Latvia

Health systems in transition
Latvia
substantially higher than the 91.3% average for the EU (WHO Regional Office
for Europe 2007a).
Minorities
Statistical data on health status by ethnic origin are not collected in Latvia;
therefore, it is not possible to arrive at any conclusion identifying or
characterizing any differences in health among minorities. The minorities in
Latvia have been residing there for long periods of time and are not localized
in one administrative territory, but are scattered throughout the country.
Health inequalities and access to health care services
A major restriction to access to medical care is low income. The proportion of
poor people is still very high in Latvia (as noted in Section 1.3 Economic context)
and there is evidence that population health depends in part on ability to pay
for health care services. Increasing prices and low incomes limit possibilities
for receiving health care services or purchasing medicines (Krastins 2005).
According to a survey of 1000 citizens in various regions of Latvia, one third
of the respondents were unable to obtain necessary health care services as a
result of low incomes (Boronenko 2003). Moreover, the regions with the more
serious access problems were also those in which the population suffers from
the poorest health, suggesting that there is a close link between health status
and access to health care services.
Other studies suggest that even larger proportions of the Latvian population
may have difficulties with access due to not being able to afford certain services.
According to the United Nations Development Programme (UNDP) Latvian
Population Development Report, 83.0% of respondents are worried about
their ability to cover health care expenses (Kesnere 2005b). A total of 48.2%
of respondents who had participated in the survey “Latvian population income
level and health care access” (Karaskevica 2003) answered they had refused
health care services due to lack of money for patient payment, and 32.9% had
worried about final treatment expenses. By comparison, only 18.9% respondents
refused health care services due to doubt about medical staff’s competence and
experience. Further, 51.6% of respondents do not buy prescribed medications
regularly, and 75% of these refer to lack of money as the reason for this. As Fig.
1.3 indicates, the lower the income, the higher the proportion of respondents
who worry about lack of money as a constraint to receiving necessary health
care services.
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