Latvia

Health systems in transition
Latvia
A key factor that in all likelihood bears a close relationship with observed
poor health status indicators concerns the issue of extensive poverty. This point
is noted in the Government’s public health policy document of 2000, which also
notes that no studies have been conducted documenting the relationship between
health and social and economic status. There is evidence, however, suggesting
that low-income people and less educated people (who often are in fact one
and the same) are more likely to engage in behaviours that are not conducive to
good health (such as poor diet, smoking, alcohol consumption, lack of physical
exercise, increased stress levels, etc.) (Ministry of Health 2000).
In addition, there is extensive evidence (in this case well documented) that
low-income people have lower health service utilization rates, which are due
to lower access to services resulting from financial barriers (user charges and
informal payments). People with low income face these barriers, but the situation
is worsened by the fact that they are also the ones who often have a greater need
for health services due to the greater burden of ill health that they shoulder. This
is especially obvious in the case of pensioners, who usually have to make ends
meet on very low incomes, but who also, due to age, require proportionately
more health services. However, the same applies to other population groups,
including the unemployed, children in low-income families, and many others
(Karaskevica 2003).
It is virtually impossible to come to any definite conclusion on the contribution
that the health care system in Latvia has made to health status. The same goes
for the contribution of the public health system (broadly interpreted to include
prevention, health promotion, lifestyles, intersectoral collaboration, etc.).
Perhaps the only conclusion that can be drawn with some degree of certainty
is to say that both the health care and the public health systems can offer more
towards making a positive contribution to the health of the population than they
have done to date. It is with this point in mind that the Latvian Public Health
Strategy of 2000–2001 was adopted.
239