Estonian Human Development Report

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Arieh A., Conti C., Kutsar D., Nicghiolla Phadraig M., Warming Nielsen H. (eds). Children in Ageing Europe, COST A19, Vol 1, pp. 81–141. Trondheim: Norwegian Centre for Child Research. 8. Polandkese, A., Reinomägi, A. (2008) Vaesus ja sotsiaalne kaitse. Lapsed. [Poverty and Social Protection. Children], Tallinn: Statistics Estonia, pp. 20–38. 9. Reinomägi, A. (2008) Riiklikud peretoetused ja hüvitised. Sotsiaalvaldkonna arengud 2000–2006. Trendide kogumik. [National Family Support and Benefits. Developments in the Social Sphere in 2000–2006. A Collection of Trends], Series of the Ministry of Social Affairs 2/2008:33–38. 10. Strömpl, J., Selg, M., Soo, K., Šahverdov-Žarkovski, B. (2007) Eesti teismeliste vägivallatõlgendused. [Estonian Teenagers’ Interpretations of Violence], Series of the Ministry of Social Affairs 3/2007. 11. Tammur, A., Randoja, M. (2008) Laste kasvukeskkond. Lapsed. [Children’s Growing Environment. Children.], Tallinn: Statistics Estonia, pp. 11–19. 12. Tiit, Ene-Margit (2004). How much do Estonian children cost? An Empirical Study. Paper presented at NFRN workshop in Uppsala, 11-12 September 2004. 13. Tiit, E.-M. (2006). Vaesus ja selle mõõtmine. Vaesuse suundumused Eestis. [Poverty and How to Measure It. Poverty Trends in Estonia], Series of the Ministry of Social Affairs 8/2006. 14. Viira, K. (2005) Deprivatsiooni seos majandusliku seisundiga ning selle mõju lapse vaba aja tegevustele. [The Connection Between Deprivation and Economic Situation and the Effect of Deprivation on Children’s Recreational Activities], Bachelor’s thesis, supervisor D. Kutsar. Tartu: University of Tartu. Manuscript. 15. Võrk, A., Paulus, A. (2007) Peredele suunatud rahaliste toetuste mõju vaesuse leevendamisele Eestis: analüüs mikrosimulatsioonimeetodi abil. Uurimisraport. [Effect of Financial Support Directed at Families on Reducing Poverty in Estonia: Microsimulation Analysis. Study Report.] Tallinn: PRAXIS. 3.6. Quality of life of the elderly Introduction As of January 1, 2008, 230,469 people aged 65 and older lived in Estonia, making up 17.2% of the entire population. There were 17,899 very old people (85 and older) constituting 1.33% of the population. During the next decades, the percentage of very old people will grow, which makes the issues related to the quality of life of the elderly increasingly topical. Discussions about the quality of life of the elderly emphasize health-based quality of life and sometimes tend to equate it with quality of life in general. This approach is justified in evaluating the treatment of specific illnesses and discussing difficulties in coping with challenges arising from such illnesses, but it does not substitute the treatment of quality of life on a wider scale. As they become older, people usually experience several losses (related to health, partners, jobs, income, position, etc.) and the subjective quality of life of the elderly is dependent, to a large degree, on psychological reserves that allow people to cope with such losses. Thus, one of the keys to aging well is the skill to employ selectiveness, optimization and substitution as the means for coping with the challenges related to aging (Baltes & Baltes 1990). With regard to material well-being, Estonia’s elderly are largely dependent on solidarity-based social support as well as the availability of services and benefits, since current pensioners have had few opportunities to accumulate material resources for themselves. The following section provides a closer inspection of the relationship of the elderly with the labour market, their social activity and assistance, health evaluations and the need for care as factors influencing the quality of life of the elderly. Data have been gathered from five studies conducted in Estonia: the Study of Health and Coping of the Older Population of Estonia in 2000 (pan-Estonian random sample of 1000 respondents aged 65 and older, data on 811 individuals, i.e. 0.5% of the elderly population; study conducted by family physicians); the Study of Tartu Seniors in 2002 (random sample of 1000 people aged 50 and older living in Tartu, data received from 480 individuals, mail-in survey); the CareKeys study (Estonia, Finland, Germany, Sweden, the United Kingdom; a random sample of 150 persons receiving home care service and 150 people on institutional care from each country; data collected in 2005); the 2006–2007 nursing care audit (sample included all nursing care institutions in Estonia, N=41, with a random sample of 10 patients from each institution or all patients if the institution had less than 10 patients in nursing care; a total of 369 cases; a survey of patients and personnel and the researchers’ analysis of documentation). Employment and exit from the labour market Compared to other EU member states (Table 3.6.1.), Estonia, like the Nordic countries, has a relatively high level of employment among the