European Perspectives |
The sociodemographic patterning of health in Estonia, Latvia, Lithuania and Finland
Ville Helasoja1, Eero Lahelma2, Ritva Prättälä1, Anu Kasmel3, Jurate Klumbiene4 and Iveta Pudule5
1 National Public Health Institute, Department of Epidemiology and Health Promotion, Finland
2 Department of Public Health, University of Helsinki, Finland
3 Estonian Centre for Health Promotion, Estonia
4 Institute for Biomedical Research, Kaunas University of Medicine, Lithuania
5 Health Promotion Centre, Latvia
Correspondence: Ville Helasoja, MSc, National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, FIN-00300 Helsinki, Finland, tel. +358 9 4744 1, e-mail: vheh{at}ktl.fi
Background: Public health problems in the Baltic countries are typical of Eastern European transition economies. A common assumption is that the economic transition has been particularly difficult for previously disadvantaged groups, and comparative research on the health differences between sociodemographic groups in the Baltic countries is therefore needed. This study compared associations of health with gender, age, education, level of urbanization and marital status in three Baltic countries and Finland. Methods: The data were gathered from cross-sectional postal surveys conducted in 1994, 1996, 1998 and 2000 on adult populations (aged 20–64 years) in Estonia (n = 5052), Latvia (n = 4290), Lithuania (n = 7945) and Finland (n = 12796). Three self-reported health indicators were used: (i) perceived health, (ii) diagnosed diseases and (iii) symptoms. Results: The prevalence of less-than-good perceived health (average, rather poor or poor) was higher in the Baltic countries (men 66–56%, women 68–64%) than in Finland (men 35%, women 31%). The odds ratios (with 95% confidence intervals) of less-than-good perceived health among the low educated compared to the highly educated in Estonia, Latvia, Lithuania and Finland were 2.03 (1.49–2.77), 2.00 (1.45–2.76), 2.27 (1.78–2.89) and 1.89 (1.61–2.20) among men, and 3.32 (2.43–4.55), 2.77 (2.04–3.77), 2.07 (1.61–2.66) and 1.89 (1.63–2.20) among women, respectively. Diseases and symptoms were also more common among the lower educated men and women in all four countries. However, urbanization and marital status were not consistently related to the health indicators. Conclusions: The Baltic countries share a similar sociodemographic patterning of health with most European countries, i.e. the lower educated have worse health. The methodological considerations of this study point out, however, that further research is needed to support public health policies aimed at the most vulnerable population groups.
Keywords: Baltic countries, sociodemographic patterning of health