Helasoja Ville, Lahelma Eero, Prättälä Ritva, Kasmel Anu, Klumbiene Jurate, Pudule Iveta
National Public Health Institute, Department of Epidemiology and Health Promotion, Finland.
Eur J Public Health. 2006 Feb;16(1):8-20. doi: 10.1093/eurpub/cki011.
Public health problems in the Baltic countries are typical of Eastern European transition economies. A common assumption is that the economic transition has been particularly difficult for previously disadvantaged groups, and comparative research on the health differences between sociodemographic groups in the Baltic countries is therefore needed. This study compared associations of health with gender, age, education, level of urbanization and marital status in three Baltic countries and Finland.
The data were gathered from cross-sectional postal surveys conducted in 1994, 1996, 1998 and 2000 on adult populations (aged 20-64 years) in Estonia (n = 5052), Latvia (n = 4290), Lithuania (n = 7945) and Finland (n = 12796). Three self-reported health indicators were used: (i) perceived health, (ii) diagnosed diseases and (iii) symptoms.
The prevalence of less-than-good perceived health (average, rather poor or poor) was higher in the Baltic countries (men 66-56%, women 68-64%) than in Finland (men 35%, women 31%). The odds ratios (with 95% confidence intervals) of less-than-good perceived health among the low educated compared to the highly educated in Estonia, Latvia, Lithuania and Finland were 2.03 (1.49-2.77), 2.00 (1.45-2.76), 2.27 (1.78-2.89) and 1.89 (1.61-2.20) among men, and 3.32 (2.43-4.55), 2.77 (2.04-3.77), 2.07 (1.61-2.66) and 1.89 (1.63-2.20) among women, respectively. Diseases and symptoms were also more common among the lower educated men and women in all four countries. However, urbanization and marital status were not consistently related to the health indicators.
The Baltic countries share a similar sociodemographic patterning of health with most European countries, i.e. the lower educated have worse health. The methodological considerations of this study point out, however, that further research is needed to support public health policies aimed at the most vulnerable population groups.
波罗的海国家的公共卫生问题是东欧转型经济体的典型问题。一个普遍的假设是，经济转型对以前处于不利地位的群体来说尤其困难，因此需要对波罗的海国家社会人口群体之间的健康差异进行比较研究。本研究比较了波罗的海三国和芬兰健康与性别、年龄、教育程度、城市化水平和婚姻状况之间的关联。
数据收集自1994年、1996年、1998年和2000年对爱沙尼亚（n = 5052）、拉脱维亚（n = 4290）、立陶宛（n = 7945）和芬兰（n = 12796）的成年人口（20 - 64岁）进行的横断面邮政调查。使用了三个自我报告的健康指标：（i）自我感知健康，（ii）确诊疾病，（iii）症状。
波罗的海国家自我感知健康状况不佳（一般、较差或差）的患病率（男性66 - 56%，女性68 - 64%）高于芬兰（男性35%，女性31%）。在爱沙尼亚、拉脱维亚、立陶宛和芬兰，低学历男性与高学历男性相比，自我感知健康状况不佳的比值比（及95%置信区间）分别为2.03（1.49 - 2.77）、2.00（1.45 - 2.76）、2.27（1.78 - 2.89）和1.89（1.61 - 2.20），女性分别为3.32（2.43 - 4.55）、2.77（2.04 - 3.77）、2.07（1.61 - 2.66）和1.89（1.63 - 2.20）。在所有四个国家中，低学历的男性和女性中疾病和症状也更为常见。然而，城市化和婚姻状况与健康指标之间的关系并不一致。
波罗的海国家与大多数欧洲国家在健康的社会人口模式上相似，即受教育程度较低者健康状况较差。然而，本研究的方法学考虑指出，需要进一步研究以支持针对最弱势群体的公共卫生政策。