older population. Employment is higher among women than men and the elderly prefer to work full time. This employment behaviour among the elderly surpasses the corresponding EU goal for 2010. A significant withdrawal from the labour market begins around the ages of 61–63 and as the older population’s willingness to stay in the labour market decreases sharply, 80% of the elderly have left the labour market by the age of 65 (Tiit et al. 2004). When people continue working after reaching retirement age, they are paid old-age pensions alongside their salaries. They are thus encouraged to remain active while aging and supported materially with regard to their quality of life. Many members of the older population would, however, prefer to use the “soft” strategy for exiting from the labour market, which would entail working part time or doing easier jobs before completely leaving the labour market (Tiit & Saks 2002; Saks et al. 2000). Social activity and informal support networks of the elderly According to the Estonian Study of the Elderly, the social activity of people over 65 is relatively small. Only 15% of the elderly said that they participate in events organized in their neighbourhoods, while about a half of the respondents stated that the reason for their lack of participation is their bad state of health, and one fifth of the respondents said that they lacked interest in the events. For the most part, the communication and hobby activities of the elderly tend to be individual, mainly comprising watching television, listening to the radio, reading books (including visiting libraries), going to the theatre and concerts. Approximately 15% of the members of the elderly population are regular visi- | 74
tors of day centres for the elderly and 14% visit the day centres sparsely, with older people living in rural areas being more active in this regard than those living in cities (Tiit & Saks, 2002; Saks et al., 2002). Nearly a quarter of the elderly population participate in church-related activities. A fifth of the respondents reported that they would like to participate in joint events or church life but are unable to do so. At the same time, over a fifth of the elderly population were not at all interested in taking part in joint activities. It is probable that one cause of the low social activity of the elderly is the shortage of opportunities aimed at their age group. A third of the respondents, however, complained about the lack of relevant information and a quarter reported that they do not care about participating in events outside their home. According to the European Social Survey (2004), people’s activeness in communicating with friends, relatives and colleagues decreases as they become older and friendship-based communication is replaced with communication based on care-related needs. Compared to men, women’s communication activeness diminishes at a slower rate because they are also more active in providing non-financial assistance (e.g. helping friends, neighbours, children, etc.) and accepting assistance when they are left alone, while men receive informal assistance primarily from their spouse/ partner and report being left without assistance more often than women when living alone. Consequently, elderly men’s quality of life is more dependent on resources within the household, while women tend to be more efficient in combining these with resources available outside the household. Health People’s functional abilities decrease in old age, but it is the increasing frequency of health problems that cause health to be the primary factor affecting elderly people’s quality of life. One of the most informative indicators for characterizing the state of health of adults is people’s own assessment of their health. The percentage of people who rated their health as good or very good is 3.5–3.9 times higher in Estonia than that of people who rated their health as bad or very bad (Figure 3.6.1.). The average proportion in the EU was as high as 6.1 (National Health Interview Surveys 2004; Health status…, EU-SILC online). In older age groups, the difference between good and bad health ratings decreases both in Estonia and other EU countries. In Estonia, the number of people with self-perceived bad health surpasses the number of people with good health already before the age of 65, while in the EU, this tendency is apparent only after the age of 75. It can be concluded that the state of health of the elderly worsens much more quickly in Estonia than in the EU on average, thus creating a situation where health is a significant negative influence on the quality of life of the elderly. Satisfaction with various aspects of quality of life Studies of the satisfaction and subjective well-being of the elderly have shown that these indicators rely largely on the health of the respondents and their coping capacities, as well as the availability of health care and nursing care services (Bowling & Gabriel 2007). Studies of the elderly