DEVELOPMENT
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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