Age, Period and Cohort Effects On Alcohol Consumption In Estonia, 1996-2018.

AIMS: To analyse the independent effects of age, period and cohort on estimated daily alcohol consumption in Estonia. METHODS: This study used data from nationally representative repeated cross-sectional surveys from 1996 to 2018 and included 11,717 men and 16,513 women aged 16-64 years in total. The dependent variables were consumption of total alcohol and consumption by types of beverages (beer, wine and strong liquor) presented as average daily consumption in grams of absolute alcohol. Mixed-effects negative binomial models stratified by sex were used for age-period-cohort analysis. RESULTS: Alcohol consumption was highest at ages 20-29 years for both men and women and declined in older ages. Significant period effects were found indicating that total alcohol consumption and consumption of different types of beverages had increased significantly since the 1990s for both men and women. Cohort trends differed for men and women. Men born in the 1990-2000s had significantly lower daily consumption compared to earlier cohorts, whereas the opposite was found for women. CONCLUSION: While age-related patterns of alcohol consumption are aligned with life course stages, alcohol use has increased over the study period. Although the total daily consumption among men is nearly four times higher than among women, the cohort trends suggest convergence of alcohol consumption patterns for men and women.

Real-time monitoring shows substantial excess all-cause mortality during second wave of COVID-19 in Europe, October to December 2020.

The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality. Europe is currently seeing another upsurge in COVID-19 cases, and EuroMOMO is again witnessing a substantial excess all-cause mortality attributable to COVID-19.

Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020.

A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March-April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45-64 (8%) and 15-44 year olds (1%). No excess mortality was observed in 0-14 year olds.

Changes over fourteen years in adult obesity in Estonia: socioeconomic status and use of outpatient health services.

It has been noted that great socioeconomic and lifestyle changes have triggered an epidemic of obesity among Eastern Europeans. The objective of this study was to assess the change of adult obesity in Estonia by socioeconomic status and the use of outpatient healthcare services among obese individuals over time. It can be maintained that obesity distribution in Estonia in 1990-2004 developed similarly to an average Western country and, regardless of an increasing level of male obesity, obesity prevalence for 16-64 year-olds was on the average level in Europe in 2004 - 14.0% for men and 14.9% for women. Change in obesity prevalence correlates quite well with changes in the economy in Estonia. From studied socioeconomic variables only age and education (among women) strongly affect the change in obesity level. Obese individuals used outpatient medical care slightly differently compared to individuals with a normal BMI.

Long-term trends in the body mass index and obesity risk in Estonia: an age-period-cohort approach.

OBJECTIVES: To analyse the age, period and cohort effects on the mean body mass index (BMI) and obesity over the past two decades in Estonia. METHODS: Study used data from nationally representative repeated cross-sectional surveys on 11,547 men and 16,298 women from 1996 to 2018. The independent effects of age, period and cohort on predicted mean BMI and probability of obesity (BMI ≥ 30 kg/m2) were modelled using hierarchical age-period-cohort analysis. RESULTS: Curvilinear association between age and mean BMI was found for men, whereas the increase in mean BMI was almost linear for women. The predicted mean BMI for 40-year-old men had increased by 6% and probability of obesity by 1.8 times over 1996-2018; the period effects were slightly smaller for women. Men from the 1970s birth cohort had higher mean BMI compared to the average, whereas no significant cohort effects were found for obesity outcome. CONCLUSIONS: Population-level BMI changes in Estonia during 1996-2018 were mostly driven by period rather than cohort-specific changes.

Use of mammography and Pap smear in Estonia, a country without organized cancer screening.

OBJECTIVES: To analyze mammography and Pap smear status in Estonia where no organized population-based cancer screening is available. METHODS: 5000 individuals (aged 16-64) were randomly chosen from the national population register; among them, 1755 women filled out postal questionnaires. RESULTS: 50% of respondents aged 45-64 reported having taken a mammogram, 51% of women aged 25-64 had the Pap smear at least once in their lifetime. Corresponding figures for the past two years were 37% and 30%. Irrespective of age, women taking fewer tests over the past two years were rural workers, unemployed, and health behavior recommendations ignorers. In most cases, initiative for mammogram came from women, and from the physician in the case of Pap smear. Moderate increase in mammography use occurred after a project for early detection of breast cancer was launched. CONCLUSION: Women must continuously be informed that early detection of breast and cervical cancer is possible. Young women should be encouraged to ask for Pap testing. Knowledge of family physicians should be improved.