Years In Estonia Research Articles

Alcohol Use Disorder Incidence, Mortality, and Disability-Adjusted Life Years in Estonia, 1990 to 2019: A Joinpoint Regression Analysis Using Global Burden of Disease Study

Background: Alcohol consumption is widely recognized as a leading cause of premature mortality and a significant global health concern. This study aimed to investigate the trends in alcohol use disorders, including incidence, mortality, and disability-adjusted life years (DALYs), in Estonia from 1990 to 2019 using data from the Global Burden of Disease (GBD) dataset. Methods: The GBD study is a comprehensive epidemiological research effort that analyzes various causes of death, diseases, injuries, and risk factors across multiple countries and territories. In this study, we utilized the GBD dataset to estimate annual incidence, prevalence, mortality, years of life lost, years living with disabilities, and DALY rates by gender and age from 1990 to 2019. To assess the trends in these indices, including DALY, incidence, mortality, and 1-mortality-to-incidence ratio (1-MIR), joinpoint regression analysis was employed. This allowed for the identification of significant changes in trends at specific time points and the calculation of annual percent change between these points. Results: Our findings revealed an overall decreasing trend in the incidence rate of alcohol use disorder over the study period. However, the average DALY, mortality, and 1-MIR trends did not exhibit significant variation during this time. Moreover, we observed a more substantial decline in alcohol use disorders among men compared to women from 1990 to 2019. Specifically, the incidence of alcohol use disorders demonstrated a significant increase from 1990 to 2000, followed by a decline from 2010 to 2018, and continued to decrease from 2017 to 2019. Conclusion: This study provides important insights into the changing trends of alcohol use disorders, including incidence and mortality, in Estonia from 1990 to 2019. Our findings indicate a decreasing pattern over time, suggesting a positive shift in alcohol consumption behavior. Additionally, we observed that men had higher rates of MIR, DALY, mortality, and incidence of alcohol use disorders compared to women. These results emphasize the need for targeted health prevention programs to sustain and further promote the downward trend in alcohol-related disorders.

"Is the World Still There?": Estonian Lockdown Diaries The Year in Estonia

"Is the World Still There?": Estonian Lockdown Diaries The Year in Estonia

Life Writing in Relational Modes: The Year in Estonia

Life Writing in Relational ModesThe Year in Estonia Leena Kurvet-Käosaar (bio) and Maarja Hollo (bio) A glance at some of the canonical works of life writing in Estonia, such as August Kitzberg's Ühe vana "tuuletallaja" noorpõlve mälestused (1924) or Jaan Kross's two-volume Kallid kaasteelised (2000, 2008), reveals the prominence of "a relational model of identity, developed collaboratively with others" (Eakin, How Our Lives 57).1 What makes relationality a worthwhile focus for our review of Estonian life writing of the last two years are its varied manifestations in texts that engage with different generic conventions and cut across different strata of (literary) culture, from award-winning authors to amateur biographers, and from leading publishing houses to scholarly presses and grassroots publishing initiatives. One of the most noteworthy trends in Estonian life writing of the twenty-first century is the emergence of biogeographical spaces that form the basis of the author's self-perception and memories. One of the prime examples of this trend is the autobiographical novel Paradiis (2009) by Tõnu Õnnepalu—currently one of the most well-known contemporary Estonian authors—that unfolds on Hiiumaa, one of Estonia's small islands, and interweaves detailed descriptions of concrete places, buildings, and landscapes with the author's emotions and memories. Õnnepalu himself has described Paradiis as a work that combines documentary features and fairy tale elements (Laurisaar). In his latest work, an autobiographical trilogy published in 2019, Õnnepalu again interweaves fictional and factual, returning to the question of how a specific place, its people, and its landscapes shape the author's subjectivity as a (look from) "ühest maailma kohast maailma ja iseendasse" [self-reflection from a particular place in the world] (Pariis, back cover) entails. The first volume of the trilogy, the diary novel Pariis, describes the author/narrator's life in Paris in the summer of 2018 with reminiscences of the summer of 1993 when he was finishing his debut novel Piiririik (1993). Although the narrator's motivation is the desire to remember and relive the beginning of his journey as a writer, his [End Page 55] self-observations, reflections, and memories are overshadowed by contemporary Parisian landscapes and descriptions of Parisians. The second, quite controversial volume of the trilogy, Aaker, does not focus on the author's interior life, his memories, and imagination, but on his experience of participating in an annual gathering of diaspora Estonians in the Muskoka region in the woods of northern Ontario. In his work, the author reflects on the meaning of North America (and North American identity), including the experience of being Canadian. He makes no effort to hide his criticism of the Canadian Estonian community, asserting that his bitterness stems from their sense of moral superiority over Estonians in Estonia (Aaker 273). The roots of the narrator's attitude lie in the Soviet era, when Estonians then living in the occupied homeland were regarded by refugees abroad as collaborators with the Soviet regime. Yet the work also stands out for its picturesque depictions of the local natural surroundings—the landscape, animals, and plants where the author utilizes his extensive knowledge of nature, as well as his reflections on the meaning of Europe, viewed from the opposite shore of the "Big Pond." The last volume of the trilogy, Lõpmatus, is dedicated to one of Estonia's small islands, Vilsandi, which has been given the poetic name Lõpmatus (endlessness), a pun by the author as a response to a question by a friend "Kuhu maailma lõppu sa siis nüüd jälle pugenud oled?" [Where in the end of the world have you been hiding yet again?] (12). Distinct from Pariis and Aaker, this text presents perception of place and the narrator's vision of himself as interconnected; self-examination takes place by feeling one's way into a place and situating oneself within it. The novel consists of a collage of essayistic portraits that sketch firmer outlines of certain residents on the island, plants, birds, or locations that the narrator finds particularly meaningful. In addition to autobiographical cartography, important elements of the novel elucidate the narrator's confessional thoughts about time, particularly...

