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Breadcrumb

  1. Home
  2. Methodology and quality
  3. ESMS metadata
  4. Estonian Health Survey

Estonian Health Survey

1. Contact
1.1. Contact organisation

Statistics Estonia

1.2. Contact organisation unit

Population and Social Statistics Department

1.3. Contact name

Karina Valma

1.4. Contact person function

Leading Analyst

1.5. Contact mail address

51 Tatari Str, 10134 Tallinn, Estonia

1.6. Contact email address

karina.valma [at] stat.ee

1.7. Contact phone number

37251917446

2. Metadata update
2.1. Metadata last certified

27/03/2025

2.2. Metadata last update

27/03/2025

3. Statistical presentation
3.1. Data description

Chronic diseases and injuries, mental health and emotional well-being, functional limitations, use of medical care, hospital stay, drug use, health behaviour, etc.

3.2. Classification system

Classification of Estonian administrative units and settlements (EHAK)

International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)

Country of Citizenship List

Estonian Classification of Economic Activities (EMTAK 2008) based on NACE Rev. 2

International Standard Classification of Occupations (ISCO 08)

Classification of Ethnic Nationalities

3.3. Sector coverage

Population health

3.4. Statistical concepts and definitions

Active movement – an intense physical activity, e.g. jogging, ball games, swimming and skating, also gardening.

Alcohol dose – equals 10 grams of absolute alcohol. 1 alcohol dose equals 1 bottle of light beer (0.5 l), a glass of wine (100 g) or a shot of strong alcohol (30 g).

Body mass index (BMI) is found by dividing the body weight (kg) by the square of the body height (m). Pregnant women are asked to record their pre-pregnancy weight. The following scale is used to evaluate the BMI:

Underweight: BMI < 18.5,

Normal weight: BMI 18.5–24.9,

Overweight: BMI 25.0–29.9,

Obesity: BMI ≥ 30.

Depression – an emotional status which is mainly characterised by low mood, loss of interest and zest for life and decreased energy. Prevalence of depression is estimated using the Emotional State Questionnaire EST-Q, a self-report questionnaire for depression and anxiety. Based on the prevalence of depression symptoms (feeling of sadness, loss of interest, feeling of worthlessness, self-accusations, thoughts of death/suicide, feeling of loneliness, hopelessness, impossible to enjoy things) during the last four weeks, respondents are distributed into groups with and without depression.

Economic activity – the term 'economically active' includes all people who participate in the labour market or in military service, as well as working old-age pensioners. Unemployed people, non-working pensioners, students, homemakers and people receiving pension for incapacity for work are considered non-active population.

Education – the highest completed educational level by the time of the survey. People with higher education have graduated from an institution of higher education and their average study period is 15–16 years. According to the International Standard Classification of Education (ISCED) 2011, vocational education based on general secondary education is considered equal to the first level of vocational higher education and is presented under higher education. People with secondary education have graduated from high school, gymnasium or some other educational institution that provides secondary education, and their average study period is 10–14 years. A group with basic education or with lower educational level is formed by those persons who have not acquired secondary education (including persons without primary education).

Emotional distress – a status when a person feels several negative disturbing emotions at the same time, especially tension, anxiety, mood decline, to which asthenia and sleeping disorders are often added. The individual’s emotional distress is assessed by the Emotional State Questionnaire EST-Q, which is elaborated according to the diagnostic criteria of depression and anxiety disorders that are presented in the international classification of mental disorders.

Household – the term refers to all individuals who live in the same dwelling and share to some extent the joint budget, which is usually the food budget. The household can also have only one member. Persons who are temporarily away (due to their work, studies or military service) are considered household members if they have retained economic relations with their household. In case the household member is temporarily (less than 4 months) in the nursing home, he/she also belongs to the household.

Nationality depends on a person’s self-definition, which is not univocally related to his/her mother tongue, yet should be in accord with the nationality of one of his/her parents.

Person in need of constant assistance – the term refers to a person who due to his/her health status cannot cope independently with everyday procedures, like shopping, food preparation or taking care of oneself, and therefore needs a personal assistant. The term does not include nursing of young children.

Region – statistical classification of Estonian regional units, NUTS 3 is used to determine the region.

Regular smoking – everyday smoking (practically every day) that has lasted for at least one consecutive year.

Relative poverty threshold – 60% of the national median equalized disposable income for household members. According to Statistics Estonia, the relative poverty threshold in 2006 was 3479 Estonian kroons (ca 222 euros) per month.

