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1.2.4<br />

Mortality<br />

In regard to the second major component of population<br />

replacement – mortality – the period since 1960 can<br />

also be divided into several distinctive stages. However,<br />

compared to fertility, Estonia’s position on the population<br />

map of Europe has changed to a lesser extent during<br />

this period. Figure 1.2.3 presents the mortality trends<br />

by means of life expectancy at birth, which, similarly to<br />

the number of expected children (the total fertility rate),<br />

condenses the characteristics of the process into a single<br />

measure that summarises the mortality pattern for each<br />

calendar year.<br />

By the late 1950s, Estonia had recovered from<br />

a crisis that, in the mid-1940s, temporarily shot the<br />

mortality rates back to the post-World War I level (Mertelsmann<br />

2011). By 1960, life expectancy for men had<br />

reached 64.7, and 73 years for women, which ensured<br />

a fairly good position for Estonia in international comparisons.<br />

The life expectancy of Estonian women was<br />

comparable to the Western European average at the<br />

time, while for the men, who had suffered greatly in the<br />

course of the war and the repressions, life expectancy<br />

lagged three to five years behind Northern and Western<br />

Europe. Unfortunately, life expectancy in Estonia<br />

only increased in the short term. After the middle of<br />

the 1960s, life expectancy stagnated throughout Eastern<br />

Europe. This can be seen as evidence of the limited<br />

developmental potential of the social model and health<br />

care systems in the state socialist countries (Coleman<br />

2006). As revealed by Figure 1.2.3, , stagnation in life<br />

expectancy was somewhat more pronounced in Estonia<br />

than in the Eastern Europe on average.<br />

In the 1970s, a new stage in the increase of life<br />

expectancy arrived in the countries behind the Iron<br />

Curtain, which was primarily driven by the retreat of<br />

cardiovascular mortality (Vallin, Meslé 2005). As a result<br />

of divergent trends, by the end of the 1980s, in Europe,<br />

an extensive health gap had developed between the East<br />

and the West, which takes several decades to reduce.<br />

Unlike the fertility trends, which were generally similar<br />

across Eastern Europe in the 1990s, mortality trends<br />

diverged after the change of societal regime. In Poland,<br />

Slovakia, Slovenia and the Czech Republic, soon after<br />

the social changes, life expectancy started to increase,<br />

but in the former republics of the Soviet Union, the economic<br />

and social upheaval was first accompanied by a<br />

noticeable decrease in life expectancy. In some countries<br />

(e.g. Bulgaria and Hungary), the situation in the early<br />

1990s was characterised by a continued stagnation in<br />

life expectancy.<br />

In this period, Estonia stands out with its large<br />

fluctuations in the mortality indicators. The life expectancy<br />

decreased markedly, and by 1994, it had fallen to<br />

60.5 years for men, and 72.7 years for women. Against<br />

the background of the Central European transition<br />

countries, such an extensive reduction attests to both<br />

the tempo of the social and economic changes, and the<br />

difficulty of adapting to new realities; this especially<br />

affected working-age men. However, after the initial<br />

crisis, since the second half of the 1990s, life expectancy<br />

has increased vigorously, and in 2011, reached<br />

71.2 years for men, and 81.8 for women (for Estonians<br />

72.4 and 81.8 respectively). The main engines for<br />

this positive development have been the reduction in<br />

mortality due to cardiovascular diseases, and external<br />

causes (accidents, homicides, and suicides). The<br />

research results suggest that the observed change is not<br />

merely quantitative, but signals the entry into a new<br />

stage marked by a systematic reduction of deaths due<br />

to cardiovascular and anthropogenic causes (Jasilionis,<br />

et. al. 2011).<br />

As a result of the trends since the middle of the<br />

1990s, the improvement in the position of Estonian<br />

women in international comparisons has been particularly<br />

visible. Among the EU’s eastern Member Countries,<br />

only in Slovenia is the average life expectancy for women<br />

longer than in Estonia, and the life expectancy of Estonian<br />

women only lags two years behind the average for<br />

women in Northern and Western Europe. Although, since<br />

the middle of the 1990s, the life expectancy for Estonian<br />

men have increased even more, the Estonian men had<br />

not yet caught up the average for Eastern Europe in 2011.<br />

The continued large, 6- to 7-year gap with other regions<br />

of Europe alludes to fact that the reduction male mortality<br />

constitutes a major reserve that would enable Estonia to<br />

considerably improve its position in international human<br />

development.<br />

Joonis 1.2.4<br />

Net migration. Estonia and the European regions<br />

1960–2011<br />

Net migration, per thousand<br />

Estonia Western Europe Eastern Europe<br />

Northern Europe Southern Europe<br />

8<br />

6<br />

4<br />

2<br />

0<br />

-2<br />

-4<br />

-6<br />

-8<br />

-10<br />

-12<br />

-14<br />

-16<br />

1960<br />

1965<br />

1970<br />

1975<br />

1980<br />

1985<br />

1990<br />

1995<br />

2000<br />

2005<br />

2010<br />

20<br />

Estonian Human Development Report 2012/2013

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