The Effect of Cover Crops on the Yield of Spring Barley in Estonia

Using cover crops in fallow periods of crop production is an important management tool for reducing nitrate leaching and therefore improving nitrogen availability for subsequent crops. We estimated the short-term effect of five cover crop species on the yield of successive spring barley (Hordeum vulgare L.) for two years in Estonia. The cover crop species used in the study were winter rye (Secale cereale L.), winter turnip rape (Brassica rapa spp. oleifera L.), forage radish (Raphanus sativus L. var. longipinnatus), hairy vetch (Vicia villosa Roth), and berseem clover (Trifolium alexandrinum L.). The results indicated that out of the five tested cover crops, forage radish and hairy vetch increased the yield of subsequent spring barley, whereas the other cover crops had no effect on barley yield. All cover crop species had low C:N ratios (11–17), suggesting that nitrogen (N) was available for barley early in the spring.

Life Writing's Coming of Age: The Year in Estonia

Life Writing's Coming of Age: The Year in Estonia

Compliance with Pregnancy Prevention Recommendations for Isotretinoin in Estonia in 2012-2016.

BackgroundIsotretinoin is an effective treatment for severe acne; no alternative treatment has an equal therapeutic effect. The teratogenic effects of isotretinoin can be avoided, and numerous recommendations and regulations are in force to minimize the risk of pregnancy during treatment.ObjectivesTo describe isotretinoin prescription patterns for women aged 15–45 years, assess the concomitancy of isotretinoin and contraceptive use, and determine the rate of potential isotretinoin-exposed pregnancies in Estonia.MethodsThis retrospective, nationwide, population-based, cohort study derived data from national health insurance databases and included female patients aged 15–45 years in Estonia for whom one or more prescriptions for isotretinoin were dispensed between 2012 and 2016. The main outcome was the proportion of women who used systemic isotretinoin and had a concomitant record of (hormonal or intrauterine) contraception use covering the isotretinoin treatment period when pregnancy is contraindicated.ResultsOf the 2792 women aged 15–45 years filling an isotretinoin prescription, 15.7% (95% CI 14.4–17.1) had full and 13.9% (95% CI 12.7–15.3) partial (not covering the whole period during which pregnancy is contraindicated) contraceptive coverage. The risk for potential isotretinoin-exposed pregnancy was 3.6 (95% CI 2.0–7.0) per 1000 treated women over the 5-year observation period. The odds for full coverage with effective contraception increased with the age of the patient, with the duration of isotretinoin treatment and over the period of observation.ConclusionOur study adds to the existing literature documenting limited compliance with pregnancy prevention programs for isotretinoin-containing products, and calls for program assessment to identify whether new measures should be taken or whether weaknesses in policy or implementation can be corrected.

