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"Reducing the Risk of Chronic Diseases in General practice/ Family medicine".

Dear doctors, researchers, and colleagues,

The main cause of death in Latvia just like a whole Europe are non-communicable diseases.
In Latvia cardiovascular diseases and diabetes alongside with chronic obstructive pulmonary disease and cancer are among the four main non-communicable diseases (NCD) altogether responsible for 82% of NCD deaths. CVD and diabetes are responsible for 50.2% of NCDs deaths.
Premature death is a major consideration when evaluating the impact of NCDs on a given population and is used as an indicator in the global monitoring framework. Approximately 42% of all NCD deaths occurred before the age of 70 years in 2012. Cardiovascular diseases (37%) and diabetes (4%) were responsible for 41% of NCD deaths under the age of 70 years followed by cancers (27%), other causes (23%) and chronic respiratory diseases (8%). Probability of dying from the four main NCDs between the ages of 30 and 70 years in Latvia in 2000 and 2012 (25,3% and 24.1%) still exceeds the global average (23% and 19%) being the highest rate among European Union countries and the third highest rate among high-income countries after Trinidad and Tobago and Russian Federation. According to WHO data (2012) age-standardized mortality rate (per 100 000 population) from cardiovascular diseases is still the highest in Latvia (males – 512.4; females – 266.5; both sexes – 361.1) compared with, for example, Estonia (387.4; 199.5; 272.1), Lithuania (448.2; 241.6; 322.5), Sweden (162.8; 105.7; 132.0), Finland (197.3; 104.1; 145.9), despite the slight decrease since 2000.


  • Screening programm

In Latvia cancer screening programme for breast cancer, cervix cancer and colorectal cancer has been started in 2009. However, the percentage of completed examinations is low for all three cancer types with not exceeding 35 % for breast cancer, 28 % for cervix cancer and 25 % for colorectal cancer.
Number of new registered cancer cases has increased both in absolute numbers (from 8834 cases in 2000 to 11123 cases in 2015) and per 100,000 inhabitants (from 373 in 2000 to 562 in 2015). There is a slight improvement regarding the stage of CA at diagnosis. In 2000 only 17% of CA were found at stage 1, while in 26 % the diagnosis was at the late stage 4. In 2015 the percentage of diagnosis at stage 1 and 4 were 28 % and 20 respectively. However, first year letality in general has decreased only by 7%, from 39 in 2000 to 32 in 2015.

  • Prevention of non-communicable diseases
  • Life style behavioural changes

It is still very low level of awareness about the importance of a healthy lifestyle among Latvian population.
Physical activity is an important part of a healthy lifestyle. Latvian adult population have insufficient physical activity. Only 17.2% of men and 12.9% of women outside work hours engage in exercise sufficiently strenuous to cause mild breathlessness or sweating at least 30 minutes and at least 4-6 times a week. Physical activity decreases by age.
The proportion of respondents reporting going to and from work on foot or by bicycle, which takes more than 30 minutes daily, is 19.5% for males and 23.8% for females. Sedentary behaviour among Latvian adult population is prevalent. A total of 49.1% of men and 49.6% of women spend their free time reading or watching TV. 40.7% of the adults (age 18 – 64 years) consider their physical condition as average. The percentage of women who rate their physical condition as rather poor or very poor is,respectively, 11.4% and 1.6% but that of men – 6.2% and 0.6%.Taking into account the insufficiency of general physical activity in the population,the attitude of health professionals is surprising. A very low percentage of respondents have reported that health professionals have suggested to them to increase their physical activity. This reflects the low value given to physical activity by health personnel in the maintenance of health of their patients.

  • Personel resources

Burnout syndrome widespread not only in Latvian among health professionals, but throughout Europe.
Number of Family doctors and general practitioners in Latvia per 10 000 inhabitants is lowest among the Baltic states (6,8), as well as nurses. despite the heavy workload with 20-60 patient visits per day , family doctors' and nursing personnel outpatient visits per person are also lowest in the Baltic States. Precise data on purposes of visits are not available, because statistics allow to register only one purpose per visit.