What Went Wrong with Public Health: Report Reveals Weaknesses 0 9

The report was prepared by the Ministry of Health, which analyzed the achievement of target indicators and political outcomes up to 2024. The document states that there are positive trends in several areas; however, some of the set goals have not been achieved or their achievement is delayed for various reasons.

According to the report, the number of healthy years lived and the life expectancy of newborns in Latvia is gradually increasing, while the number of potentially lost years of life is decreasing. At the same time, in some cases, data for 2024 is still unavailable, which limits the assessment of goal achievement.

Regarding the promotion of a healthy lifestyle, it is noted that among adults, certain dietary habits are improving, including the consumption of fruits and vegetables; however, the level of physical activity and the prevalence of overweight still do not meet the set goals. Among adolescents, several indicators—physical activity and dietary habits—have not met the goals, which is explained by the influence of the Covid-19 pandemic, distance learning, and increased screen time.

Both adolescents and adults do not always achieve the desired level of dental care habits. The report emphasizes that further preventive measures are necessary to maintain the achieved results.

In the section dedicated to psycho-emotional health, it is indicated that a high percentage of the population continues to experience stress, tension, and depression, while the prevalence of depression, despite a decrease in some years, remains significant overall. Suicide rates in some age groups align with forecasts; however, the report emphasizes the need for sustainable long-term improvements.

The proportion of people aged 15 to 64 with depression is on the rise, with the most significant increase associated with the onset of the Covid-19 pandemic. Considering the measures initiated after the pandemic to provide psychological and psychotherapeutic assistance, the proportion of depression slightly decreased in 2024. The report predicts that this indicator will not change significantly in the following periods.

In the area of psychoactive substance use, it has been established that alcohol consumption, daily smoking, and the use of electronic cigarettes exceed planned target values. The report notes that the situation was influenced by pandemic conditions, the availability of alcoholic and nicotine-containing products, and marketing often targeted at youth.

The report also points out the insufficient availability of state-funded services for addiction treatment and smoking cessation.

In the field of child and adult trauma, progress has been noted, especially in reducing child mortality from external causes; however, drowning rates and overall mortality from external factors do not always meet planned values.

In the area of sexual and reproductive health, it has been established that the proportion of teenage pregnancies and HIV incidence is decreasing, while the dynamics of the number of induced abortions significantly depend on the decline in birth rates.

In the field of infectious diseases, goals for hepatitis B and C, HIV, and tuberculosis have generally been achieved, although the pandemic affected the indicators in some years.

In the vaccination section, it is noted that coverage for basic vaccinations among children remains high; however, vaccination rates for influenza among children, the elderly, and pregnant women significantly lag behind the set goals. The report states that public vigilance regarding flu risks has decreased after the Covid-19 pandemic.

Intensive information about the possibility of simultaneous vaccination against Covid-19 and influenza, as well as individual outreach during the 2022 season, ensured a significant increase in vaccination coverage. However, the seasonal target for 2024 and 2025—35% of vaccinated individuals aged 65 and older—was not achieved, as the volumes of purchased influenza vaccines this season did not exceed those of the previous season, the report states.

In the area of accessibility and quality of medical care, it has been established that mortality from cardiovascular diseases before the age of 64 and from malignant tumors is decreasing, while participation in cancer screenings is generally increasing, although breast cancer screening rates still do not meet target values.

At the same time, the report indicates that the provision of medical personnel is generally improving, especially in terms of the share of young specialists; however, the number of nurses remains insufficient. In the area of healthcare digitalization, progress is assessed as slower than planned, and several target indicators have not been achieved.

The report notes that for some performance indicators, data is not available annually, as some studies are conducted every two, four, or even five years, and in other cases, methodological changes, digitalization, or preliminary data status have affected data comparability. More complete and regular availability is characteristic of mortality, vaccination, infectious disease, and healthcare utilization indicators, while more limitations have been identified in the areas of behavior, habits, psycho-emotional health, and addictions, where data is based on periodic studies.

As stated in the report, at the final stage of implementing the Public Health Fundamentals until 2027, it is necessary to focus resources on promoting health, strengthening mental health, reducing dependency, increasing vaccination coverage, and improving accessibility, quality, and data management in the healthcare system.