Lugejauuringust selgus Eesti tervishoiutöötajate meditsiinimeedia kasutamise tava

Eesti Arst 2012; 91(4):174-17

Comparing the cognitive functioning of middle-aged and older foreign-origin population in Estonia to host and origin populations

BackgroundIn migration and health research, the healthy migrant effect has been a common finding, but it usually pertains to specific contexts only. Existing findings are inconsistent and inconclusive regarding the cognitive functioning of the (aging) foreign-origin population relative to the populations of their host and sending countries. Moreover, this comparison is an understudied design setting.ObjectiveWe analyze the outcomes and associations of cognitive functioning outcomes of the non-institutionalized middle-aged and older population, comparing the Russian-origin population in Estonia with Estonians in Estonia and Russians in Russia in a cross-sectional design. We aim to estimate the (long-term) effects of migration on cognitive functioning in later life, contextualizing the findings in previous research on the healthy migrant effect.Data and methodsWe use data from face-to-face interviews conducted within the SHARE Estonia (2010–2011) and SAGE Russia (2007–2010) surveys. Respondents aged 50+ living in urban areas were grouped by self-identified ethnicity, including 2,365 Estonians, 1,373 Russians in Estonia, and 2,339 Russians in Russia (total N = 6,077). Cognitive functioning was measured using a 25-percentile cut-off threshold for the results of two cognition outcomes - immediate recall and verbal fluency - and the odds of impairment were estimated using binary logistic regression.ResultsRussian men and women living in Estonia have significantly higher odds of impairment in immediate recall than Estonian men and women, though they do not differ from Russians in Russia in the final adjusted models. The differences between all groups are non-significant if age at migration is considered. There are no significant differences between the groups in verbal fluency.ConclusionContrary to the commonly found healthy migrant effect, the middle-aged and older foreign-origin population in Estonia fares initially worse than the native population in the immediate recall outcome, but does not differ from their sending country population, possibly due to Russia’s higher mortality rate and therefore the selective survival of healthier people. Different results depending on the cognitive functioning outcome suggest that migration may affect temporary memory more than crystallized knowledge. However, there are no differences between the groups if defined based on age at migration, which suggests that the age profile differences explain most of the groups’ differences in cognitive functioning

Fertility Intentions and Views on Gender Roles: Russian Women in Estonia from an Origin-destination Perspective

In this article we investigate fertility intentions of Russian women in Estonia from an origin-destination perspective. Russian migrants to Estonia and their descendants are compared with women in the sending and host countries in order to identify similarities and differences in intended transitions to first, second and third births. The study is based on the Estonian and Russian Generations and Gender Surveys, which were conducted in 2004/2005, and employs logistic regression models. The dependent variables are intentions to become a mother, to have a second child, or to have a third child. The hypotheses for the study are mainly derived from the adaptation, cultural maintenance, and selection (characteristics) perspectives. We also incorporate attitudes towards gender roles into the models, which have proven to be a salient factor in shaping childbearing intentions, but have seldom been considered in studies of migrant fertility.Our results lend support to both the adaptation and cultural maintenance perspectives. In accord with the latter, the similarity between the childbearing intentions of Russian migrants and their descendants in Estonia and those of their counterparts in Russia suggests that socialisation to the ethnic subculture has prevailed over the influence of the host society. We attribute this outcome to contextual features that have retarded integration processes. By contrast, we observe that proficiency in the host country language, residence in areas where the host population constitutes a large majority and having a native partner significantly contribute to the adaptation of migrants’ intentions to have another child to those of the host population. These results provide support to the adaptation argument. Finally, our study reveals a positive association between egalitarian views on gender roles and women’s intentions to have another child. However, variation in gender role attitudes accounts for a relatively minor part of the difference in intended fertility between the groups addressed in this study.* This article belongs to a special issue on migrant fertility

Life-course Factors and Later Life Health in Eastern and Western Europe

Human development and ageing are lifelong processes, where earlier life conditions and events are interlinked with later life outcomes. Patterns of inequality within and among cohorts emerge over time as products of the interplay between institutional arrangements and individual life, often dependent on childhood or earlier life circumstances. The life conditions and experiences of older adults in Eastern and Western Europe differ significantly, but whether their cumulative effects on later life outcomes vary across these two regions has not been compared. We explore the effects of socioeconomic position, the experience of a period of hunger, the dispossession of assets, and discrimination suffered by parents in respondents’ life courses on later life health inequalities in Europe. Self-reported health, everyday activity limitations, and cognitive functioning are the main outcomes that provide an adequate overview of different health domains. We mainly use data from the seventh wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE 2017) and restrict our sample to respondents aged 65 and older from 26 European countries (N=41,566). We find that older people in Eastern Europe fare worse in self-rated health and everyday activity limitations than Western Europeans, while Eastern Europeans indicate somewhat better outcomes in cognitive functioning. A disadvantaged socioeconomic position in childhood and adulthood has the strongest association with all health outcomes, followed by the experience of hunger over the life course for the whole of Europe. However, we do not find diverging associations between life-course factors and health outcomes in Eastern and Western Europe. We argue that self-reported health, everyday activity limitations and cognitive functioning have to be analysed within their own frameworks and cannot yield conclusions that are uniform for all health outcomes. Moreover, major generalisations either about Eastern or Western Europe must be treated with caution as the regions have very different historical as well as demographic developments and thus cannot be treated as uniform. * This article belongs to a special issue on “Demographic Developments in Eastern and Western Europe Before and After the Transformation of Socialist Countries”

