Papers on Anthropology XXV/1, 2016, pp. 55–65

CHANGES OF LIFE EXPECTANCY IN DURING THE LAST 70 YEARS E.-M. Tiit

CHANGES OF LIFE EXPECTANCY IN ESTONIA DURING THE LAST 70 YEARS

Ene-Margit Tiit

ABSTRACT The life expectation characterises the health conditions, especially mortality of a population at the year of calculation. The changes of life expectancy in time characterise the general health trends of a population. The difference between men’s and women’s life expectation in Estonia is large, about 9 years, but the difference of remaining lifetime lessens with age. Life expectancy of both men and women has increased quite rapidly during the last decades, also infant mortality has reached the value typical for highly developed countries (40 times lower level than 70 years ago). International forecasts show that Esto- nians’ life expectancy will approach to that of by the end of 21st century.

Keywords: life expectancy; population health; infant mortality

Life expectancy is one of the most important and informative demographic characteristics for estimating the health condition of a population. Life expec- tancy for some fi xed age (most oft en this age has been taken as zero, that is, we speak about the life expectancy at birth) can be calculated for the population if the data on mortality and age-sex distribution exist. Life expectancy charac- terises the health situation of the population for the fi xed year of calculation. Th erefore, it is not right to say that, if we calculate the life expectancy at birth today, this means that the child born today will live so long. Th is statement is true when we add the condition: if mortality will be unchanged during his/her lifetime. Naturally, this condition is not true; in general, mortality is constantly descending, and probably the child will live much longer. Life expectancy characterises the health conditions, especially mortality, of a population in the year of calculation, briefl y – today. Hence, its changes in time characterise the general health trends of a population.

http://dx.doi.org/10.12697/poa.2016.25.1.05 56 | E.-M. Tiit

ESTONIA TODAY Life expectancy and remaining lifetime Usually, tables of life expectancy demonstrate the average remaining lifetime in years for persons who attain a given age if mortality remains unchanged. It is understandable that the longer person has lived, the shorter is the remaining lifetime for them, but the higher age they will reach; see Figures 1 and 2.

90 Males 80 Females 70 60 50 40 30 20 10 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100

Figure 1. Remaining lifetime for men and women of diff erent ages living in Estonia, 2014.

It is quite enlightening to compare Figures 1 and 2. For instance, a man at the age 60, knowing that men’s life expectancy is about 70 years in Estonia, will be gladly surprised seeing from Figure 2 that his expected lifetime is almost 78 years. Th e same fact is visible in Figure 1 as well, where the expected remaining lifetime is about 18 years. We can also see that the diff erence between men’s and women’s remaining lifetime lessens with age: being more than 9 years at the moment of birth, the diff erence remains almost at the same level for 20 years. During the following twenty years – from ages 21 to 40 – the diff erence also changes for less than one year and is more than 8 years for people aged 40. More rapid convergence of men’s and women’s life expectancy starts in the age-group 50+. For men and women aged 80+, the diff erence in expected lifetime is less than two years. Changes of life expectancy in Estonia during the last 70 years | 57

105 Males 100

95

90

85

80

75

70 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100

Figure 2. Expected summary lifetime for men and women of diff erent ages living in Estonia, 2014.

Regional differences in life expectancy

85 83 81 79 77 75 73 71 69 Males 67 Females 65 Võru county Järva county county Põlva county county Pärnu county Lääne county Jõgeva county county Ida-Viru county Lääne-Viru county

Figure 3. Life expectancy of men and women in diff erent of Estonia, data from 2013/2014.

In spite of the fact that Estonian population is quite small, the diff erences in life expectancy by counties are rather remarkable: for both men and women, 58 | E.-M. Tiit the diff erence between the “best” county and the “worst” county is more than three years. What is remarkable – for both men and women, the worst county in terms of life expectancy is Ida-Viru County where the ethnic structure is quite diff erent from other counties; here the share of ethnic is less than 20%, while in Estonia as a whole the share of Estonians is almost 70%. Th e best county in this sense for both men and women is where the population has comparatively high education. Th e order of other counties is rather random and does not coincide for men and women.

DEVELOPMENT OF LIFE EXPECTANCY IN ESTONIA The first year of life and infant mortality Th e most problematic time in a human’s life is its beginning and the fi rst year. Th is time is statistically characterised by infant mortality. Infant mortality has been measured in all countries for a long time, and we have also statistics on infant mortality in Estonia from the time before the Second World War, see Figure 4.

140 Boys 120 Girls 100

80

60

40

20

0 1924 1928 1932 1936 1940 1944 1948 1952 1956 1960 1964 1968 1972 1976 1980 1984 1988 1992 1996 2000 2004 2008 2012

Figure 4. The number of boys and girls who died before their fi rst birthday per 1000 newborn boys and girls.

