Gaining health : analysis of policy development in European ...

Chapter 4
38
Finland
Anna Ritsatakis
1. Country profile
Finland is bordered by Norway to the north-west and
north, by the Russian Federation to the east, by the Baltic
Sea to the south and by Sweden to the west. It is one of
the largest countries in Europe, one quarter of it lying north
of the Arctic Circle.
For administrative purposes, the country is divided into five
provinces. In 1993, there was a general decentralization
of responsibilities to the municipalities, many of which had
fewer than 10 000 inhabitants. Now the municipalities are
being amalgamated with the aim of creating units with about
20 000 inhabitants. There are currently 416 municipalities
and about 20 mergers are currently being processed (1).
Following independence from Russia in 1917 and the
ensuing civil war, a rather exceptional requirement for
two-thirds or five-sixths majority decisions on constitutional
and other major political issues led to a culture of broad
coalitions and consensus building. The multi-party governments
that followed strengthened this approach of striving
for consensus, which is still characteristic of Finland.
Finland has been an active member of the Nordic Council
since the 1930s and joined the EU in 1995. Finnish and
Swedish are the official languages, while the Saame and
Roma languages have minority language status.
1.1. Socioeconomic development
Finland enjoyed robust economic growth during the 1980s.
By the end of the decade, however, the economy had overheated.
Combined with the changes that then took place in
eastern Europe, this created a deep economic recession in
1991–1994. From around 6% in the 1980s, unemployment
jumped to a peak of 19% in 1993. By 2002, this had fallen
back to around 9% but was still dramatically high among
young people (2). Although the previous low levels were
not regained, continued efforts brought the overall level
below the euro area average (8%) in 2006 (3).
Growth performance in recent years, at over 3%, has been
among the best in the Organisation for Economic Cooperation
and Development (OECD) area and is presently
around 6–7% “underpinned by a strong innovation performance
and high educational achievement” (3). Traditional
industry continues to lose ground, however, and new jobs
for young people tend to be part-time or temporary so that
job security has become an issue. Also, since the minimum
salary refers to full-time employment, there is a growing
group of the “employed poor”, including single mothers
working part-time and low-paid immigrants.
Until recently, Finland was considered to be a generally
egalitarian society. According to the Gini index, Finland
has a relatively low overall level of income inequality and
a distribution of wealth that is better than the European
average. More recently, partly affected by globalization, the
two extremes appear to be diverging, with income of the
top 5% increasing dramatically while that of the lowest 10%
deteriorates.
1.2. The people and their health (4)
From 4.6 million in 1970, the population of Finland has now
increased to 5.2 million owing to a positive rate of natural
increase and net migration. With the decreasing birth
rates of recent years and the large birth cohorts of the late
1940s, the population is rapidly ageing. The proportion of
the population over 65 years is expected to rise from about
15.5% in 2003 to about 19.4% in 2030. Between 1970 and
2005, life expectancy at birth for men increased from 66.2
to 75.8 years, while that for women rose from 74.5 to 82.8
years. While the gender gap in life expectancy has dimin-
Case studies: policy development in countries for tackling noncommunicable diseases