The Republic of Estonia is a democratic parliamentary state in the Baltic region of Northern Europe. With a population of approximately 1.3 million inhabitants it is one of the least populous members of the European Union of which it became a member in 2004. The economy, is the 58th fastest growing in 2017, is driven by engineering, food products, metals, chemicals, and wood products.
Since declaring independence in 1991 Estonia has undergone significant political and social reform. Healthcare in Estonia is supervised by the Ministry of Social Affairs and is primarily funded through general taxation. Discussions on health inequalities began in the late 1990s and in 2000 the World Bank Expert Commission requested the Estonian Ministry of Social Affairs to conduct a study on inequalities as a prerequisite for an official loan. The study resulted in the report “Social Inequalities in Health in Estonia” which triggered further studies and discussions in this area. As a result, local NGOs became involved and were able to build momentum behind this issue. Although there is no single explicit policy document relating to health inequalities, there are several epidemiological studies as well as national actions aimed at tackling the issue.
Estonia has the EU’s greatest inequalities in self-reported health status by income. The disparity is evidenced by
marked inequalities in the prevalence of chronic conditions by education level. As people with the lowest level are almost 50% more likely to live with asthma or other chronic respiratory diseases, and 40% more likely to live with hypertension, than those with the highest level of education.
Health inequalities are high on the political agenda in Estonia, with the current national health plan explicitly describing the need to tackle social inequalities. There are also a number of policy responses that implicitly address the issue. Cross – sector collaborations at a national level are often the starting point for action with the message then being convened to the lower level authorities. The Estonian government is also working together on health equity issues with international organizations, such as the WHO, to establish and define targeted approaches that tackle inequalities. There have been government efforts to tackle risk behaviours through increased excise taxes on alcohol and cigarettes (2006–17) and through the introduction of a smoking ban in public spaces, public transport and workplaces (2007) as well as the introduction of picture warnings on tobacco products (2016) and a ban on smoking areas in buildings (2017). However, more needs to be done to reach certain vulnerable groups such as men with lower levels of education.
An overview of policy responses addressing health inequalities in can be found in our Policy Database.
An overview of projects and initiatives that are currently taking place or that have successfully been finalized, and that are addressing health inequality issues, can be found in our Project Database.
Please find below an overview of key actors in Estonia working on health inequality issues:
- Tervise Arengu Instituut – (National Institute for Health Development (NIHD)). The mission of NIHD is the consistent promotion of the health of the Estonian population and the permanent rise of the quality of life through the knowledge-based development and applied research activities.
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Please find below an overview of relevant documents addressing health inequality issues in Estonia. Further publications can be found in our Publications Database.
- National Strategic Reference Framework 2007–2013. The main objective of the document is to provide the planning and administrative framework for the implementation of the EU Structural Funds in Estonia. The document presents the strategy, the priorities, the financing and implementation plans for the EU Structural Funds. In terms of R&D and knowledge development, the NSRF states 2 major priorities: 1- Educated and active people; and 2-increase in the R&D capacity, the innovativeness and the productivity of the enterprises.
- Tackling health inequalities together with labour sector
- National Seminar on Health Inequalities (2007)
- National Strategy Reports on Social Protection and Social Inclusion 2008-2010
- Introduction of picture warnings on tobacco products (2016)
Are you aware of any other key resources that should be added to this list?
Please let us know!