Self-estimated health – for calculating the variable, the first question “How do you evaluate your health in general?” of the health status mini module is used.

Settlement type – a town settlement is an administrative unit with population density more than 100 people per square kilometre. An administrative unit with a lower population density is considered to be a rural area. Due to the fact that the basis for calculating the variable in the HIS 2006 survey is not population size, but density, the settlement type variable is not comparable to the variable used in HIS 1996.

Trauma – an injury or intoxication caused by an accident or deliberate activity.

3.5. Statistical unit

Person

3.6. Statistical population

Permanent residents aged 15 and older

FRAME

The list of permanent residents of Estonia based on the 2011 Population and Housing Census and the Population Register

3.7. Reference area

Estionia as a whole

3.8. Time coverage

1996, 2006, 2014

3.9. Base period

Not applicable.

4. Unit of measure

Persons – number, percentage

5. Reference period

Year

6. Institutional mandate
6.1. Legal acts and other agreements

DIRECTLY APPLICABLE LEGAL ACTS

Commission Regulation (EU) 2018/255 of 19 February 2018 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics based on the European Health Interview Survey (EHIS) (Text with EEA relevance. )

OTHER LEGAL ACTS

Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work

OTHER AGREEMENTS

Not available

7. Confidentiality
7.1. Confidentiality - policy

The dissemination of data collected for the purpose of producing official statistics is guided by the requirements provided for in § 32, § 34, § 35, § 38 of the Official Statistics Act.

7.2. Confidentiality - data treatment

The treatment of confidential data is regulated by the Procedure for Protection of Data Collected and Processed by Statistics Estonia: http://www.stat.ee/dokumendid/19410.

8. Release policy
8.1. Release calendar

The publication of the statistics is reported by the publication calendar of the National Institute for Health Development, available to the consumer on the Iinstitute’s website.

8.2. Release calendar access

http://pxweb.tai.ee/PXWeb2015/Resources/Info/ReleaseCalendar2018.pdf

8.3. User access

All users have been granted equal access to official statistics: dissemination dates of official statistics are announced in advance and no user category (incl. Eurostat, state authorities and mass media) is provided access to official statistics before other users. Official statistics are first published in the statistical database. If there is also a news release, it is published simultaneously with data in the statistical database. Official statistics are available on the website at 8:00 a.m. on the date announced in the release calendar.

9. Frequency of dissemination

Over six years

10. Accessibility and clarity
10.1. News release

As the data is published by the National Institute for Health Development, they also decide the publication of press releases.

10.2. Publications

List of publications in the Estonian Health Survey 2006: http://www.tai.ee/images/PDF/Uuringud/Estonian_HIS_publications_2015.xls

10.3. Online database

The data are published in the Health Statistics and Health Research Database of the National Institute for Health Development at http://pxweb.tai.ee/PXWeb2015/pxweb/en/05Uuringud/?rxid=dc891bdb-5f23-4e8c-8da2-5ebb9a1d45e7

10.4. Microdata access

The dissemination of data collected for the purpose of producing official statistics is guided by the requirements provided for in § 33, § 34, § 35, § 36, § 38 of the Official Statistics Act. Access to microdata and anonymisation of microdata are regulated by Statistics Estonia’s procedure for the dissemination of confidential data for scientific purposes: http://www.stat.ee/dokumendid/51669.

10.5. Other

Data serve as input for statistical activity 50101 “Regional development”.

10.6. Documentation on methodology

European Health Interview Survey (EHIS wave 3) — Methodological manual, March 2018

10.7. Quality documentation

The quality report sent to Eurostat is available at https://circabc.europa.eu.

11. Quality management
11.1. Quality assurance

To assure the quality of processes and products, Statistics Estonia applies the EFQM Excellence Model, the European Statistics Code of Practice and the Quality Assurance Framework of the European Statistical System (ESS QAF). Statistics Estonia is also guided by the requirements in § 7. “Principles and quality criteria of producing official statistics” of the Official Statistics Act.

11.2. Quality assessment

Standardised output has been achieved through the definition of specific formats (list and description of output variables, data formats) and fixed deadlines for data transmission.

12. Relevance
12.1. User needs

Ministry of Social Affairs

National Institute for Health Development

Users’ suggestions and information about taking these into account are available on the website of Statistics Estonia at http://www.stat.ee/statistikatood.

12.2. User satisfaction

Since 1996, Statistics Estonia has conducted reputation and user satisfaction surveys.

