Abstract

In May 2004, ten countries joined the 15-member EU. EU-15 became EU-25. Estonian is one of the smallest countries in EU – its area forms 1.1% of the total area of EU-25 and the population forms 0.3% of the total EU-25 population. Estonia is characterized by steadily increasing gender differences in mortality (life expectancy 59 years for men, and 67 years for women) and by steadily decreasing birth rate as well by negative growth and by fertility rate below replacement level.

Estonia together with Latvia, Lithuania and Hungary belongs to the group of countries with low child and high adult (males aged 15–59 years) mortality.

Cardiovascular diseases are the most important cause of death (59%) and disease burden (17%). Injuries represent the second important cause of death (14%) and disease burden (22%) and malignant neoplasms account for 13% of death and 8.5% of the disease burden. The disorders related to excessive alcohol use are responsible for 2.8% of the disease burden and for 0.3% of all deaths – exceeding more than twofold the EU-15 average for this mortality group. There are 564 smoking-related deaths per 100 000 population each year in Estonia (EU-15 average 229). Drug users make up more than 16% of the population (EU-15 average 0.5%). HIV/AIDS is a serious problem in Estonia. Sixty-six new cases of HIV infection per 100 000 population were reported in 2002 (EU-15 average 4/100 000).

In the last decade the number of doctors has been continuously decreasing. There is also a shortage of nurses. The number of hospitals and hospital beds has been sharply reduced and the average length of hospital stay has been halved.

Most of the fundings for health care, 80% come from the public sources and out-of-pocket payment covers 20% of total expenditure on health. Total expenditure on health, 5.5% of GNP in Estonia, is the lowest in EU-25.