In the mid-1980s, the average life expectancy in Estonia peaked at about sixty-six years for males and seventy-five years for females. Thereafter, these figures declined somewhat, especially for males, most likely because of deteriorating living standards. In 1994 overall life expectancy was estimated to be 70.0 years (65.0 years for males and 75.2 years for females). Infant mortality was about 19.1 deaths per 1,000 live births, according to a 1994 estimate. Fertility rates dropped from an estimated 2.3 children born per woman in 1988 to about 2.0 in 1994. Abortion remained the main form of birth control, more so among Russians than Estonians. There were 24,981 abortions in 1992 (1,389 per 1,000 live births), although that figure was down from about 36,000 a decade earlier. Most women who have abortions are married. Nearly half of all marriages end in divorce. In recent years, a greater number of people have begun living together instead of marrying. Such couples account for 17 percent of all births in the country.
The primary cause of death is cardiovascular diseases, accounting for about 64 percent of all deaths in the mid-1990s. Cancer and accidents account for a large share as well. Estonia's suicide rate over the years has reflected the country's sociopolitical condition. In the mid-1970s, during the politically stagnant Brezhnev years, there were about 530 suicides per year. In 1990, after Estonia's political reawakening, suicides dropped to 425. In 1992, as economic conditions worsened, suicides climbed again, to 498. In November 1993, twenty-nine cases of acquired immune deficiency syndrome (AIDS) were reported in Estonia, with two deaths having resulted from AIDS-related illnesses.
The state-run health care system inherited from the Soviet regime was being decentralized in the early 1990s and had yet to meet Western standards. In 1992 the number of physicians, equivalent to thirty-two per 10,000 inhabitants, was relatively high, but there was a shortage of nurses and other auxiliary medical staff. Hospital beds numbered ninety-two per 10,000 inhabitants, down from 121 in 1990. Although the cost of medicines increased, new imports from the West eased some of the chronic shortages of the Soviet era. But overall, shortages of basic medical supplies, including disposable needles, anesthetics, and antibiotics, remained a serious problem.
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