The structure of the causes of death in Estonia is similar to those of demographically developed nations. Endogenous causes of death together with violent deaths and accidents make up more than 95% of all deaths. From the point of view of the causes of death, Estonia stands out among European countries due to its large share of violent deaths and accidents, which in 1990 amounted to 16.4% among men and 5% among women. According to the occurrences of suicides, committed by males, the Estonian indigenous population has been among the leading European countries since the 1960s; in recent years, mortality from homicide and traffic accidents has gone up sharply. Mortality from cardiovascular diseases, which are more and more frequent causes of death among middle-aged men, has not declined in Estonia. Also, mortality from cancer has not decreased since the 1960s.

At the beginning of the 1990s, a new sharp fall occurred in the average life expectancy. Such an extensive rise in mortality indicates the condition of public health as one of the most critical demographic issues in Estonia. Today, the decline has ceased and life expectancy has returned to the level of hiatus described above. At the same time, there are signs that there will be no further growth, at least not in the near future, and it is quite probable that the hiatus in mortality development will remain a serious issue also in the 21st century.

Until the end of the 1950s, the mortality development in Estonia had been quite similar to the same processes in Northern and Western European countries. According to level of life expectancy at birth, Estonia held the leading position among Eastern and Southern European states and the Soviet Union. Notably, despite the fact that the years 1940–1950 represented one of the darkest periods in the history of the Estonian nation, the life expectancy at birth kept rising regardless of the war casualties and the consequences of repressions. (The alleged contradiction between demographic development and social conditions can be explained by the inert character of the demographic processes. The life force of a generation cannot be crushed in a short period of time. Regardless of repression and poor living conditions, the changes in the health of the Estonian population became apparent through the mortality process only a couple of decades later, when the worst was already over.)

The hiatus in the mortality development in Eastern European countries (stabilisation of average life expectancy at a relatively low level) has magnified the disparity between the life expectancies of men and women, as the negative trends in public health and mortality are considerably more manifest in the case of the male population. In regard to gender inequality in mortality, Estonia is even among the leading countries in Eastern Europe. The difference between men’s and women’s average life expectancy at birth increased steadily until the end of 1970s, exceeding then, and again in the 1990s, the ten-year level; the same is characteristic of the 1990s. Even in a few developing countries, men’s life expectancy at birth is about ten years higher than in Estonia.

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