1. HEALTH OF LITHUANIAN POPULATION IN THE EUROPEAN CONTEXT PROFESSOR RAMUNE KALEDIENE PROFESSOR RAMUNE KALEDIENE LITHUANIAN UNIVERSITY OF HEALTH SCIENCES

2. Gross domestic product, US$ per capita

3. Total health expenditure as % of gross domestic product (GDP) 4 5 6 7 8 9 10 11 1995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

4. Hospital beds (per 100 000 population) 2 3 4 5 6 7 8 9 10 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

5. Physicians (per 100 000 population) 200 250 300 350 400 450 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

6. General practitioners (per 100 000 population)

7. Nurses (per 100 000 population) 400 500 600 700 800 900 1000 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

8. Average length of stay, all hospitals 5 10 15 20 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

9. Percent of population aged 65+ years 10 11 12 13 14 15 16 17 18 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

10. Number of live births per 1000 population 5 10 15 20 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

11. Crude death rate per 1000 population 9 10 11 12 13 14 15 16 17 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

12. Natural population growth -10 -5 0 5 10 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

13. Infant mortality

14. Perinatal mortality 0 5 10 15 20 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

15. Life expectancy at birth

16. Difference in life expectancy of males and females in EU countries 5 6 7 8 9 10 11 12 13 14 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

17. Life expectancy of Lithuanian males and females in 1997 (1) and 2001(2) Females Males Healthy life expectancy - Unhealthy life expectancy 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2

18. Structure of cause-specific mortality of Lithuanian population, 2010 Total: 55.4 % 19.3 % 9.9 % 3.7 % 5.3 % 1.1 % 5.3 % 100.0 % Cardiovascular diseases Cancers External causes (injuries, poisoning, suicides) External causes (injuries, poisoning, suicides) Respiratory diseases Digestive system diseases Infectious and parasitic diseases (tuberculosis = 50 %) Infectious and parasitic diseases (tuberculosis = 50 %) Other

19. Mortality from ischaemic heart disease (0 – 64 years), per 100 000 0 50 100 150 200 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

20. Mortality from cerebrovascular diseases (0 – 64 years), per 100 000 0 10 20 30 40 50 60 70 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

21. Mortality from cancer (0 – 64 years), per 100 000 60 70 80 90 100 110 120 130 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

22. Female mortality from cervix cancer, per 100 000

23. Female mortality from cervix cancer in selected EU countries SDR / 100000

24. Female mortality from breast cancer, per 100 000 15 20 25 30 35 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

25. Female mortality from breast cancer in selected EU countries SDR / 100000

26. External causes mortality (0 – 64 years), per 100 000 0 50 100 150 200 250 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

27. Suicide mortality (0 – 64 years), per 100 000

28. Male suicide mortality SDR / 100000

29. Female suicide mortality SDR / 100000

30. Proportion of persons who assessed their health status as good or reasonably good in 1994-2010

31. Prevalence of risk factors for non- communicable diseases Tobacco use (age 20-64) daily smoking 34% males, 15% females Risky – harmful alcohol consumption (age 15-74) 31% males, 9,5% females Inadequate fruits and vegetable intake (age 20-64) Reported use of vegetables at least 3 times a week 63% males, 68% females Physical inactivity (age 20-64) Reported physical activity (at least 30 minutes 4 days per week) 20% males, 22% females Raised Blood Pressure (age 25-64) 60.3 % in males, 44.6% females. Obesity/overweight (age 20-64) obesity 17 % males, 20% females overweight 61% males, 46% females

32. Prevalence of daily smoking among Lithuanian population aged 20-64 in 1994-2010

33. Smoking-related mortality of Lithuanian population, 2006

34. Proportion of 11-15-year-old boys and girls who reported smoking in 2005-2006 school-year Data from 37 countries standardized by age. Countries are ranked by ascending smoking prevalence

35. Proportion of persons drinking strong alcohol at least once a week in 1994-2010

36. Proportion of persons drinking bear at least once a week in 1994-2010

37. Alcohol related problems dynamic (cases per 100 000 population) 31% decrease in 2 years 27 % decrease in 2 years

38. Dynamic of alcohol related problems (2009) 456 people less died (30% decrease) from alcohol related causes 1.8 times decrease of alcoholic cardiomiopathy 7.5% decrease of social risk families with drinking problems 41% decrease of drunk drivers caused road accidents

39. Proportion of regular users of alcohol in 1994, 1998, 2002 and 2006

40. Proportion of 11-15-year-old boys and girls who reported weekly drinking of alcoholic beverages in 2005-2006 school-year Data from 37 countries standardized by age. Countries are ranked by ascending prevalence of weekly alcohol use

41. Proportion of respondents who reported has been „really drunk“ one and two or more times, in 1994, 1998, 2002 and 2006

42. Proportion of 11-15-year-old boys and girls who have been drunk two or more times, in 2005/2006 school-year Data from 37 countries standardized by age. Countries are ranked by ascending prevalence of drunkeness

43. Proportion of 15-year-old regular drinkers of alcopops, beer and other alcoholic drinks in 2006 *** p  0,001 Z test, when comparing responses of boys and girls

44. Proportion of 11-15-year-old boys and girls who have ever used cannabis, in 2005/2006 school-year Data from 37 countries standardized by age. Countries are ranked by ascending prevalence of cannabis use

45. Proportion of 11-15-year-old boys and girls who took part in physical activity less than two times per week, in 1994, 1998, 2002 and 2006

46. Proportion of 11-15-year-old boys and girls who took part in physical activity less than two times per week, in 2005-2006 school-year Data from 38 countries standardized by age. Countries are ranked by ascending prevalence

47. Schoolchildren rating their health as excellent or good (%) HBSC 2001/02

48. Proportion of unhappy schoolchildren (%, 1994-2002)

49. Schoolchildren with 7 or more scores of a life satisfaction scale (%) HBSC 2001/02

50. Proportion of boys at high suicide risk (%, 1994-2002)

51. Proportion of girls at high suicide risk (%, 1994-2002)

52. AIDS (clinically diagnosed) incidence 0 1 2 3 4 5 6 7 1980198519901995200020052010 Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

53. Trends in age-standardized mortality of urban and rural Lithuanian populations

54. Differences in life expectancy of urban and rural populations (years)

55. Comparison of suicide mortality of urban and rural populations (mortality of urban population=1)

56. Age-standardized overall mortality rates per 100,000 population by sex and level of education

57. Proportion of men, who assessed their health status as good or reasonably good by the level of education in 1994-2010

58. Proportion of women, who assessed their health status as good or reasonably good by the level of education in 1994-2010

59. Difference between total life expectancy of Lithuanian males and life expectancy by different educational categories

60. Difference between total life expectancy of Lithuanian females and life expectancy by different educational categories

61. Proportion of daily smoking among men in 1994 – 2010 by the level of education

62. Proportion of daily smoking among women in 1994 – 2010 by the level of education

63. Proportion (%) of daily smokers, by family income % * - p<0.05, if compared with average and high income

64. Age-standardized overall mortality rates by sex and marital status MaleFemale

65. Interventions to reduce health differentials: policy options 3 Socio-economic specific determinantshealth position status 12 4 1. Reduce inequalities in education/occupation/income 2. Reduce inequalities in specific determinants (e.g. smoking) 3. Diminish the effect of health on socio-economic position (e.g. keeping unhealthy in the position) 4. “Extra” health care for lower socio-economic groups, more unhealthy

66. Thank you for attention!