Becoming an Adult in France, Estonia and Russia

The aim of this study is to compare the sociodemographic events marking the transition to adulthood in France, Estonia and Russia: first leaving parents, completion of education, first partnership, first marriage and first childbirth. We used the first waves of the Generations and Gender Survey for these three countries and an advanced method – Sequence Analysis. According to the Second Demographic Transition Theory, we expected a convergence in the sequencing, timing and tempo of the occurrence of target events. The results showed the slow convergence of sequences, but not of timing and tempo. Estonia and Russia are still close in the timing of the occurrence of events, but in tempo Estonia and France are more alike. The ages at which people start families in Estonia and Russia have decreased in younger generations in comparison with older ones, despite our expectation that they would increase. For the youngest generation (1970s), the time between leaving parents and becoming a parent is 5-7 years in France, 4-6 years in Estonia and 2-3 years in Russia. The sociodemographic behaviour of Estonians clearly positions them between Europe and Russia. Thus, the comparison of France, Estonia and Russia only partially confirms the Second Demographic Transition Theory.

The Legal Problems of Occupational and Health Safety in Estonia

Summary Number of occupational accidents has decreased in recent years in Estonia. Article discusses whether the reason for this can be insufficient labour inspection legal system. The conformity of Estonian occupational health and safety regulation on supervision to the international law providing rules for labour inspection in this field is evaluated. More specifically, ILO conventions no 81 and no 129 and European Council directive 89/391/EEC are analysed to find out whether the high number of occupational accidents derive from the non-compliance of the international rules. Difficulties in following the international law rules are analysed, presenting and discussing also the problems appearing in the context of new labour relations in a changing society

Trends in self-rated health and association with socioeconomic position in Estonia: data from cross-sectional studies in 1996-2014.

BackgroundSelf-rated health (SRH) and socioeconomic position (SEP) as important determinants of health differences are associated with health and economic changes in society.The objectives of this paper were (1) to describe trends in SRH and (2) to analyze associations between SRH and SEP among adults in Estonia in 1996–2014.MethodsThe study was based on a 25–64-year-old subsample (n = 18757) of postal cross-sectional surveys conducted every second year in Estonia during 1990–2014. SRH was measured using five-point scale and was dichotomized to good and less-than-good. Standardized prevalence of SRH was calculated for each study year. Poisson regression with likelihood ratio test was performed for testing trends of SRH over study years. Age, nationality, marital status, education, work status and income were used to determine SEP. Logistic regression analysis was used to assess association between SRH and SEP.ResultsThe prevalence of dichotomized good self-rated health increased significantly over the whole study period with slight decrease in 2008–2010. Until 2002, good SRH was slightly more prevalent among men, but after that, among women. Good SRH was significantly associated with younger age, higher education and income and also with employment status among both, men and women. Good SRH was more prevalent among Estonian women and less prevalent among single men.ConclusionsThere was a definite increase of good SRH over two decades in Estonia following economic downturn between 2008 and 2010. Good SRH was associated with higher SEP over the study period. Further research is required to study the possible reasons behind increase of good SRH, and it’s association with SEP among adults in Estonia.

Tohu varumine elus puudelt. Emotsioonid, eetika, esteetika ja seadused / The Collection of Birch Bark from Living Trees: Emotions, Ethics, Aesthetics and the Law

Recent years in Estonia have seen a growing level of interest in working with birch bark, and yet practicing this craft requires accessibility to raw materials – birch bark – that are of suitable quality. As the act of felling trees damages the bark, handicraft and construction work that requires bark generally tends to harvest it from trees that are still growing. The author suggests that careful and mindful bark peeling only affects the health of the tree to a small extent and for a short period. However, the widespread ethic, aesthetic, and emotional attitudes in modern society do not look kindly upon removing bark from a living tree and allowing that tree to continue to grow. With this view in mind, the author concludes that it is currently more appropriate to remove bark only from those trees that are about to be cut down in the same year.

Preventable fractions of cervical cancer via effective screening in six Baltic, central, and eastern European countries 2017–40: a population-based study

