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The European Journal of Public Health Advance Access published online on April 28, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp038
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Measuring burden of disease in Estonia to support public health policy

T. Lai1, J. Habicht2 and R.-A. Kiivet1

1 Department of Public Health, University of Tartu, Estonia
2 WHO Country Office in Estonia, World Health Organization Regional Office for Europe

Correspondence: Taavi Lai, Department of Public Health, University of Tartu, Ravila 19, Tartu 50411, Estonia, tel: +372 7 374 203, fax: +372 7 374 192, e-mail: taavi.lai{at}ut.ee

Received October 27, 2008 , accepted February 27, 2009

Background: Many countries have an overview on mortality and morbidity but few have performed contextualized national burden of disease studies. The objective of the present study is to provide a first set of national and sub-national burden of disease estimates for Estonia. Further, we present the causes and age-gender distribution of the burden. We conclude with the description of result uptake and impact of the study in Estonian public health policy arena. Methods: A burden of disease estimation procedure modified for best fit to country situation was used. That included disease classification reflecting Estonian disease profile, national disease severity assessments, mortality and morbidity prevalence data. Calculations were performed on national and sub-national levels. Results: Estonian population lost 446 361 (327/1000 persons) disability adjusted life-years in 2002. Premature mortality caused majority of the burden and cardiovascular diseases, external causes (e.g. suicide and injuries) and cancers were main sources of burden. Working age population (16–64 years) shouldered 60% of the burden. Sub-national levels of burden range from 114 to 725 disability adjusted life-years per 1000 persons and are correlated to regional socioeconomic development. Conclusion: Cardiovascular disease and injuries, premature mortality, working age population, male and people from economically less developed regions should be the priority targets for public health interventions. Estonian main public health strategies now address burden of disease concerns highlighted by our study.

Keywords: burden of disease, DALY, Estonia, national estimates, population health, public health strategy


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