Quality of life in Finland Quality of Life

Quality of life in Finland Quality of Life sub-module Petri Kainulainen EUREKA 2013, Mosonmagyarovar, Hungary

Referred studies (all in finnish) Heikkilä M, Rintala T, Airio I and Kainulainen S (2002). The Welfare and Future of Rural and Urban Areas. Gummerus Kirjapaino Oy. Saarijärvi. Karvonen S, Lahelma E, Winter T (2006). Työikäisten terveys ja hyvinvointi 2000 -luvun alussa. Gummerus Kirjapaino Oy. Vaajakoski. Karvonen S and Rintala T (2006). Asuinympäristö hyvinvoinnin määrittäjänä. Gummerus Kirjapaino Oy. Vaajakoski. Kytö H, Tuorila H, Leskinen J (2006). Maaseudun vetovoimaisuus ja kuluttajien yksilölliset elämäntavat. Kuluttajatutkimuskeskus, julkaisuja 5: 2006, Helsinki. Rimpelä M, Luopa P, Räsänen M, Jokela J (2006). Nuorten hyvinvointi 1996 -2005 – Eriytyvätkö hyvinvoinnin ja pahoinvoinnin kehityssuunnat? Gummerus Kirjapaino Oy. Vaajakoski. Vaarama M, Luoma M-L, Ylönen L (2006). Ikääntyneiden toimintakyky, palvelut ja koettu elämänlaatu. Gummerus Kirjapaino Oy. Vaajakoski.

QOL of young people The Quality of Life of young people can be defined as follows Family circumstances Do both parents have a job Do the families spend time together School circumstances Adequate amount of work Do the children like going to school Teasing in school Habits Enough exercise Smoking Use of alcohol Sexual activity Health General feeling of health Tiredness Ref. Rimpelä et al

QOL of working age people The quality of life (or well-being) of working people can be divided in the following categories Material well-being Income and assets, living circumstances Health Usually the subjective, self experienced health Long term diseases, stress Social relationships Collectivity Feeling of safety Working conditions Increase of part time jobs Mentally more demanding tasks Hurry, stress Ref. Karvonen et al

QOL of working age people Questionnaire: The welfare of Finnish people N = 3164 Age between 25 -64 Gender distribution 50/50 Comprehensive sample from whole Finland (no division between rural and urban) High response rate (76 %) Ref. Karvonen et al

QOL of working age people Ref. Karvonen et al

QOL of working age people Ref. Karvonen et al

QOL of working age people Conclusions Poverty or low income is a best predictor of almost all of the low well-being factors The structures related to work have only a minor effect on well-being. The only affecting items were Position of leadership Persistence of employment Working circumstances doesn’t have a big influence on well-being. The referred working circumstances were such as Equity in working place Behavior and functioning of the foremen (managers, directors) Ref. Karvonen et al

QOL of elderly people The factors affecting on QOL of elderly people can be Socio-economic factors like education, income, housing conditions Personal factors like age, health, emotional life related issues Social factors like family, social networks and relationships Changes in life – traumatic events Living conditions like living alone, abilities to move and function at home, nearby services, neighborhood, transport and safe environment Social and health services Personal autonomy like possibilities to choose and control of life Free time activities like exercise, other hobbies and profitable action (work) Mental health like loneliness, happiness Satisfaction in life, subjective QOL Ref. Vaarama et al

QOL of elderly people Questionnaire for elder people N = 1394 Age over 60 Gender distribution: males 42 % and females 58 % Comprehensive sample from whole Finland (division between rural and urban) Almost 80 % response rate Ref. Vaarama et al

QOL of elderly people Ref. Vaarama et al

QOL of elderly people Ref. Vaarama et al

QOL of elderly people Ref. Vaarama et al

QOL of elderly people Ref. Vaarama et al

QOL of elderly people Conclusions Elderly people live healthy life, have hobbies and participate in social activities until a high age Only few of them are frustrated due to lack of activities Elderly people help each others quite much The risk factors that will affect on QOL are High age, female gender Low income Poor health and ability to function Loneliness and depression Deficiencies in accommodation Lack of nearby services and public transportation Elderly people want to live at home Ref. Vaarama et al

Rural vs urban QOL Finland is a large country where People are all the time moving closer to the growth centres Is inequality between different areas (rural vs urban) How much and in which way the living area affects on the QOL of people? Heikkilä et al have studied it

Rural vs urban QOL Results of the questionnaire N = 3018 Age between 18 and 70 Response rate: 61, 2 % Gender distribution: 54 % males, 46 % females Rural/urban distribution 36 % in towns/cities (urban) 29 % rural areas nearby towns/cities (near urban) 34 % sparsely populated rural areas (rural) Ref. Heikkilä et al

