DEVELOPMENT

1.4
Health
Raul-Allan Kiivet
Changes and developments in the population’s health can
be illustrated using very different indicators, of which
each is informative in its own way. The indicators that
have been chosen for this chapter characterise the events
in Estonia from three viewpoints, in an attempt to answer
the following questions:
• How much, and based on what, is life expectancy in
Estonia increasing?
• How can the illness-related behaviour of the Estonian
population be changed, based on the example
of the use of prescription drugs?
• What is the future prognosis for the health indicators
of Estonian schoolchildren?
1.4.1
Life expectancy
In international comparisons, life expectancy, which is
based on mortality data, and is one of the three components
of the Human Development Index, is the indicator
most often used to assess the state of the population’s
health. Life expectancy shows, in years, how long a person
of a certain age will live if the current mortality rate
or the distribution of deaths based on gender and age
persists. For instance, in 2010, the average life expectancy
for men in Estonia was 70.6 years, i.e. a boy born in that
year would live that long if the mortality rate for the given
year did not change.
In the UN Human Development Reports, Estonia’s
persistent characteristic is the fact that its health indicators
lag significantly behind its general standard of living
and level of education; and Estonia was ranked between
80 th and 90 th place in the life expectancy rankings until
the beginning of the 21 st century. The people in all the
states wealthier than us, and also those in the 40 poorer
states lived longer than the people in Estonia.
During the last decade, life expectancy in Estonia
has increased dramatically, and, in 2010, achieved
an all-time record for both men and women. Between
2004 and 2010, the average life expectancy of women
increased by 3 years (from 77.8 to 80.8 years) and 4.2
years for men (from 66.4 years to 70.6 years). Life expectancy
increased because, during this time, the accidental
deaths, and deaths caused by other outside factors, of
young people were reduced significantly, along with the
deaths of middle-aged people from heart disease and
cardiovascular diseases.
Life expectancy can be calculated for every age
group, and as age increases, life expectancy, understandably,
decreases – in 2010, for 65-year-old men it was 14.2
years and 19.4 years for women, thereby lagging behind
the European average by 3.1 and 1.7 years, respectively.
In other words, although, if based on the adjusted life
expectancy at birth, Estonia continues to be among the
last five in the European Union, the prognosis for those
over 65 is as good as in the rest of Europe.
Comparing the gap between the life expectancies
in various age groups, we see that two-thirds of the
difference falls in the 20- to 65-year age group, and
reducing deaths among the young and middle-aged continues
to provide the greatest reserves for lengthening life
expectancy.
1.4.2
Living healthy during one’s
remaining years
Life expectancy, which is calculated on the basis of mortality
data, does not tell us anything about the health,
illnesses, or the health-related quality of life of the living.
The incidence of illness and the health-related quality of
life can be measured using many indicators, and this is
done from various points of view. However, since we are
interested in the question of whether a longer life (which
is definitely a value onto itself) is a full and healthy life,
the concept of living a healthy life (Aru 2012) can be of
help. This concept assesses both the duration of life, as
well as the health-related quality of life, and takes into
account the incidence of good and bad health in people
of various ages.
In this case, mortality statistics are derived from
data obtained by survey research, in which people of
various ages assess the state of their health, and the life
expectancy is multiplied by the percentage of healthy
people in the corresponding gender-age group. Since
health can be measured in several ways, the definitions
of a healthy life can also vary. The European Union’s official
statistics use a definition that is based on every-day
limitations, or the concept that living healthy means a
disability-free life expectancy.
A definition like this does not reflect people’s subjective
feelings about their health, but rather, their ability
to cope on their own and manage their own affairs. The
incidence of bad health in the population can be overestimated
if health-related limitations are used as an
excuse in situations where coping is actually hindered
by other factors, for instance socio-economic reasons.
Despite the possibilities for various interpretations, this
method is appropriate for compiling time-series data and
international comparisons.
Compared to the data for 2004, the number of
years of disability-free life for Estonian boys born in
2010 had increased by 4.1 years and by 4.4 years for
Estonian Human Development Report 2012/2013
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