SummaryBackgroundCervical cancer incidence remains high in several Baltic, central, and eastern European (BCEE) countries, mainly as a result of a historical absence of effective screening programmes. As a catalyst for action, we aimed to estimate the number of women who could be spared from cervical cancer across six countries in the region during the next 25 years, if effective screening interventions were introduced.MethodsIn this population-based study, we applied age–period–cohort models with spline functions within a Bayesian framework to incidence data from six BCEE countries (Estonia, Latvia, Lithuania, Belarus, Bulgaria, and Russia) to develop projections of the future number of new cases of cervical cancer from 2017 to 2040 based on two future scenarios: continued absence of screening (scenario A) versus the introduction of effective screening from 2017 onwards (scenario B). The timespan of available data varied from 16 years in Bulgaria to 40 years in Estonia. Projected rates up to 2040 were obtained in scenario A by extrapolating cohort-specific trends, a marker of changing risk of human papillomavirus (HPV) infection, assuming a continued absence of effective screening in future years. Scenario B added the effect of gradual introduction of screening in each country, under the assumption period effects would be equivalent to the decreasing trend by calendar year seen in Denmark (our comparator country) since the progressive regional introduction of screening from the late 1960s.FindingsAccording to scenario A, projected incidence rates will continue to increase substantially in many BCEE countries. Very high age-standardised rates of cervical cancer are predicted in Lithuania, Latvia, Belarus, and Estonia (up to 88 cases per 100 000). According to scenario B, the beneficial effects of effective screening will increase progressively over time, leading to a 50–60% reduction of the projected incidence rates by around 2040, resulting in the prevention of cervical cancer in 1500 women in Estonia and more than 150 000 women in Russia. The immediate launch of effective screening programmes could prevent almost 180 000 new cervical cancer diagnoses in a 25-year period in the six BCEE countries studied.InterpretationBased on our findings, there is a clear need to begin cervical screening in these six countries as soon as possible to reduce the high and increasing incidence of cervical cancer over the next decades.FundingNone.

Improvement in out-of-hospital cardiac arrest survival over last 10 years in Estonia

Improvement in out-of-hospital cardiac arrest survival over last 10 years in Estonia

The incidence of hip fractures in Estonia, 2005–2012

The incidence of hip fractures among individuals aged over 50 in Estonia and trends over time were assessed for 2005-2012. The incidence among women is relatively low, with the declining trend, but the rate among men is among the highest in Eastern and Central Europe. The aim of this study was to assess the incidence and trends of hip fractures among individuals over 50 years in Estonia in 2005-2012 and to increase understanding of the incidence of hip fractures in Eastern Europe. We identified all patients aged 50 years or older with hip fracture (ICD-10 codes S72.0, S72.1 and S72.2) in 2005-2012 using medical claims data from the Estonian Health Insurance Fund. Crude and age-specific incidence rates were calculated for men and women using the population of Estonia in 2005-2012. To adjust for age differences in the population, standardized incidence rates (SIR) were estimated. The SIR per 100,000 for the entire observation period was 209.2 (95% CI 204.2 to 214.2) in women and 215.6 (95%CI 208.2 to 223.1) in men, resulting in a female to male rate ratio of 0.97 (95% CI 0.84 to 1.11). Over the period of 2005-2012 the estimated SIR/100,000 ranged from 211.5 (95% CI 196.8-226.3) in 2005 to 183.7 (95% CI 170.8-196.7) in 2012 in women, and from 238.5 (95% CI 215.4-261.7) in 2005 to 187.9 (95% CI 169.0-206.8) in 2012, in men. For women, the decrease in SIR for the study period approached statistical significance (p = 0.058), and for the period of 2009-2012, we observed an accelerated 16% decrease (p = 0.008). The incidence of hip fractures among Estonian women is relatively low, whereas the rate among men is among the highest in Eastern and Central Europe. In line with many countries, we found a recent decline in incidence among women.

Educational differences in cigarette smoking among adult population in Estonia, 1990-2010: does the trend fit the model of tobacco epidemic?

BackgroundIn developed countries, smoking spreads through society like an epidemic in which adults from higher socioeconomic groups are the first to adopt and earlier to quit smoking, and in which exists a lag in adoption of smoking between men and women.The objective of this study was to describe trends in daily and occasional smoking, to investigate association between smoking status and education, and to examine if the associations in 1990–2010 in Estonia fit the pattern predicted by the model of tobacco epidemic.MethodsThe study was based on a 20–64-year-old subsample (n = 18740) of nationally representative postal cross-sectional surveys conducted every second year in Estonia during 1990–2010. Cigarette smoking and education were examined. χ2 test for trend was used to determine daily and occasional smoking trends over study years. Multinomial logistic regression model was used to test educational differences in daily and occasional smoking for every study year. Adjusted relative risk ratios (RRRs) with 95% confidence intervals were calculated.ResultsIn 1990–2010, daily smoking varied largely between genders showing decreasing trend among men, but not among women. In 2010, one third of men and one fifth of women were daily smokers. Daily smoking was not clearly associated with education among men in 1990–1994 and among women in 1990–2000. Men revealed inverse relationship between daily smoking and education since 1996, but women since 2002. In 2010, compared to men and women with higher education, relative risk ratio of daily smoking was 2.92 (95% CI = 2.01–4.25) among men and 2.29 (95% CI = 1.65–3.17) among women with secondary education, but 4.98 (95% CI 3.12–7.94) among men and 6.62 (95% CI = 4.07–10.76) among women with basic education.In 1990–2010, occasional smoking was stable and similar (varying between 7–10%) among men and women, no association with education was found.ConclusionsDaily smoking patterns in Estonia fit the model of tobacco epidemic in developed countries. Educational differences in daily smoking highlight the importance of addressing smoking behaviour in the general population by educational subgroups in Estonia.