Rural vs urban QOL Economic welfare Average income per / person including the whole family (p=0, 003): Urban: 1165 € Near urban: 1108 € Rural: 888 € Income is divided in salary (or respective) based or social income (such as pension). Proportion of salary based income: Urban: 78 % Near urban: 79 % Rural: 70 % Ref. Heikkilä et al

Rural vs urban QOL Health Hospital visits during last year (p=0, 04) Urban: 9 % Near urban: 11 % Rural: 12 % Good subjective feeling of physical health (p<0, 001) Urban: 72 % Near urban: 70 % Rural: 57 % Energic feeling, scaled 1 -6 (bigger number, more energic), averages Urban: 4, 16 Near urban: 4, 26 Rural: 4, 21 The difference is between Near urban vs others (p=0, 0015) Ref. Heikkilä et al

Rural vs urban QOL Health (cont. ) Mental health, scaled 1 -6 (bigger number, better health), averages Urban: 4, 68 Near urban: 4, 79 Rural: 4, 72 The difference is between Near urban vs others (p=0, 0027) Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Ref. Heikkilä et al

Rural vs urban QOL Conclusions In urban areas the QOL can be characterized by High material living standard Number of psychosocial problems higher than average In rural areas the QOL can be characterized by Modest or poor material living standard Plenty of psychosocial problems In near urban areas the QOL can be characterized by Moderate material living standard Low number psychosocial problems Ref. Heikkilä et al

Rural vs urban QOL Karvonen et al had another study comparing the QOL of life in different areas According counties According type of district N = 4350 Age between 18 and 79 Response rate 78 % Rural/urban distribution 51 % city centres (cities) 4 % municipalities which are almost cities/towns (municipalities) 22 % rural areas close to urban (rural close to urban) 15 % populated rural areas (populated rural) 8 % sparsely populated rural areas (non populated rural) Ref. Karvonen et al

Rural vs urban QOL Ref. Karvonen et al

Rural vs urban QOL Ref. Karvonen et al

Attractive rural area Kytö et al studied the attraction of rural areas and the lifestyle in rural areas A questionnaire on people who have moved into rural areas within years 2001 – 2004 Three different rural areas Near by city/town Core rural area Sparsely populated rural area N = 810 Response rate 45 % Study included also qualitative research where Study subjects were interviewed Subjects were selected amongst who answered to the quantitative part Subjects enjoyed living in new area 27 interviews were conducted Ref. Kytö et al

Strengths Weaknesses Unhealthy competition between municip. Social environment Lack of work Bad public transport Lack of services Population centre services Long work trips Hobbies City Utilization of internet Ekological way of life Hobbies Lack of hurry Marketing the silence Small businesses Knowledge tarnsfer Countrylike scenery Social marketing of env. Maintenance of services People moving back Opportunities New work possibilities -Elderly care -- Summer residents -- Experiance travelling Changing attitudes Prejudice towards movers Aging Social control Travelling costs Young people moving away Fuel prices Suburbanization Decreasing traffic connections Decreasing workin g possibilities Reducing services Citylike town planning Threats Ref. Kytö et al

Attractive rural area: conclusions and recommendations Relocation of people from municipality to other will vital for small minucipalities The age structure has to be lowered in addition to the increasing migration Attractivity could be increased by new structures of serveces specially related to the housing issues Quality of life, environment, identity and roots will have an incearsing value when moving The new living area will be more cosy and suit better for peoples’ living conditions. The time and money spent on work journeys will have smaller importance Life situations and living conditions have and lafge effect on selection of the living area False preconceptions for example on idyllic countryside and sense of community in rural areas may be unrealistic and cause disappointments Ref. Kytö et al

Attractive rural area: conclusions and recommendations People who move to rural areas value the most the peacefulness, freedom and social relations The feeling of peacefulness and freedomness can be seen mostly in near-by-cities rural areas One should find out in detail does the future living area match his/her values and needs before moving to the rural areas. How flexible those values are? Municipalities shound increase and centralize the information sharing for those who are planning to move to the rural areas. The information should correct and accurate The people are willing to pay more municipal taxes to increase the quality of services New ways of transport should be developed for those who cannot travel with their own car Ref. Kytö et al

Attractive rural area: conclusions and recommendations The development of regional communities of rural areas is one the most important projects to improve the attractiveness of the rural areas The need for social and healthcare services will increase specially in municipalities with high aging. The municipalities scould buy the services in order to fulfill the needs Municipalities and areas should generate more clear, unique and honest profile for marketing purposes Different kinds of services should be centered in suitable places (e. g. grocery shops, basic elementary schools) The movement into cities can be characterized mostly by the increase of economic living starnards The increase of Quality of Life is the main reason when moving into the rural areas Investing in cosy environment and services yield more tax incomes for the municipalities rather than traditional and risky investments in companies Ref. Kytö et al

