1.
Haridus murdepunktis
2.
Hariduse andmetarkus
3.
Haridus kui tuluteenimise vahend
4.
Haridus kui sotsiaalne lift
5.
Tarkvara uuendatud, aga kas õppimine ka?
6.
Kestlikkus hariduspeeglis
7.
Haridus on turvalise ühiskonna alus

Reflection

Educational inequality in health in Estonia is substantial and has not declined – people with higher education live on average 11 years longer than those with basic education. One third of this health gap is explained by smoking, one fifth by an unhealthy diet and one tenth by alcohol consumption, with access to healthcare services also playing an important role. Prevention must therefore address these risk factors and ensure access to medical care. Evidence-based policy makes unhealthy choices more expensive, reduces their availability, restricts advertising and requires clear labelling. This is easier said than done, as several evidence-based interventions lack broad political support, making rapid implementation unlikely.

What could be three steps towards a longer and healthier life for all?

First, stop placing responsibility solely on individuals. The risk of morbidity and mortality is linked to socio-economic characteristics in every country. Wider health disparities between population groups reflect social injustice. If education shapes health behaviour, income determines access to healthcare and parental background influences children’s health, then health outcomes are not determined solely by personal choice but are also shaped by social norms, the distribution of resources and the broader living environment. As long as obesity is attributed to laziness, alcohol use to personal failure and smokers are told to cover their own healthcare costs, current health inequalities will be reproduced in the next generation.

Second, implement evidence-based recommendations so that children grow up healthier. Examples include providing healthy free school meals, banning advertising of unhealthy food to children, enforcing and strengthening supervision of existing regulations on the minimum age for alcohol sales and e-cigarettes, and restricting the distance sale of alcohol so that beer does not arrive at the doorstep within 20 minutes together with takeaway food.

Third, design prevention and healthcare services so that they are accessible and appropriate for target groups. The financial burden on vulnerable groups within the healthcare system should not increase, and the shift of service provision towards the private sector should be limited. Personalised, risk-based prevention should be developed – including support for smoking cessation, improved treatment adherence and weight reduction – and its design should take into account the views and experiences of people with lower levels of education.

The risk of morbidity and mortality is linked to socio-economic characteristics in every country.