Impact and cost-effectiveness analysis of the national school-based sexuality education programme in Estonia

Policy-makers making decisions on the implementation of school-based sexuality education (SE) programmes face two important questions: (1) what are the costs of implementing and scaling up SE programmes, and (2) what are the impacts? This paper responds to these questions by retrospectively assessing costs, impact and cost-effectiveness of the national school-based SE programme in Estonia 1997–2009. The three-year curriculum had been taught to 190,000 students at the end of 2009. The cost of reaching one student was USD 32.90 and the total costs were USD 5.6 million. There has been a remarkable improvement in sexual health indicators in the age groups 15–19 and 20–24 years in Estonia between 2001 and 2009. During this period, annual abortions, STIs and diagnosed HIV infections in the age groups were reduced by 37%, 55% and 89%, respectively. It is difficult to assess to what extent the improvements in these sexual health indicators are attributable to the SE programme. Nevertheless, our conservative threshold analysis indicates that the Estonian SE programme could be considered cost-saving if only 4% of the observed reductions in HIV infections are attributable to the programme. There is strong evidence, therefore, to support that the Estonian school-based sexuality programme has been cost-effective.

Postponing Births – Comparing Reasons Among Women in St Petersburg, Estonia and Finland

We compared the reasons for postponing first birth in the three neighbouring areas of St Petersburg (Russia), Estonia and Finland. Data from three population-based surveys among women aged 18–44 years in St Petersburg (response rate 67%); Estonia (54%) and Finland (63%) in the early 2000s were used and analysed with logistic regressions. Childbearing intentions and reasons for postponing parenthood differed between both study areas and age groups. The proportion of women aged 35–44 still planning to have children was highest in Estonia. In the two post-Soviet areas, job insecurity increased postponement intentions among women aged 18–34 years. Enrolment in education was an important reason for postponement among women below 35 years in Estonia and aged 25–34 years in St Petersburg. In Finland, poor economic situation in the youngest age group and desire to advance a career among all women were important reasons to postpone birth. The importance of prolonged education and job insecurity for the timing of births in St Petersburg and Estonia suggests that governments should improve family policy measures to encourage childbearing among the young. In Finland policies to support the reconciliation of family and career and to increase permanent employment could promote parenthood among well-educated women.

Gender Differences in Reading Habits Among Boys and Girls of Basic School in Estonia

Problem Statement: Reading habits and reading interest of teenagers is probably the most discussed issue among teachers and in media as well in Estonia during last five years. The year 2010 had been announced as reading year in Estonia. Therefore it is not hard to understand the actuality of named issue, especially in the light of 5 Education Benchmarks for Europe defined by the European Commission in the framework of the Lisbon-Strategy. It is hard to find a better timing for the dealing with reading issues, taking into consideration that starting from September 2010 the new National Curriculum came into force in Estonia, where literature is named as separate subject from grade 5 upwards. This leads to a stereotypical conception about reading, which expresses the opinion that: 1) reading (also the skill of reading) mostly refers to reading fiction; 2) our teenagers are bad readers (they don’t read enough literature); 3) especially boys tend to read less and less.Purpose of Study: The above discussed standpoints and participation in the ADORE-project provided the need to organize the research, the goals of which was to find out 1) what kind of texts are authentic for the students, what they read voluntarily, how long time teenagers spend with reading etc. and 2) are there differences between boys and girls in reading habits.Research Methods: The quantitative research method in the form of questionnaire was used, which included 15 open-ended and multiple-choice questions. 140 students participated in the survey.Findings: The results of the research showed that there are differences between boys and girls in many aspects of reading habits and preferences. Boys named themselves mostly as average or poor readers, they read less classical literature voluntarily, they spend less time with reading, they don’t like to read long books and books with small letters etc. In the same time, boys and girls seemed to be rather similar readers by computer.Conclusions: The results of the conducted questionnaire provided the food for thought about broadening the assortment of reading materials for students and for making Estonian language lessons more suitable for every student.

