Background: The focus of the article is on organizational reform measures in public health in Estonia, Latvia and Lithuania from 1992 to 2005 and the associated changes in population health. Methods: The study draws on published reports and analyses official statistics over time and cross-nationally. Changes in population health are measured by indicators of population health status and indicators of primary prevention or avoidable mortality, which reflect performance of national health policy. Results: Our study shows some similarities and some important differences in terms of public health development inthe Baltic countries since beginning of the 1990s. Conclusions: This study highlights the importance of political stability and support in achieving public health improvements and the pervasive influence of socio-demographic factors on several key health indicators in Baltic countries. It points to the need to introduce evidence-based public health interventions, enhance social trust, address corruption and tackle poverty.
|Journal||The European Journal of Public Health Vol 18 No. 6: 586-592|
|Publication status||Published - Oct 2008|
Bibliographical noteReference text: 1 O’Connor JS. Convergence in European welfare state analysis: convergence
of what? In: Clasen J, Siegel NA, editors. Investigating welfare state change the
‘dependent variable problem’ in comparative analysis. UK: Edward Elgar,
2 Bankauskaite V, O’Connor JS. Health policy in the Baltic countries
since the beginning of the 1990s. Health Policy 2008; doi:10.1016/
3 Jesse M, Habicht J, Aaviksoo A, et al. Health care systems in transition:
Estonia. Copenhagen: WHO Regional Office for Europe on behalf of the
European Observatory on Health Systems and Policies, 2004. Available from:
http://www.euro.who.int/Document/E85516.pdf (Accessed 20 April 2008).
Public health development in the Baltic countries 591
4 Tragakes E, Brigis G, Karaskevica J, et al. Latvia: Health system review.
Health Systems in Transition 2008;10:1–253.
5 Grabauskas V, Klumbiene J, Petkeviciene J, et al. Health Behaviour among
Lithuanian Adult Population, 2006. Publications of the National Public
Health Institute, B7/2007. ISBN 978-951-740-650-5. Available from:
http://www.ktl.fi/portal/2920; http://www.ktl.fi/eteo/finbalt (Accessed
15 September 2008).
6 Pomerleau J, McKee M, Robertson A, et al. Physical inactivity in the Baltic
countries. Prev Med 2000;31:665–72.
7 Pomerleau J, Pudule I, Grinberga D, et al. Patterns of body weight in the
Baltic Republics. Public Health Nutr 2000;3:3–10.
8 Ministry of Health of the Republic Latvia: Public Health Strategy.
9 Lithuanian Health Program. 1998. Approval of the Lithuanian Parliament,
2 July 1998, No. VIII-833, Vilnius.
10 Concerning the implementation of the State alcohol and tobacco control
policy (in Lithuanian). Available from: www.lrinka.lt/uploads/files/dir21/
dir1/3_0.php (Accessed 28 January 2008).
11 Order 30/01/07 Nr. N-1 On the implementation of the State Program on
alcohol prevention, Vilnius. Available from: http://www3.lrs.lt/pls/inter/
w5_show?p_r=698&p_d=63768&p_k=1 (Accessed 18 January 2008).
12 Hellman M. Alcohol-use harm and policy. A report from a Nordic-Baltic
seminar. Riga 3–4 October 2005. Nordic Council for Alcohol and Drug
Research. Available from: http://www.nad.fi/riga/English%20report%
20Riga.pdf (Accessed 10 March 2008).
13 Report on the HIV/AIDS situation in Lithuania. Available from: www.
integration-projects.org (Accessed 17 August 2008).
14 HIV & AIDS in Estonia. 2004. Available from http://www.integrationprojects.
(Accessed 07 January 2008).
15 AIDS/HIV Latvia. Available from: http://data.unaids.org/pub/Report/2006/
2006_country_progress_report_latvia_en.pdf (Accessed 15 April 2008).
16 Koppel A, Aaviksoo A. Evaluation of health prevention projects – Estonia.
Health Policy Monitor, October 2007. Available from: http://www.hpm.org/
17 Polluste K, Mannik G, Axelsson R. Public health reforms in Estonia: impact
on the health of the population. Br Med J 2005;331:210–13.
18 Koupil I, Rahu K, Rahu M, et al. Major improvements, but persisting
inequalities in infant survival in Estonia 1992–2002. Eur J Public Health
19 State Audit Report on Public Health Care Promotion. 31/05/06 No. VA-
2010-6-7. Available from: http://www.vkontrole.lt/veikla_ataskaita.php?1350
(Accessed 18 April 2008).
20 Korzuniene J, Aleknavicius D. 2006. Republic of Lithuania State Control.
State Audit Report. Evaluation of the program ‘Health system development’
of the Ministry of Health. Available from: http://www.vkontrole.lt/audito_
ataskaitu_paieska1.php (Accessed 20 April 2008).
21 Brauna A. Controlling the income of individuals in Latvia. 2005. Available
22 Transparency international. The global coalition against corruption.
Available from: www.transparency.org (Accessed 15 April 2008).
23 World Health Organization European Region. European Health For All
Database (HFA-DB). Available from: http://www.euro.who.int/hfadb
(Accessed 18 April 2008).
24 Cockcroft A, Andersson N, Paredes- Solis S, et al. An inter-country
comparison of unofficial payments: results of a health sector social audit in
the Baltic states. BMC Health Serv Res 2008;8:15.
Received 27 May 2008, accepted 20 September 2008
592 European Journal of Public Health
- public health