All results are available on the website at http://www.stat.ee/user-surveys.

12.3. Completeness

The data are complete and in compliance with the data composition requirements of European Health Interview Survey (EHIS) regulation of the European Commission.

13. Accuracy and reliability
13.1. Overall accuracy

The accuracy of source data is monitored by assessing the methodological reliability of data sources and the adherence to the methodological recommendations.

The type of survey and the data collection methods ensure sufficient coverage and timeliness.

13.2. Sampling error

Not applicable

13.3. Non-sampling error

Although a person has the obligation to ensure correctness of residential address in the Population Register, there is some under-coverage of persons and households in the register. Assuming that all persons living permanently in Estonia are registered in the Population Register and considering the amount of imprecise addresses in the Population Register, the under-coverage of households may be at most 1–1.5%.

Measurement errors can stem from the questionnaire (wording of questions, design, etc.), the respondents, the interviewers and the data collection method. While it is impossible to avoid this type of errors completely in social surveys, steps have been taken in Statistics Estonia to reduce them as much as possible.

Data checking is done in three stages: preliminary data entry checking in the laptop during the interview, secondary checking of newly received data in the office and finally data cleaning.

Data entry mistakes have decreased thanks to the continuing development of primary logical checks in the data entry program.

14. Timeliness and punctuality
14.1. Timeliness

The data will be published in the database of the National Institute for Health Development.

14.2. Punctuality

The data have been published at the time announced in the release calendar.

15. Coherence and comparability
15.1. Comparability - geographical

The health survey is part of the European Health Interview Survey (EHIS) coordinated by Eurostat. In all countries of the European Union, the survey is carried out at the same time, using a harmonised questionnaire and methodology, which makes it possible to publish internationally comparable statistics. The Estonian survey has been supplemented by questions about Estonia. The data acquired on the basis of these questions are not internationally comparable.

15.2. Comparability - over time

The data are comparable with the data of 1996, 2006 and 2014.

15.3. Coherence - cross domain

Not applicable

15.4. Coherence - internal

Not applicable

16. Cost and burden

–

17. Data revision
17.1. Data revision - policy

The data revision policy and notification of corrections are described in the dissemination policy of Statistics Estonia at http://www.stat.ee/dissemination-policy.

17.2. Data revision - practice

Not applicable.

18. Statistical processing
18.1. Source data

SURVEY DATA

The population includes all persons living in Estonia whose main residence is in Estonia and who are not in an institution (children’s home, nursing home, monastery, prison, etc.).

The sample size is 8,500 people. The sample is obtained by systematic random selection.

ADMINISTRATIVE DATA

Data on education are received from the Estonian Education Information System.

Information on earnings and sickness benefits paid by the employer is received from the Tax and Customs Board.

Data on pensions and benefits and degree of disability are received from the Social Insurance Board.

Data on sickness benefits, certificates of incapacity for work and health insurance are received from the Estonian Health Insurance Fund.

Data on unemployment insurance benefits and allowances are received from the Unemployment Insurance Fund.

DATA FROM OTHER STATISTICAL ACTIVITIES

Not used

18.2. Frequency of data collection

Every six years

18.3. Data collection

1) The person enters the data in a web-based questionnaire (CAWI method); 2) the data received from the person with an on-site questionnaire are entered into the input programme in the laptop (CAPI method), from where they are added to the database.

18.4. Data validation

Arithmetic and qualitative controls are used in the validation process, including comparison with other data. Before data dissemination, several checks on the internal coherence of the data are carried out.

18.5. Data compilation

In the case of missing or unreliable data, estimate imputation based on established regulations will be used.

Variables and statistical units which were not collected but which are necessary for producing the output are calculated. New variables are calculated by applying arithmetic conversion to already existing variables. This may be done repeatedly, the derived variable may, in turn, be based on previously derived new variables.

For statistical units weights are calculated, which are used to expand the data of the sample survey to the total population.

The weights are calculated on the basis of design weights derived from inclusion probabilities. The weights, which are first adjusted to compensate for the bias caused by non-response and then calibrated to the population data, are used in calculating the final data. The basis of the calibration is the distribution of the population of Estonia by sex and age group and county on the 1st of January according to demographic data.

Microdata are aggregated to the level necessary for analysis. This includes summation of data according to the classification and calculating various statistical measures, e.g. average, median, dispersion, etc. The collected data are converted into statistical output. This includes calculating additional variables.

18.6. Adjustment

Not applicable

19. Comments

Not available

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