Inequalities in health need to be addressed, the Minister of Social Affairs said, after the results of a study showed Estonia has some of the largest gaps between socioeconomic groups in the European Union.
The health of Estonian people is dependent on gender, education, income and place of residence, the "On the state of health in the European Union" report by the European Commission, OECD and the European Observatory on Health Systems and Policies found. The study compiled health profiles for all countries in 2019.
The report starts by saying: "Life expectancy since 2000 has increased more in Estonia than in any other EU country. The health status of Estonian people is now nearing the EU average, mainly due to fewer deaths from ischaemic heart disease and stroke." The increase in life expectancy was more than seven years from 71.1 to 78.4 years.
But, the results also showed there is a large gap between life expectancy rates for women and men which also vary by region, level of education and income. For example, women are expected to live nine years longer than men while the EU average is 5.2 years longer. A person living in Tartu County is predicted to live 4.5 years longer than a person living in Ida-Viru County.
"About half of deaths" in Estonia are attributed to risk factors, such as smoking, drinking, unhealthy diets and a lack of exercise. The European Union average is 39 percent.
In Estonia, 10 percent of deaths are attributed to alcohol compared to the EU average of 6 percent. Diet is related to 26 percent compared to the EU average of 18 percent. Smoking-related deaths are slightly below the EU average of 17 percent, at 15 percent in Estonia.
The feeling of not being able to access services, "unmet needs", is the highest in the EU. In Estonia 11.8 percent of people feel their health needs are not being treated compared with an average of 1.7 percent in the EU. The main reason for this is long waiting lists.
Estonia spends €1,559 per person on health care, which is nearly half the EU average of €2,884. At the same time, people contribute 23.6 percent of the total cost of health care, while the EU average is 15.8 percent. A large part of the population is also permanently uninsured in Estonia, while health insurance is universal in most EU countries, the survey shows.
Minister of Social Affairs Tanel Kiik said Estonia has achieved relatively good health outcomes with relatively low health care costs: several health indicators have improved and life expectancy has increased in more than any other EU country.
"But inequalities in health by gender, income, education and regions are a major problem. For example, men who have basic education have a life expectancy of 8.5 years less than the average men with higher education," he said.
In order to achieve better health outcomes, Kiik said, inequalities need to be addressed. "In order to increase people's average life expectancy, we need to focus on the most vulnerable groups and help those who are in a worse position."
The proportion of people who value their own health in Estonia is one of the lowest in Europe and there are big differences in the assessments of low and high income people. In total, 53 percent of people rate their health as good, while 65 percent is the average in the EU.
The report also showed the HIV rate in Estonia is three times higher than the EU average. "Although the number of new HIV cases has decreased over the past decade, the epidemic is not yet under control," the report says.
Head of the European Commission Representation in Estonia Keit Kasemets said the health profiles are a valuable source of data, know-how and best practices for the Commission, which will hopefully contribute to national policy-making and EU cooperation.
"One of the biggest threats to public health across Europe is the hesitancy of people to vaccinate. Access to healthcare is also still a problem everywhere," said Kasemets. He said there are promising examples across the EU of changing roles for health professionals, particularly regarding the role of nurses and pharmacists.
"Digital solutions also provide opportunities for health promotion, provided that the digital transition does not exclude those with less access to technology or digital literacy. Many of these problems are relevant to Estonia as well," he said.
Editor: Helen Wright