THE EFFECTS OF POLITICAL AND ECONOMIC TRANSITIONS ON HEALTH AND SAFETY IN ESTONIA - AN ESTONIAN-SWEDISH COMPARATIVE-STUDY

A general and dramatic deterioration of health in Estonia during the t ransition period 1990-1994 was analysed using Sweden as a comparative example. Though there were diverging trends between Estonia and Sweden in the leading cause of death, cardiovascular diseases, the gap in mo rtality from injury had increased most rapidly. While the injury morta lity rate slightly decreased in Sweden from 1990 to 1994, it almost do ubled in Estonia. In 1994, the total injury death rate for men was abo ut 6 Limes higher in Estonia than in Sweden. The death rates for some types of injuries, such as alcohol intoxication and homicide, were man y tenfolds higher in Estonia than in Sweden. Injury contributed the mo st to the widening health gap between the countries, especially in mal es. The mechanisms of this sudden health deterioration remain to be fu lly explained. It could be hypothesised that behind the traditional be havioural risk factors, the influence of socio-political factors relat ed to economic and political reconstruction is present. A widespread r isk-taking and unhealthy behaviour among Estonians can likely be partl y explained as a way of coping with the distress created by the new de mands of transition society. An important challenge on the way to impr ovement is creating the political will among policy-makers to confront the tremendous problems of controlling the factors in society that af fect the population's health in Estonia. (C) 1998 Elsevier Science Ltd . All rights reserved.