The Estonian Generations and Gender Survey 2020:

In Estonia, the Generations and Gender Survey 2020 (GGS-II) is the third large-scale demographic survey that collects data on family and fertility dynamics. As the country participates in the Survey of Health, Ageing and Retirement in Europe, the GGS-II opted for a shorter age range of the sample (18–59). The questionnaire in the GGS-II in Estonia follows the GGS-II wave 1 baseline questionnaire. The questionnaire also includes the Global Uncertainties’ module developed by the Nordic countries, a battery of questions on the perceived impact of COVID-19, and several country-specific items. The GGS-II in Estonia was implemented using only computer-assisted web interviewing (CAWI). In this article, we present a concise overview of the sampling and data collection process, analyse representativeness and response rates, and briefly assess the data quality. We conclude that despite low response rates, the GGS-II provides a good basis for the analysis of fertility and family dynamics

Fertility and family policies in Central and Eastern Europe after 1990

This paper examines fertility and family policies in 15 Central and East European (CEE) countries to establish firstly, likely directions of cohort fertility trends for the coming decade; and secondly, to provide an overview and analysis of family policies in CEE countries, and to assess their impact on cohort fertility trends. Demographic analysis suggests that the cohort fertility decline of the 1960s cohorts is likely to continue at least among the 1970s birth cohorts; stagnation cannot be ruled out. Births that were postponed by women born in the 1970s were not being replaced in sufficient numbers for cohort fertility to increase in the foreseeable future, and shares of low parity women (childless and one child) were larger than shares of high parity women among the late 1960s cohorts than in older cohorts. Also, childbearing postponement which started in the 1990s is reflected in dramatic changes of childbearing age patterns. As period fertility rates have been increasing in the late 2000s throughout the region an impression of a fertility recovery has been created, however the findings of this project indicate that no such widespread childbearing recovery is underway. For the first time ever an overview and analysis of CEE family policies is conceptualized in this paper. It demonstrates that fertility trends and family policies are a matter of serious concern throughout the region. The following family policy types have been identified: comprehensive family policy model; pro-natalist policies model; temporary male bread-winner model; and conventional family policies model. The majority of family policies in CEE countries suffer from a variety of shortcomings that impede them from generating enhanced family welfare and from providing conditions for cohort fertility to increase. The likely further decline of cohort fertility, or its stagnation, may entail long-term demographic as well as other societal consequences, such as continuous declines in total population numbers, changes in age structures, as well as implications for health and social security costs.Publisher PDFPeer reviewe

Fertility Intentions and Views on Gender Roles: Russian Women in Estonia from an Origin-destination Perspective

In this article we investigate fertility intentions of Russian women in Estonia from an origin-destination perspective. Russian migrants to Estonia and their descendants are compared with women in the sending and host countries in order to identify similarities and differences in intended transitions to first, second and third births. The study is based on the Estonian and Russian Generations and Gender Surveys, which were conducted in 2004/2005, and employs logistic regression models. The dependent variables are intentions to become a mother, to have a second child, or to have a third child. The hypotheses for the study are mainly derived from the adaptation, cultural maintenance, and selection (characteristics) perspectives. We also incorporate attitudes towards gender roles into the models, which have proven to be a salient factor in shaping childbearing intentions, but have seldom been considered in studies of migrant fertility. Our results lend support to both the adaptation and cultural maintenance perspectives. In accord with the latter, the similarity between the childbearing intentions of Russian migrants and their descendants in Estonia and those of their counterparts in Russia suggests that socialisation to the ethnic subculture has prevailed over the influence of the host society. We attribute this outcome to contextual features that have retarded integration processes. By contrast, we observe that proficiency in the host country language, residence in areas where the host population constitutes a large majority and having a native partner significantly contribute to the adaptation of migrants’ intentions to have another child to those of the host population. These results provide support to the adaptation argument. Finally, our study reveals a positive association between egalitarian views on gender roles and women’s intentions to have another child. However, variation in gender role attitudes accounts for a relatively minor part of the difference in intended fertility between the groups addressed in this study. * This article belongs to a special issue on migrant fertility

The formation of ethnically mixed partnerships in Estonia: A stalling trend from a two-sided perspective

Background: Ethnically mixed partnerships are often regarded as the ultimate evidence of the integration of migrants and their descendants into their host society. A common finding in the literature is an increase in the occurrence of mixed partnerships across migrant generations. Objective: This study investigates the formation of minority-majority partnerships in Estonia, with special attention to the variation associated with the migrants' generation and their exposure to the majority population. Methods: The study uses pooled data from the Estonian Family and Fertility Survey (FFS) and the Estonian Generations and Gender Survey (GGS), and estimates proportional hazards models. Results: The experience of second-generation migrants indicates a stalling trend in the incidence of mixed partnerships between the majority population and migrant groups, which is rooted in contextual features. Apart from residential proximity, the study shows the salience of early acquisition of the host society language. Our results for the majority population highlight the role of international migration, which exposes host populations to mixed partnership formation. Conclusions: The results lend support to the view that the integration of migrant populations through mixed partnering is a lengthy process that stretches across several generations. A linguistically divided school system and residential segregation contribute to the pillarization of society. Contribution: By focussing on an Eastern European context, the study contributes to a more comprehensive account of mixed unions in different socioeconomic and cultural settings. Estonia provides an interesting case as its migrant-origin minorities span several generations. The study underscores the importance of contextual factors for both the minority and majority populations