The Health Transition in Estonia: Breaking Away from the Soviet Legacy

Abstract

Estonia, with a total population of slightly more than 1.3 million in 2010, offers an interesting opportunity to investigate the health transition and its determinants. On one hand, Estonia has been among the forerunners of the demographic transition (Coale et al. 1979; Katus 1994). This implies that the so-called epidemiological transition follows the trends of that of Northern and Western Europe (Omran 1971; Caselli 1995). However, the occupation of Estonia by the Soviet Union, which began in the 1940s and lasted for almost 50 years, introduced other systems, one of which pertained to health care. Estonia was brought into this new system that aimed to tackle the challenges of the second and third stages of the epidemiological transition. These challenges had already been overcome by Estonia by the beginning of the occupation. The Soviet Union on the whole was still in the previously mentioned stages. Most of the measures introduced took into account the overall situation in which the diversity of the population was substantial. Therefore, the approach of this past regime and health policy ignored regional variations and was ill suited to the small population of Estonia. Estonia had by that time reached the threshold of the later phase of health transition, as defined by Vallin (2005). The impact of the Soviet health care system, vaunted as a means of conquering all diseases, suppressed any initiative on the part of the population itself and neglected preventive programs. Such programs as existed were mostly oriented toward combating infectious diseases rather than advocating for a healthy lifestyle and early detection (Hertrich and Meslé 1999; Meslé 2004; Cockerham et al. 2002). The results of this approach are clearly manifested in mortality stagnation, starting at the beginning of the 1960s and lasting for almost 40 years in Estonia (Katus and Puur 1997). The deterioration of health in Estonia during the economic transition in the early 1990s, after the restoration of independence, is the continuation of this long-term stagnation. Since the end of the 1990s life expectancy gradually increased and recent years’ findings support our conviction that Estonia is the first country to break away from the Soviet legacy of population health development. Opportunities and Challenges for Applied Demography in the 21st Century Opportunities and Challenges for Applied Demography in the 21st Century Look Inside Within this Chapter Introduction Background Data and Methods Methods Results Discussion and Conclusions References References Other actions Export citation About this Book Reprints and Permissions Add to Papers Share Share this content on Facebook Share this content on Twitter Share this content on LinkedIn