Many people in Finland are losing years off their lives because of preventable conditions such as those caused by alcohol addiction, according to the results of a report by the Finnish Consulting Group (FCG).
"It reminds me of Murheellisten laulujen maa, with so much emphasis on alcohol, violence and suicide. It paints a pretty grim picture," expert physician Emma Kajander of FCG said.
Murheellisten laulujen maa (roughly translated as 'Land of sad songs') was the name of a track released in 1982 by the Finnish pop-rock group Eppu Normaali, which describes how a Finnish person's life might slip into unemployment, alcoholism and suicide.
The song was intended as a parody of sorrowful Finnish schlager (known as iskelmä in Finnish) music but has instead become the go-to example of the genre.
The FCG report noted that although healthcare professionals save the lives of many people across the country every day, still others are dying of preventable or avoidable conditions.
In addition, the study found sizable differences between regions, genders and income groups in relation to alcohol addiction, mental health issues and suicide statistics.
"This is the time to seize the moment. We have really big differences, so we can't just go by the national average any longer," Kajander said.
Alcohol was found to be the biggest cause of preventable deaths in 15 welfare regions across Finland, while suicide was the highest factor in 5 regions and ischemic heart disease in three.
Sote reform aims to reduce health inequalities
Finland will begin to overhaul how social and healthcare services ('Sote') are provided across the country from the beginning of next year, when responsibility for provision passes from municipalities to 21 regional authorities plus the city of Helsinki.
One of the main aims of the reform is to reduce regional and socio-economic inequalities in relation to health.
A key measure in this respect is the number of lives, or years of lives, lost to preventable conditions. For example, the average number of years of life lost in the region of Kainuu is almost twice that of the Åland islands.
Furthermore, although alcohol is the biggest cause of preventable deaths in both North Karelia and West Uusimaa, the loss in North Karelia is one third higher.
There are also huge discrepancies in unnecessary deaths between genders.
Finland's PYLL (potential years of life lost) index revealed that the average number of years lost to avoidable premature death is 2.3 times higher for men than for women. Regional and socio-economic differences between the genders are even greater, with men's worst score being almost four times higher than women's best score.
The PYLL index is a widely used international measure of premature deaths, highlighting in particular the significance of deaths at a young age.
Finland's public health authority THL uses deaths that occurred before the age of 80 in its PYLL measurements, and FCG's report focused on preventable deaths in people aged between 0 and 75.
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Alcohol a perennial problem
Responding to the results of the report, Emma Kajander said that the statistics on deaths linked to alcohol, drugs and suicide should be given careful attention.
"By international standards, alcohol is a really big problem for us [Finns]. Alcohol-related deaths have still not fallen to European levels," Kajander said.
This view is one echoed by the Director-General of Finland's public health authority THL, Markku Tervahauta.
"It's nonsense that we've learned to be French wine sippers. There is still plenty of risky behaviour," Tervahauta said.
This is reflected in a report published by THL last month, which found that deaths and liver diseases caused by alcohol increased following the reform of Finland's Alcohol Act in 2018.
The law change raised the maximum alcohol content of drinks sold in grocery stores from 4.7 percent to 5.5 percent, and also allowed the sale of mixed drinks made from spirits in grocery stores.
THL and the Finnish Medical Association are opposed to further liberalisation of alcohol policy, including that wine would be sold in grocery stores, arguing that increased availability and supply will also lead to further alcohol-related harm.
Tervahauta also noted the socio-economic and regional differences in the potential years of life lost to alcohol consumption.
"In Kymenlaakso, for example, this is still an old industrial worker culture. There has certainly been a kind of Friday boozing culture there, and it is probably more prevalent there than anywhere else. Then in some of the Laestadian [a Lutheran revival movement that abstains from alcohol] areas of Ostrobothnian or North Ostrobothnia, very little alcohol is consumed," he said.
"There is a lot to lose"
In terms of diseases that cause the most deaths in Finland, vascular diseases and cancers still top the charts.
But the data on years of life lost show that a huge number of years of life are lost prematurely to unnecessary, avoidable deaths.
Deaths from cancer or vascular disease usually occur much later in life, but fatalities from drugs and suicide do not.
"When you lose a young person, perhaps just on the threshold of their working life, it's unnecessary in every way, very costly and miserable," Kajander said.
FCG figures found that up to 75 percent of prematurely lost years of life could have been saved, with unnecessary deaths strongly linked to substance abuse.
Kajander emphasised the importance for Finland's newly-formed healthcare regions to invest in the prevention of drug use and suicide, adding that each region should work with local experts to find the most effective means required to tackle the problem.
For example, the report noted that alcohol is taking years off the lives of low-income earning men in Kymenlaakso. Sanna Koste, Head of Welfare and Health Promotion for the Kymenlaakso region told Yle that, for some, substance abuse and social problems are a dead end.
"We know that health and economic deprivation is unfortunately transmitted across generations," Koste said.
She added that the Kymenlaakso region has identified the most difficult problems in its own region and rolled out a multidisciplinary effort across social and healthcare sectors to tackle the issue.
Kinnunen: Lifestyle is most important
In the PYLL comparison, Ostrobothnia is an example of the other extreme. There are many reasons for this, according to Marina Kinnunen, Director of the region's healthcare authority.
"If people have a job, something to do, a sense of belonging and security, then of course the conditions for life are much better. I believe that these are strongly linked," Kinnunen said.
The health and well-being of people in Ostrobothnia is reflected by the fact that alcohol consumption is lower than in many other parts of Finland.
As the welfare regions will in future receive funding on the basis of their needs, funding for Ostrobothnia will be cut. However, Kinnunen said that while this may have an impact, the most important aspect determining longevity of life is people's lifestyles.
"That is the most important factor before the actual social and health services," she said.
Emma Kajander of FCG further added that each member of society could play their own part by helping others.
"The most important thing we need is to care and intervene to help others if needed. So that we don't leave people alone. Loneliness is a really big underlying factor in many of these issues," Kajander said.
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