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

Gross domestic product, US$ per capita

Total health expenditure as % of gross domestic product (GDP) Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Hospital beds (per population) Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Physicians (per population) Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

General practitioners (per population)

Nurses (per population) Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Average length of stay, all hospitals Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Percent of population aged 65+ years Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Number of live births per 1000 population Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Crude death rate per 1000 population Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Natural population growth Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Infant mortality

Perinatal mortality Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Life expectancy at birth

Difference in life expectancy of males and females in EU countries Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

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

Structure of cause-specific mortality of Lithuanian population, 2010 Total: 55.4 % 19.3 % 9.9 % 3.7 % 5.3 % 1.1 % 5.3 % % 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

Mortality from ischaemic heart disease (0 – 64 years), per Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Mortality from cerebrovascular diseases (0 – 64 years), per Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Mortality from cancer (0 – 64 years), per Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Female mortality from cervix cancer, per

Female mortality from cervix cancer in selected EU countries SDR /

Female mortality from breast cancer, per Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Female mortality from breast cancer in selected EU countries SDR /

External causes mortality (0 – 64 years), per Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

Suicide mortality (0 – 64 years), per

Male suicide mortality SDR /

Female suicide mortality SDR /

Proportion of persons who assessed their health status as good or reasonably good in

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

Prevalence of daily smoking among Lithuanian population aged in

Smoking-related mortality of Lithuanian population, 2006

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

Proportion of persons drinking strong alcohol at least once a week in

Proportion of persons drinking bear at least once a week in

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

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

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

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

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

Proportion of 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

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

Proportion of 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

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

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

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

Proportion of unhappy schoolchildren (%, )

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

Proportion of boys at high suicide risk (%, )

Proportion of girls at high suicide risk (%, )

AIDS (clinically diagnosed) incidence Estonia Latvia Lithuania EU members before May 2004 EU members since 2004 or 2007

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

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

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

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

Proportion of men, who assessed their health status as good or reasonably good by the level of education in

Proportion of women, who assessed their health status as good or reasonably good by the level of education in

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

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

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

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

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

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

Interventions to reduce health differentials: policy options 3 Socio-economic specific determinantshealth position status 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

Thank you for attention!