2010/2011

CHAPTER 2
Population changes,
life expectancy and health
2.1. Introduction
Mare Ainsaar
This chapter discusses people’s lives, the birth of children,
family life and mortality in the Baltic states. It explores
the similarities and differences between the three Baltic
states in terms of population change. In almost all transition
countries, the 1990s brought about a decrease in
birth rates and life expectancy and an increase in emigration.
In the case of the three Baltic states, which are
among Europe’s smallest countries in terms of population
size, the negative population changes will affect the societies
for centuries to come.
Problems related to reconciling work and family life
might be one of the factors that contributed to the high
price that the Baltic peoples paid for their social transition
in terms of the worsening of their population indicators.
This chapter addresses problems related to family
and family policies, points out the connections between
the changes in people’s professional lives and their opportunities
and migration, mortality and the birth rate.
The most distinctive feature of the Baltic countries in
Europe at the end of the 20th century and the beginning of
the 21st century is short life expectancy, especially among
men. Mortality is a composite indicator that reflects people’s
quality of life throughout their lives, their own ability
to take care of their health and their will to live, as well as
the capacity of the state’s health care policy to preserve people’s
lives. This chapter consists of three parts, the first of
which discusses general demographic changes in the Baltic
states over the past two decades, while the second explores
the issue of mortality and the third provides an overview of
the developments of the Baltic health care system.
2.2. Demographic costs of transition
and the future of the Baltic states
Mare Ainsaar, Vlada Stankuniene
Introduction
The majority of European countries enjoyed continuous
population growth throughout the 1990s and the first decade
of the 21 st century, despite low birth rates in the 1990s.
This growth was supported both by a greater number of
births over deaths and migration inflows. Total population
decline has manifested in only a few countries (Figure
2.2.1), including the Baltic states. Analyses from 1990–
2009 demonstrate that the Baltic states were in the group
with one of the steepest declines in population together
with Romania, Ukraine, Bulgaria and Hungary. In this
chapter, we analyse why these changes occurred and how
population change might influence other areas of life in
society.
Demographic trends are produced in combination
with individual and social factors. The Baltic states had
a common social and structural heritage until the beginning
of the 1990s. The period after 1990 can be described
as a transition period, but the transition outcome varied
in different countries and for different population groups.
All the Baltic states, but especially Latvia and Estonia,
experienced intensive immigration from Soviet Union
territories from the Second World War until the end of
the 1980s, and they also had positive natural growth.
Although life expectancy was not very high, the birth
rate was sufficient to guarantee replacement and an even
growth of population. As a result of these processes, all
the Baltic states had a comparatively young population,
and Estonia and Latvia also contained a significant share
of the so-called Russian-speaking immigrant population
(Russians, Ukrainians and Belarusians) at the beginning
of the 1990s (Table 2.2.2). The analyses of Nobile (1994)
from 1980 demonstrated that Estonia, Latvia and Lithuania
were the closest countries to each other in the context
of child-bearing characteristics in Europe.
Beginning of the 1990s
Population changes at the beginning of the 1990s can
be interpreted in the contexts of general social transformation.
The transformation period in the 1990s can
be described as the reconstruction of new social norms,
structures and values. The building up period was associated
with higher social mobility and opportunities
(Helemäe et al 1997, Helemäe 2010) on the one side, but
also with higher risks and adaption difficulties (Milano-
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