should be implemented. Additional funding could be gained through a more equitable distribution of the burden of financing as well as through increasing the range of options in areas where the interests of less capable members of the society would not be hurt, thus guaranteeing a wide basic service coverage. In relation to the suggestions above, it is very important to ensure that the financial risk involved in using the services does not increase, as this has been a growing danger in Estonia during recent years. In addition to the monitoring of contribution sizes, successful risk management also requires us to guarantee the deliberate interaction of various policies. In an economically difficult context, residential policies, transport, education and tax policies as well as regional policies can be used to increase the health and life expectancy of the population. In any case, analyses indicate that investment in health is profitable. References 1. Aaviksoo et al. (2007). Rinnavähi varajase avastamise projekt aastateks 2002–2006. Tallinn: PRAXIS Center for Policy Studies. 2. Aaviksoo A, Paat G. (2007). Tervishoiuteenuste kättesaadavus . Sotsiaaltrendid 4/2007, Statistics Estonia. 3. Aaviksoo et al. (2008). Noorte reproduktiivtervisealane nõustamine ja sugulisel teel. Tallinn: PRAXIS Center for Policy Studies. 4. Abdel R. Omran The Epidemiologic Transition: A Theory of the Epidemiology of Population Change The Milbank Memorial Fund Quarterly, Vol. 49, No. 4, Part 1 (Oct., 1971), pp. 509–538 5. Arvisto M, Noormets J, Paju K, Piisang M, Roosalu M. (2004). Noorte spordiharrastuse struktuur ja arenguvõimalused, Estonian Sports Information Centre. | 52
6. Caselli Graziella (1995). The key phases of the European health transition. Polish Population Review, No. 7, pp. 107–125. 7. CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. 8. Drew et al. (2008). EVALUATION OF FIGHTING HIV/AIDS IN ESTONIA. World Health Organization. 9. Drew R, Donoghoe M, Koppel A, Laukamm-Josten U, Politi P, Rotberga S, Sarang A, Stöver H. Evaluation of Fighting HIV/AIDS in Estonia, World Health Organization 2008. 10. Estonian Institute of Economic Research. (2008). Alcohol market, consumption and harms in Estonia. Yearbook 2008, Estonian Institute of Economic Research. 11. Esmatasandi arengukava. (2008). Esmatasandi tervishoiu arengukava aastateks 2009–2015. Tallinn: Ministry of Social Affairs. 12. ESPAD. (2008). KOOLINOORED JA UIMASTID: 15–16-aastaste õpilaste legaalsete ja illegaalsete narkootikumide tarvitamine Eestis. Tallinn: TLÜ Kirjastus. 13. Estonian Health Insurance Fund. (2008). PATSIENTIDE HIN- NANGUD TERVISELE JA ARSTIABILE. Tallinn: Estonian Health Insurance Fund. 14. EU Common Principles. (2006) Council Conclusions on Common values and principles in European Union Health Systems (2006/C 146/01) 15. European Commission and Parliament (2004). Building our common Future: Policy challenges and Budgetary means of the Enlarged Union 2007–2013. Communication from the commission to the council and the European parliament. COM (2004). 16. Eurostat. (2008). Retrieved 01 12, 2009, from http://epp.eurostat.ec.europa.eu/portal/page?_pageid=1090,30070682,1090_ 33076576&_dad=portal&_schema=PORTAL 17. Farrington et al. (2006). to evaluate the Estonian National Strategy for the Prevention of Cardiovascular Diseases 2005–2020. World Health Organization. 18. Habicht J, Xu K, Couffinhal A, Kutzin J. Detecting changes in financial protection: creating evidence for policy in Estonia. Health Policy and Planning (2006); 21 (6): 421–31 19. Habicht J, Lai T, Aaviksoo A. (2008). Ebavõrduses tervises – lahendamata väljakutse. Sotsiaaltrendid 3/2008. Statistics Estonia. 20. HBSC. (2005/2006). Inequalities in young people’s health. Health policy for children and adolescents. no. 5. 21. HDR. (2007/2008). Human development reports . Retrieved 01 06, 2009, from 21. http://hdr.undp.org/en/ 22. HealthGap. (2008). Closing the health gap in European Union. HEM-Closing the Gap. 23. Health Protection Inspectorate. (2008). Nakkushaigused. Retrieved 01 08, 2009, from www.tervisekaitse.ee 24. HEW. (2008). US Department of Health Education and Welfare. Retrieved 01 12, 2009, from http://flagspot.net/flags/us_hew.html 25. Kaasik et al . (2008). Eesti vigastuste ennetamise strateegia alusdokument. Tallinn: PRAXIS Center for Policy Studies. 26. Katus, Kalev (2009). Data on population mortality in the Baltic countries. Vallin, Jacques; Hertrich, Veronique; Jasilionis, Domantas; Katus, Kalev; Krumins, Juris; Mesle, France; Shkolnikov, Vladimir; Stankuniene, Vlada. (Eds) Mortality and the causes of death in the Baltic States. Paris, INED (to be published in 2009). 