Public Health Challenge: Combating the Top Diseases in Estonia
A member of the European Union since 2004, Estonia is among the wealthiest nations in the Baltic region. Likewise, the country has a modern health system that can reasonably support its population of 1.3 million.

Almost all Estonians are covered by health insurance, and the greatest menaces to public health, like heart disease and cancer, are characteristic of a developed country.

Nonetheless, more than one in five Estonians lives below the poverty line and are especially at risk for certain health problems that are prevalent in the country. Here are some of the top diseases in Estonia and what is being done to combat them.

HIV/AIDS

While the death toll from AIDS is dwarfed by that of heart disease and cancer in Estonia, the country has the highest prevalence of HIV in all of Europe. Around 1.3 percent of the population carries HIV, comparable to rates in Sierra Leone or Mali.

The first case of HIV was diagnosed in 1988, and the rate of incidence remained minuscule until the turn of the century. According to a report by the World Health Organization (WHO), the disease exploded in 2000, mostly among drug users.

Since then, the incidence rate has declined, but still more cases are reported each year. Epidemiologists have found that heterosexual transmission has increased in recent years, adding to the more than 9 thousand Estonians who have been infected.

Estonia has seriously grappled with HIV/AIDS for decades. All treatment for HIV-positive patients is free, and education about the disease is standard in Estonian classrooms. Some trends have epidemiologists in the country hopeful: according to UN AIDS, both safe sex practices and HIV testing are on the rise among Estonians.

Tuberculosis

Like AIDS, tuberculosis is not one of the major killers in Estonia, but the disease poses complex challenges for the country’s health system. Estonia has one of the highest multi-drug resistant tuberculosis burdens in the world. In many ways, tuberculosis in the country is tied to the issue of HIV: the prevalence of TB/HIV co-infection in Estonia is one of the highest in Europe at 15 percent.

Beyond people who suffer from AIDS, tuberculosis also particularly threatens Estonians who use intravenous drugs or drink heavily — a population that reports from WHO suggest could be large.

The rate of tuberculosis incidence is decreasing, indicating that Estonia is winning its battle against the disease. But according to WHO, as the incidence decreases, new challenges will arise. As the issue shrinks in magnitude, political and financial commitment may also dwindle — something that Estonia’s government must avoid if the disease is to be defeated in the country.

Obesity

There is still controversy over whether obesity is actually a “disease,” but reports and data on public health in Estonia have outlined it as a clear issue. Sources disagree, but 2014 research from the University of Tartu found that as many as one in three Estonians are clinically obese (a body mass index of over 30).

Obesity can greatly increase the risk of a myriad of health issues, including diabetes, heart disease and stroke. Heart disease and stroke accounted for nearly half of all deaths in Estonia in 2012 (48 percent), so many physicians believe the issue should be taken seriously as one of the top diseases in Estonia.

The issue may be correlated to modernization. WHO estimates that nearly half of Estonian adults are insufficiently active, while salt intake is growing.

Obesity is not an easy issue to tackle, but growing scholarship and research on obesity has helped Estonia assess its magnitude and effects. In recent years the government has implemented some policies to promote consumer awareness and healthy eating habits in schools.

Estonia faces unique but surmountable public health challenges. The government likely has the means to solve such issues, and the nation, therefore, serves as a good example of how funding is not the only weapon fights like these; there must be political attention, commitment and patience. Coming years will tell the extent Estonia’s diligence in the realm of health, and likely provide valuable lessons for nations facing similar issues.

Charlie Tomb

Photo: Flickr