Latvia

Health systems in transition
Latvia
population of pension age, the age–dependency ratio has increased from 1 to
1.9 in 1980 to 1 to 2.2 in 2004 (Table 1.1). In 2000, 2.6% of Latvia’s residents
were 80 years of age or older, and by 2004 the proportion of this group had
already reached 3%.
In the future, it is expected that the size of the population will continue to
fall, while the population continues to age.
The decrease in the size of the population has been accompanied by a fall
in the number of separate nationalities, as well as by a drop in their proportion
of the total population. At the beginning of 2005, the proportion of Latvians of
the total population was 58.8%. The second largest group consists of Russians,
with a share of 28.6% in 2005, followed by Belarusians with 3.8%, Ukrainians
with 2.6%, Poles with 2.5% and Lithuanians with 1.4%. The share of other
ethnic groups is below 1% (Gypsies, Germans, Estonians and others). The main
religions are Lutheran (the largest share) and Roman Catholic.
Approximately 60% of the population live in urban areas, with approximately
one third of the population in Riga alone. The population density in 2004 was
35.8 people per km 2 , which lies below the average of the European Union (EU).
Latvia has a very high literacy rate, at 99.7 in 2003.
Empirical evidence suggests that the majority of the Latvian population
(about three quarters) do not feel well-informed about their health care
entitlements; moreover, Latvian speakers feel better informed about the
health care system than the non-Latvian speaking part of the population: 28%
of Latvian-speaking households feel they have all necessary information on
health care services, as compared to 21% of non-Latvian speaking households
(CIET International 2002). Other characteristics of ethnic minorities do not play
an important role in the process of receiving health care services. It appears
that lack of knowledge of the language results in lack of information about
the possibilities of receiving health care services (Chapter 2 Organizational
structure, Subsection Patient information).
1.2 Economic context
The transformation of the economy has proceeded faster and further in Latvia
than in most other countries of the former Soviet Union, with rapid expansion
of the services sector at the expense of both agriculture and industry. The share
of agriculture in gross domestic product (GDP) fell from approximately 23%
in 1990 to 4% in 2005. Due – in part – to small farm size, agriculture remains
inefficient. Latvian industry during the Soviet period provided the Soviet Union
with radios, telephones, minibuses and other equipment, but was unable to stand