7.1 General context
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Main trends in the health conditions of young people
Two cross-national studies provide information about young people's well-being, health behaviours and their social context:
- Health Behaviour in School-aged Children (HBSC) is conducted once every four years among 11, 13 and 15-year-old students.
- The European School Survey Project on Alcohol and Other Drugs (ESPAD) collects data on substance use among 15-16-year-old students once every four years.
According to the latest HBSC study, most Estonian young people rate their health (an indicator of general health) as fair (88% rated their health as good or very good) and are satisfied with their life (88% rated life satisfaction high). During recent years mental health problems have increased in frequency among Estonian youth – students have reported more episodes of depression and difficulties in sleeping. Increased screen time (TV, computer, tablet) also affects students’ well-being. About half of the students aged 11-15 spend five or more hours using electronic devices. Excessive internet use and internet addiction are growing problems in Estonia.
According to the HBSC and ESPAD surveys, young people are using less tobacco and alcohol compared to previous years. At the same time, Estonian young people are among the first three countries in Europe where tobacco and alcohol initiation and binge drinking are highest (young people were asked at what age they first smoked a cigarette, drank alcohol or got drunk). A positive trend is that compared to previous studies, the usage of illegal substances, including cannabis, has decreased remarkably over the years, however, the usage of cannabis during the previous 30 days has not decreased. According to the study published in 2019, the usage of drugs and alcohol is connected with risk behaviour and bullying, satisfaction with school, etc.
Another serious problem in Estonia is obesity caused by inactive lifestyles and poor nutrition. Only one in every six children takes part in moderate-to-vigorous physical activity that lasts 60 minutes per day. Less than half of all children consume fruit and vegetables daily. Strategies and interventions are needed that focus on increasing physical activity and shaping children's eating habits.
Sexual behaviour among Estonian youth has consistently improved: the number of teenage pregnancies, abortions and sexually transmitted infections has decreased. At the same time, the last HBSC study demonstrated a decrease in the use of condoms at the time of last intercourse.
Main concepts
In general, both "health” and “well-being” are in use in Estonia but as the understanding of factors that influence health and well-being and cooperation need has increased, the use of the well-being concept is more prevalent.
According to the Child Protection Act, a child’s well-being means “the condition supporting the development of the child in which the physical, medical, psychological, emotional, social, cognitive, educational and economic needs of the child are satisfied”.
In the renewed Public Health Act, the use of the term "health profile" will be changed to "health and well-being profile". The reason for this change is that all partners at local, regional and state levels feel more connected to making the communities healthier.