Does Induction Programme Support Novice Teachers’ Intrinsic Motivation to Work?

Newly qualified teachers frequently experience difficulties starting their careers at school and in many cases, leave the profession during their first five years. A support programme for novice teachers, ‘The Induction Programme’, has been running now for nine years in Estonia. However we do not know how the programme has influenced several important features, such as novice teachers’ intrinsic motivation for their work, which can have an impact on whether or not they stay in the profession. Teachers’ motivation is of fundamental importance as it not only predicts their own well-being and job satisfaction but also students’ outcomes and engagement. The main aim of this research was to evaluate the possible impact of the induction programme on novice teachers’ intrinsic motivation. The present study analysed novice teachers’ level of motivation in six sub-categories such as enjoyment, perceived competence, perceived choice, pressure, effort and relatedness with colleagues. The sample was formed of two independent teacher groups (N=114). The first group participated in an induction programme in 2010/2011 and the second one in 2011/2012. The Intrinsic Motivation Inventory (Ryan, 1982; Deci, Eghrari, Patrick, & Leone, 1994) was used at the beginning of both school years. The results indicated a rather high level of intrinsic motivation and a rather low level of the negative factor, such as pressure and tension. Significant differences also exist between class teachers and teachers of social sciences and languages, and between teachers of sciences and teachers of several subjects. Relatedness with colleagues were considered very important and the score grew along the year as well. These findings tell us that novice teachers come to school with positive attitudes which remain the same or even improve by the end of the first year. The induction programme may have contributed to such positive outcomes.

Impacts of artificial drainage on amphibian breeding sites in hemiboreal forests

Artificial drainage is widely used to increase timber production and improve its quality in northern boreal and temperate forests, but its impact on biodiversity remains largely unexplored. Amphibians are particularly dependent on forest wetland qualities to complete their complex life cycles. We explored the supply of water bodies, their occupancy by amphibians, and persistence during the larval period comparatively in drained and natural forest plots in two years in Estonia. The water bodies in drained plots were more abundant but less diverse and of generally lower quality than in natural plots; however, the drainage ditches were favoured by newts. In the dry spring of 2009, water bodies were used more frequently in natural than in drained plots, while in the typical spring of 2010, several natural depressions appeared in drained plots and the frequency of use of water bodies did not differ between natural and drained plots. However, most natural depressions used for breeding in drained plots dried out before tadpole metamorphosis; such drying was not observed in natural plots. Thus, by profoundly changing natural hydrology, intensive large-scale forest drainage reduces the variety of water bodies and the quantity and quality of amphibian breeding sites. Moreover, we suspect that, at least in some years, temporary water bodies in drained areas function as ecological traps for amphibians. We suggest that, where possible, intact wet-forest areas with remaining natural hydrology should stay undrained. In areas already drained, breeding sites for amphibians can be provided by creating depression-like enlargements to some ditches.

Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis

Although life expectancy in the European Union (EU) is increasing, whether most of these extra years are spent in good health is unclear. This information would be crucial to both contain health-care costs and increase labour-force participation for older people. We investigated inequalities in life expectancies and healthy life years (HLYs) at 50 years of age for the 25 countries in the EU in 2005 and the potential for increasing the proportion of older people in the labour force. We calculated life expectancies and HLYs at 50 years of age by sex and country by the Sullivan method, which was applied to Eurostat life tables and age-specific prevalence of activity limitation from the 2005 statistics of living and income conditions survey. We investigated differences between countries through meta-regression techniques, with structural and sustainable indicators for every country. In 2005, an average 50-year-old man in the 25 EU countries could expect to live until 67.3 years free of activity limitation, and a woman to 68.1 years. HLYs at 50 years for both men and women varied more between countries than did life expectancy (HLY range for men: from 9.1 years in Estonia to 23.6 years in Denmark; for women: from 10.4 years in Estonia to 24.1 years in Denmark). Gross domestic product and expenditure on elderly care were both positively associated with HLYs at 50 years in men and women (p<0.039 for both indicators and sexes); however, in men alone, long-term unemployment was negatively associated (p=0.023) and life-long learning positively associated (p=0.021) with HLYs at 50 years of age. Substantial inequalities in HLYs at 50 years exist within EU countries. Our findings suggest that, without major improvements in population health, the target of increasing participation of older people into the labour force will be difficult to meet in all 25 EU countries. EU Public Health Programme.