Finland s motivation to engage in health in all policies

Transcription

1 Health in All Policies in European Neighbouring countries Brussels June 2007 Finland s motivation to engage in health in all policies Dr Eero Lahtinen, MD WHO/EURO European Office for Investment for Health and Development

2 Political decision making People Contextual influences Economic, social, cultural, historical Structures and processes Data and information International influences Societal values

3 Domestic influences and processes Epidemiology 1960s Political activation 1960s Health monitoring 1970s Committee and report on CVDs 1970s Strong alliance with NGOs (health education) Occupational and environmental health 1970s Public Health Act 1970s North Carelia project 1970s Decentralisation 1990s

4 International influences Nordic country collaboration Pilot country of WHO HFA 1980s WHO evaluation of the HFA 1990s Tobacco and health report 1980s EU membership 1996 WHO evaluation 2000

5 Structures Ordinary structures Permanent civil service Ad hoc committees from 1970s EU coordination 1996 Advisory public health committee 1997 Law on health and social report 1997 Constitution 1999

6 Evidence Subjective health Life expectancy and healthy life expectancy Cardiovascular mortality vs nutrition Cancer mortality vs tobacco policy (health protection, tax policy, health at work)

7 Figure 15. Proportion of people reporting average or worse health in the population aged years in (source: National Public Health Institute) Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

8 Figure 13. Life expectancy at birth in Finland in (source: Statistics Finland) Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

9 Figure 42. Life expectancy of a 35-year-old by social group in (Source: Valkonen et al. 2003). Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

10 Figure 18. Breakdown of the life expectancy of a 65-year-old man and woman between healthy and unhealthy years of life according to managing with basic activities of daily living, self-perceived health and chronic illness in 1980 and 2000 (source: Sihvonen et al. 2003). Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

11 Figure 20. Age-standardised mortality from coronary heart disease in selected countries in and 2002, population aged (sources: World Health Statistics Annual 1988 and WHO database). Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

12 Figure 4. Changes in foodstuffs consumption between (source: Ministry of Agriculture and Forestry) Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

13 Figure 14. Age-standardised mortality (per 100,000) by cause of death in , age groups and (source: Statistics Finland) Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

14 Figure 9. Proportion (%) of daily smokers in the population aged in (source: Helakorpi et al. 2005) Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

15 Figure 25. Age-standardised cancer incidence among Finnish men in (source: Finnish Cancer Registry). Koskinen S, Aromaa A, Huttunen J, Teperi J. Health in Finland. Helsinki

16 EU membership Interpretation of the Treaty: focus in Health promotion Intersectoral action for health Systematic EU coordination increased the collaboration and contacts between the ministries Finland s EU health policy As powers have been transferred to the EU level, member states are not anymore able to decide fully independently on all health relevant policies EU should implement the requirement of the treaty of high level of health protection across its policies Presidency initiatives on Health in all policies 1999 and 2006

17 What is needed? Know-how Evidence Structures Legal basis Societal values Political support

18 Motivation to HiAP? Further increasing commitment to intesectoral work for health in national policy Influencing EU decision making Sharing the experience with other countries Health is to a large extent defined outside the health care services in everyday environments Health care services and conventional public health measures alone are not enough Intersectoral collaboration and a systematic focus on social determinants of health may help to improve population health faster Positive effect on the economy?

19 This paper was produced for a meeting organized by Health & Consumer Protection DG and represents the views of its author on the subject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumer Protection DG's views. The European Commission does not guarantee the accuracy of the data included in this paper, nor does it accept responsibility for any use made thereof.