conducted in Estonia revealed that more than two thirds of people aged 65 and older were generally satisfied with their lives. Approximately half of the elderly respondents rated Table 3.6.1. Employment rates in EU member states and candidate countries, 2002 (%) Employment rate (15–64) Women’s (15– 64) employment rate Source: Eurostat, Statistics Estonia (Tiit et al. 2004). Employment rate of the older workforce (55–64) Belgium 59.9 51.4 26.6 Denmark 75.9 71.7 57.9 Germany 65.3 58.8 38.6 Greece 56.7 42.5 39.7 Spain 58.4 44.1 39.7 France 63.0 56.7 34.8 Ireland 65.3 55.4 48.1 Italy 55.5 42.0 28.9 Luxembourg 63.7 51.6 28.3 The Netherlands 74.4 66.2 42.3 Austria 69.3 63.1 30.0 Portugal 68.2 60.8 50.9 Finland 68.1 66.2 47.8 Sweden 73.6 72.2 68.0 United Kingdom 71.7 65.3 53.5 EU 15 64.3 55.6 40.1 Cyprus 68.6 59.1 49.4 Czech Republic 65.4 57.0 40.8 Hungary 56.6 50.0 26.6 Lithuania 59.9 57.2 41.6 Latvia 60.4 56.8 41.7 Malta 54.5 33.6 30.3 Poland 51.5 46.2 26.1 Slovenia 63.4 58.6 24.5 Slovakia 56.8 51.4 22.8 Estonia 2002 61.7 57.8 51.5 Estonia 2003 62.6 58.8 52.1 the EU goal for 2010 70 More than 60 50 Figure 3.6.1. Health self-assessment by age groups in Estonia and the EU, 2004 and 2006 70 60 50 40 30 20 10 0 EE 2004 EE 2006 EU 2006 Very good/good Very bad/bad EE EE EU 65–74 65–74 65–74 2004 2006 2006 EE EE EU 75–84 75–84 75–84 2004 2006 2006 EE EU 85+ 85+ 2006 2006 Source: National Health Interview Surveys 2004; Health status…, EU-SILC online; Saks et al. 2000; Tiit & Saks 2002). their ability to cope economically as satisfactory or good. A large segment of the elderly were satisfied or relatively satisfied with their dwelling and the surrounding area, while a tenth of the respondents reported dissatisfaction with these spheres of life. Only a small part of this target group evaluated the work local governments do with the elderly as good (11–13%), a large percentage of respondents had no opinion on it, and the percentage of respondents who were dis- 75 |
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Estonian Human Development Report
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Estonian Human Development Report T
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4.2. Ethnic differentiations in sat
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Preface This year, the Estonian Hum
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CHAPTER 1 Estonian Human Developmen
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Figure 1.1.3. Life expectancy in co
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Figure 1.2.2. Life expectancy at bi
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to reality. The greatest inaccuracy
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Figure 1.2.9. Internal migration ev
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12. Marksoo, A. 1992. “Dynamics o
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Table 1.3.1. PISA 2006 study result
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Page 30 and 31: Figure 1.4.3. Estonian GDP (right a
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Page 40 and 41: Figure 2.4.4. Various accidents, tr
Page 42 and 43: 2.5. Lifestyle and behaviour as a s
Page 44 and 45: Figure 2.5.5. Smoking in Estonia in
Page 46 and 47: Figure 2.6.1. Overview of the compo
Page 48 and 49: Table 2.6.2. Use of specialized med
Page 50 and 51: dren. The majority of services are
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Page 56 and 57: CHAPTER 3 Quality of life and life
Page 58 and 59: Table 3.2.1. Characteristics of liv
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Page 62 and 63: Figure 3.2.4. Difference in the job
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Page 68 and 69: Figure 3.3.4. Percentage of people
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Page 72 and 73: Figure 3.5.1. Percentage of teenage
Page 74 and 75: Figure 3.5.4. Percentage of respond
Page 78 and 79: Figure 3.6.2. Subjective quality of
Page 80 and 81: Pieper, A. Sixsmith, Care related q
Page 82 and 83: Figure 3.7.1. The placement of Euro
Page 84 and 85: Figure 4.2.1. Life satisfaction by
Page 86 and 87: Table 4.2.1. Factors forming genera
Page 88 and 89: Annexes Annex 4.2.1. Socio-demograp
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Page 92 and 93: Figure 4.3.4. Attitudes of the Esto
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Page 104 and 105: CHAPTER 5 Quality of life in a cons
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Page 108 and 109: Figure 5.2.3. Distribution of consu
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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 H
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Honorable mentions Estonian Human D
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Estonian Human Development Report P
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Estonian Human Development Report A
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