From Figure 4, we can see that at the beginning of the period, about 90 years, ago infant mortality was quite high, almost 12% for boys and 10% for girls. During the less than twenty years in the independent Republic of Estonia, the situation improved markedly; in the late 1930s, boys’ mortality was 8.6% and Changes of life expectancy in Estonia during the last 70 years | 59 girls’ mortality less than 7% – so the improvement was more than 20%. In the time-series of infant mortality, there is a gap in the years of the fi rst Soviet occupation and the war. Aft er the war, the situation had considerably worsened for boys and girls as well: less than seven out of eight neonates survived the fi rst year. Still, the situation improved rather rapidly and aft er ten years, by the mid-1950s, infant mortality was almost fi ve per cent for both boys and girls. Reduction of the infant mortality rate continues but with a slackening tempo, and for the last decade of the 20th century the rate was about 1–2%. During the last decade the rate has dropped the level of 0.2–0.4%, which is a good result among all the European countries. Comparing the results of the last three years with the equal aft er-war period, we can see an improvement of about 40 times.

Life expectancy in Estonia before the Second World War Statistical publications issued before the Second World War did not show life expectancy, but it can be estimated using the mortality and census data that were probably of quite a high quality.

64.0 Males 62.0 Females 60.0

58.0

56.0

54.0

52.0 1930 1931 1932 1933 1934 1935 1936 1937 1938

Figure 5. Life expectancy in Estonia before the Second World War.

When we compare the diagrams of remaining lifetime for 2014 and 1929, we can see a big diff erence. In 1929, the expected remaining lifetime increased in early childhood when the risk of death was the highest. Th en more than 1000 newborn boys died before their fi rst birthday. Th e risk to contract diff erent children’s diseases was also high in the following age groups; in the young age, a big risk of death was tuberculosis. Th e diff erence between men’s and women’s life expectancy was quite big in early years but decreased soon and in middle 60 | E.-M. Tiit age the diff erence between women and men (3–4 years) was almost twice less than 85 years later, in 2014.

70.0 M 60.0 F 50.0

40.0

30.0

20.0

10.0

0.0 0 1-4 5-9 85+ 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84

Figure 6. Remaining lifetime for men and women of diff erent ages living in Estonia, 1929.

Trends in life expectancy after the Second World War During the war and aft er it, until the fi rst Soviet census in 1959, there were no demographical data about the population of Estonia. Nevertheless, the UN has calculated life expectancies from the mid-20th for almost all the countries of the world, including Estonia. Statistics Estonia has made calculations since the census of 1959, combining in the fi rst twenty-year time period two sequential years for each estimation of data; see Figures 7 and 8. In Figure 7, the life expectancy data from diff erent sources are combined, and here the trends and stagnation periods are quite well visible. During the fi rst period of independent Estonia, when we have the data of about ten years, the life expectancy of men and women increased by 4 months per year, while the average diff erence was almost six years in favour of women. Th ere is no data about the period 1940–1950 and only estimated data for period 1950–1960, when the most rapid increase in life expectancy took place. At this time practical medicine developed very rapidly – antibiotics were taken into every-day use; general vaccination protected children from infectious dis- eases, as seen from Figure 4. Changes of life expectancy in Estonia during the last 70 years | 61

85.0

80.0 Males Females

75.0

70.0

65.0

60.0

55.0

50.0 1940-45 1945-50 1950-55 1955-60 1960-65 1965-70 1970-75 1975-80 1980-85 1985-90 1990-95 2000-05 2005-10 2010-15 2015-20 1930-1935 1935-1940 1995-2000

Figure 7. Life expectancy at birth. Combined data for 5-year periods (SA and UN).

Th e consequent trend can be followed in Figure 8. In the early 1960s, the increase in life expectancy stopped – for men somewhat earlier than for women – and the period of stagnation began that extended for twenty years. Women’s life expectancy increased somewhat, men’s dropped. In 1983/84, men’s life expec- tancy was 64.41, that is by 1.19 years less than 20 years ago, and women’s life expectancy 74.41 exceeded the level of 1963/64 by 0.9 years.

85 Males 80 Females

75

70

65

60 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 1988** 1958/59 1964/65 1966/67 1972/73 1975/76 1977/78 1979/80 1981/82 1983/84 1985/86 1962/63* 1968/69* 1970/71*

Figure 8. Estimated life expectancy at birth in Estonia. 62 | E.-M. Tiit

An increase in men’s life expectancy started in the mid-1980s. Probably this was connected with Gorbachev’s prohibition policy. During 1984–1988, men’s life expectancy increased by more than two years; for women the increase was about half a year. Aft er this period, a big downtrend lasting six years started. In 1994 the bot- tom was reached – men’s life expectancy was 60.5, women’s – 72.8 years. Th is can be explained by the so-called transition stress that occurred in all East and Central European countries disengaged from totalitarian regimes. Th ereaft er, the increasing trend started that during the last decade was also quite rapid in comparison with other countries of the EU. Since 1994, men’s life expectancy has increased by almost twelve, women’s life expectancy – by nine years. But we are still far from the top countries of and world; see Figure 9. Especially problematic is the big gap among women’s and men’s life expectancies.

