Injury mortality patterns in Estonia: enduring the breakdown of the Soviet world and riding through the global recession

Peeter Värnik, Estonian Institute for Population Studies
Luule Sakkeus, Tallinn University

Injury mortality is usually greatest in countries with low of economic development. It is generally accepted that European countries, which were part of the communist bloc, form an exception. Still the two-fold rise from the average level of the 80’s to an injury SDR of 242 per 100000 in 1994 in Estonia is remarkable, while the same indicator for countries, which form the EU, was 54. Interestingly today, when the injury mortality is much lower and decreasing every year, inherent characteristic features still remain in Estonia. The male/female ratio, which globally is around 2, has firmly stayed between 4 and 5 during the past 20 years. Unlike in most countries where injury mortality is peaking in the oldest age group, a second peak at the age of 45-59 is evident and this phenomenon has persisted similarly. Estonia is seen as part of the western civilisation by Huntington. The demographic transition started there already in the mid-19th century. Still the effects of the Soviet legacy are undeniable, including involuntary migration. In concurrence with Gordon’s understanding that injuries have the same patterns as diseases, the development in the beginning of ‘90s can be viewed as an epidemic of injury deaths in the Baltics. Watson and Stuckler among others have offered their views on the reasons. The current study revisits the transitional period in Estonia with retrospective knowledge, including the institutional context. Individual level data are scrutinized to determine the underlying socio-demographic factors. Multilevel analysis is applied to periods of pre/post-transition, which allows to model the change from transitional effects. It is generally acknowledged that the level of injury deaths reacts quickly to socioeconomic changes. During the latest economic recession the Estonian data are contradicting that belief - the SDR has steadily fallen from 110 per 100000 in 2007 to 75 in 2010.