27. Klaster (2008). Hinnangud tubakaseaduse mõjule. National Institute for Health Development / Klaster, Tartu 2008 28. Kunst, A. H. (2002). Social inequalities in health in Estonia. Tallinn. 29. Kunst A, Leinsalu M, Kasmel A, Habicht J. Social inequalities in health in Estonia. Main report. Tallinn: Estonian Ministry of Social Affairs; 2002. 30. Lai T, K. R. (2004). Haiguskoormuse tõttu kaotatud eluaastad Eestis: seosed riskifaktoritega ja riskide vähendamise kulutõhusus. Ministry of Social Affairs, University of Tartu. 31. Lõhmus & Trummal. (2007). HIV-i TEMAATIKAGA SEOTUD TEADMISED, HOIAKUD JA KÄITUMINE EESTI NOORTE HULGAS. Tallinn: National Institute for Health Development. 32. Mackenbach J, Bakker M (eds). Reducing inequalities in health: a European perspective. London: Routledge, 2002 33. Ministry of Social Affairs. (2007). Health statistics. www.sm.ee. 34. National Institute for Health Development. (2004). Riiklik tuberkuloosiprogramm aastateks 2004–2007. Tallinn: National Institute for Health Development. 35. Nolte E, McKee M. (2004). Does health care save lives? Avoidable mortality revisited. The Nuffield Trust 2004 36. Public Health Development Plan. (2008). Public Health Development Plan. Tallinn: Minsitry of Social Affairs. 37. Raudsepp L, Veskimets E. Võsaste A, Kaljurand A (2008). Kehalise kasvatuse õpetamise tingimused ja olukord Eesti koolides. Estonian Sports Information Centre 2008. 38. Rüütel, K. (2008). HIV, AIDS ja seotud nakkused arvudes. Seisuga 31. detsember 2007. aasta. Tallinn: National Institute for Health Development. 39. Saame, I. (2008). Laste ja noorte tervis 2003–2008. Valdkonna arengud. Tallinn: Ministry of Social Affairs. 40. Sakkeus, L. (2007). Rahvastiku areng sidusrühmade kaudu. A. Purju (ed.) Sotsiaaltrendid 4, (11–38). Tallinn: Statistics Estonia. 41. Sakkeus L. (2009). Eesti rahvastiku tervise areng. To be published in 2009. 42. Statistics Estonia. (2008). Statistics Estonia database. Retrieved 01 03, 2009, from www.stat.ee 43. Statistics Estonia. (2009). Statistics database. (12.01.2009) www. stat.ee 44. Suhrcke M, Võrk A, Mazzuco S. The Economic Consequences of Ill-health in Estonia. WHO Regional Office for Europe, Ministry of Social Affairs of Estonia, PRAXIS Center for Policy Studies. Tallinn, May, 2006. 45. Tallinn Charter. (25–27 June 2008). The Tallinn Charter: Health Systems for Health and Wealth. Tallinn: WHO European Ministerial Conference on Health Systems. 46. Tekkel M, Veideman T, Rahu M. (2007) Eesti täiskasvanud rahvastiku tervisekäitumise uuring, National Institute for Health Development, 2007 47. UNAIDS. (2008). 2008 Report on the global AIDS epidemic. XVII International AIDS Conference held in Mexico City August 2008. 48. UNAIDS (2008), 2008 Report on the global AIDS epidemic http:// www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp (12.01.2009). 49. Vallin J. (2005). Diseases, deaths and life expectancy. Genus, vol. LXI (Nos. 3–4), 279–296 50. Vallin, J., Meslé F. (2005). Convergences and divergences: an analytical framework of national and sub-national trends in life expectancy. A new approach to health transition. Genus, LXI (No.1), 83–124. 51. Vals K, Lai T. (2005). Rahvastiku tervisekaotus ehk haiguskoormus: hindamise metoodika. Eesti Arst , 84 (7): 473–480. 52. Whitehead M. The concepts and principles of equality and health. Copenhagen: World Health Organization, 1990 53. WHO (2002), World Health Report 2002, World Health Organisation 54. WHO. (2007). Boundaries of the health system. Retrieved 01 08, 2009, from http://www.euro.who.int/healthsystems/20070323_2 55. WHO. (2008). The global burden of disease: 2004 update. World Health Organization . 56. WHO/EURO Health for All Database; http://www.euro.who.int/ HFADB (12.01.2009) 53 |
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Estonian Human Development Report
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Page 9: Preface This year, the Estonian Hum
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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 T
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Honorable mentions Estonian Human D
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Estonian Human Development Report A
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Estonian Human Development Report T
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