85 83 81 79 77 75 73 71 Males 69 Females 67 65 Ireland Iceland Estonia Finland Norway United Kingdom

Figure 9. Life expectancy of men and women in the countries of North Europe (UN estima- tion for 2015–2020, medium variant), ordered by the values of men’s life expectancy.

Probable reasons of men’s short life expectancy It is probable that life expectancy depends on a person’s habits and general lifestyle. One of the indicators of lifestyle is education. It is a well-known fact that in Estonia women’s level of education is much higher than men’s (share of men and women having higher education is correspondingly 24% and 35% by census 2011). As the following step, we checked the dependence between the limitations to everyday activities due to health problems and educational level, Changes of life expectancy in Estonia during the last 70 years | 63 using the data of the census of 2011. Th e dependence turned out to be quite strong in both men and women, but the diff erences between genders had almost disappeared. For instance, in Figure 10, we can see that about 10% of people with higher education have severe problems; among the people with secondary education, the share was 16–17%, and among the people with basic education or less, about 30% had severe limitations in everyday activities due to health conditions. Naturally, it is not easy to check if low education is caused by poor health or vice versa, but the common connections exist. Th e jerk in the curves at the age of 60–64 seems to be connected with the pension age – then the intensity of activities falls, and therefore, in some cases severe limitations do not disturb them anymore.

70.0

60.0

50.0 M_Basic

40.0 M_Secondary M_Higher 30.0 F_Basic 20.0 F_Secondary 10.0 F_Higher

0.0 85+ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84

Figure 10. Share of men and women having severe limitations in everyday life due to health problems depending on their age group and educational level.

Using the data of the census of 2011, another characteristic was also calculated; that shows the disability-free life expectancy. It is interesting that the diff erence between men and women in disability-free life expectancy is not as big as the diff erence in life expectancy. From here it follows that women spend a longer time from their life being restricted by health conditions than men. Th is indicator demonstrates once more that the infl uence of educational attainment on health is quite strong. Saying robustly: learning a year, you save this year for disability-free life. 64 | E.-M. Tiit

60 Basic_M Basic_F 50 Secondary_M 40 Secondary_F Higher_M 30 Higher _F 20

10

0 0 85+ 1--4 5--9 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 10--14

Figure 11. Disability-free life expectancy by sex, age group and educational attainment, data of census 2011.

FUTURE TRENDS IN LIFE EXPECTANCY Th e Population Division of the United Nations prepares population projections for all the countries of the world, using diff erent versions of premises – optimis- tic, pessimistic, etc. For making projections, some other characteristics should also be forecasted. Figure 12 shows the forecast of life expectancy for Estonian, Swedish, Finnish and Latvian men and women until the year 2100. In the Figure the diff erences in development are visible. For the Finnish and Swedish people, the life expectancy of both men and women has been growing, and in the future it will continue in a similar way. In Estonia and Latvia, the curve of life expectancy refl ects the intricate course of history of these coun- tries – aft er recovering from the war wounds, the growth of life expectancy was very fast, but aft er the growth period, twenty years of stagnation followed in both countries. In both countries, the growth of life expectancy started about fi ve years aft er gaining independence, and for Estonian men and women it is predicted to be somewhat faster than in Latvia, but the discrepancies between all the countries are diminishing in time, especially in the case of women. So, according to the forecast of the UN, by the end of the century, the life expec- tancy of Estonian men will be 85 years and of women 90 years, some years more than in Latvia, while Finnish and Swedish women and men will live as long as 90–94 years. It can be hoped that disability-free life expectancy will also grow rapidly, so that our people can enjoy a long and healthy life. Changes of life expectancy in Estonia during the last 70 years | 65

95

90

85

80

75

70 Est M Est F 65 Fin M Fin F Swe M Swe F 60 Lat M Lat F 55 1950-1955 1955-1960 1960-1965 1965-1970 1970-1975 1975-1980 1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 2020-2025 2025-2030 2030-2035 2035-2040 2040-2045 2045-2050 2050-2055 2055-2060 2060-2065 2065-2070 2070-2075 2075-2080 2080-2085 2085-2090 2090-2095 2095-2100

Figure 12. Life expectancy. Estimation, statistics and forecast for Estonia and some close neighbours.

SOURCES Statistics Estonia, Statistical Database, http://pub.stat.ee/px-web.2001/dialog/statfile2.asp United Nations Population Division, http://esa.un.org/unpd/wpp/

Address for correspondence: Ene-Margit Tiit Institute of Mathematical Statistics Faculty of Mathematics and Computer Science University of Tartu, Tartu, Estonia J. Liivi 2–513, 50409 Tartu, Estonia E-mail: [email protected]