Attractive rural area: conclusions and recommendations The attractivity of rural areas and individual living conditions of people will increase the movement into rural areas The projects which focus on the development of living conditions and gainng more new movers will increase vitality of rural areas The third sector can be utilized to support the development work without new resources The municipalities should offer more building properties, houses and rental appartments in order to increase living in rural areas The peaple are aware of the negative influence of living style in cities on the global and local environmental issues Rural areas can be profiled into the living environment where the high Qo. L, clean nature and sustainable Ref. Kytö et al living style can be experienced

Registry data rural vs. urban � The data comes from the database of the National Institute for Health and Welfare (www. thl. fi) � The database is called SOTKAnet (www. sotkanet. fi) which includes large amount of health related data � It includes all the Finnish municipalities (2009) � N = 342 � Municipalities are divided in three categories (based on the Statistics of Finland): �City/town, n = 62, average population = 58 552 �Population centres, n = 65, average population = 12 857 �Rural, n = 215, average population = 4 119 � 11 different health indicators

Registry data rural vs. urban Proportion of working age people (25 -64 years) N Mean Std City/town 62 53, 9 1, 68 Population centre 65 52, 5 1, 91 Rural 215 51, 1 2, 73 Total 342 51, 9 2, 64 The difference was statistically significant in all of the pairwise comparisons (p < 0, 001)

Registry data rural vs. urban Proportion of higher educated (age above 15) N Mean Std City/town 62 27, 8 6, 14 Population centre 65 21, 7 4, 68 Rural 215 17, 1 3, 99 Total 342 19, 9 6, 15 The difference was statistically significant in all of the pairwise comparisons (p < 0, 001)

Registry data rural vs. urban Unemployed, % from the working population N Mean Std City/town 62 10, 8 3, 24 Population centre 65 10, 3 3, 33 Rural 215 10, 6 4, 06 Total 342 10, 6 3, 78 The difference between the areas was not statistically significant (p = 0, 821)

Registry data rural vs. urban Net migration / 1000 inhabitants N Mean Std City/town 62 2, 26 5, 88 Population centre 65 -0, 16 6, 83 Rural 215 -1, 66 11, 30 Total 342 -0, 67 9, 86 There was a statistically significant difference between City/town vs. Rural (p = 0, 016), Others were not (p = 0, 346 and p = 0, 522)

Registry data rural vs. urban Proportion of tightly living households N Mean Std City/town 62 8, 62 1, 57 Population centre 65 9, 51 1, 69 Rural 215 10, 30 2, 22 Total 342 9, 85 2, 12 The difference was statistically significant in all of the pairwise comparisons (p = 0, 037, p < 0, 001 and p = 0, 016)

Registry data rural vs. urban Sickening index, age adjusted N Mean Std City/town 62 98, 9 11, 3 Population centre 65 105, 2 12, 4 Rural 214 108, 7 18, 0 Total 341 106, 3 16, 4 There was a statistically significant difference between City/town vs. Rural (p < 0, 001), Others were not (p = 0, 073 and p = 0, 257)

Registry data rural vs. urban The costs of alcohol and drug related care (€ / inhabitant) N Mean Std City/town 62 26, 6 14, 1 Population centre 65 16, 2 12, 3 Rural 215 9, 1 7, 9 Total 342 13, 6 12, 2 The difference was statistically significant in all of the pairwise comparisons (p < 0, 001)

Registry data rural vs. urban Life threatening crimes / 1000 inhabitants N Mean Std City/town 62 6, 62 2, 68 Population centre 65 5, 30 1, 78 Rural 215 4, 56 2, 38 Total 342 5, 01 2, 47 The difference was statistically significant in all of the pairwise comparisons (p = 0, 003, p < 0, 001 and p = 0, 001)

Registry data rural vs. urban Number of drug related crimes / 1000 inhabitants N Mean Std City/town 62 1, 01 0, 59 Population centre 65 0, 62 0, 57 Rural 215 0, 34 0, 64 Total 342 0, 51 0, 67 The difference was statistically significant in all of the pairwise comparisons (p < 0, 001)

Registry data rural vs. urban Discretionary psycho therapy within age group of 25 -64 years / 1000 respective aged inhabitants N Mean Std City/town 61 3, 46 1, 82 Population centre 61 2, 68 1, 21 Rural 133 1, 66 1, 49 Total 255 2, 34 1, 69 The difference was statistically significant in all of the pairwise comparisons (p = 0, 024, p < 0, 001 and p < 0, 001)

Registry data rural vs. urban Number of days in psychiatric care / 1000 inhabitants N Mean Std City/town 62 309, 7 89, 3 Population centre 65 239, 4 83, 0 Rural 215 232, 0 138, 8 Total 342 247, 5 125, 2 There was a statistically significant difference between City/town vs. PC (p = 0, 004) and City/town vs. Rural (p < 0, 001) but not between PC vs. Rural (p = 0, 903).