Health inequalities in Poland: current situation and Case Studies conducted Pomorskie Zachodniopomorskie Warmiński-Mazurskie Podlaskie Kujawsko-Pomorskie Lubuskie Wielkopolskie Mazowieckie Łódzkie Lubelskie Dolnośląskie Opolskie Świętokrzyskie Śląskie Małopolskie Podkarpackie Brussels 29-30th March 2012r.
Diagnose Important factors responsible for health inequality in Poland: Specific consequences of political transformation process Low level of public expenditures for medical system (4,87% of GNP per year) Life expectancy shortened by gender, low income, low educational level, geographical region High level of infant mortality Limited effectiveness of treatment for rural area inhabitants Limited access to innovations ( innovative medicaments are 15% of pharmaceutical trade in Poland). Personal resources
74.0 74.7 74.5 74.5 74.4 74.7 75.1 74.7 74.9 75.1 74.8 75.6 75.5 Liczba lat 76.0 76.0 76.4 76.5 77.2 77.2 77.5 77.4 77.5 77.6 77.5 78.2 78.0 78.1 78.6 78.6 78.5 78.6 78.8 79.0 79.4 79.1 79.7 79.8 80.1 80.1 80.2 80.4 80.4 80.5 80.6 80.8 80.9 81.0 81.0 81.4 81.8 81.9 Przeciętne trwanie życia kobiet wg województwa zamieszkania w latach 1991, 2000 i 2010 (dane GUS) 84 1991 2000 2010 82 80 78 76 74 72 70
Ministry of Health National Level National Health Programme 2007-2015: Strategic Objective: 8. Reducing geographical and social inequalities in health status of the population. Expected health effect in 2015: Increased life expectancy in voivodeships with the lowest average life expectancy by 2 years for men and by 1 year for women
Health Inequalities Monitoring Indicators Life expectancy Healthy life expectancy (HLY) Dysfunctions and disabilities [due to accidents and chronic musculoskeletal diseases] Incidence and morbidity of chosen diseases
SDR primary/ SDR above secondary. 5,0 4,0 3,0 2,0 1,0 0,0 Fig. 4.9. Ratio of standardized death rate (SDR) in adults (25 years and older) with primary education and in those with above secondary education by gender and main groups of the causes of death in Poland, 2002 2,5 Males 2,2 2,1 Females 3,2 2,3 2,4 1,8 1,9 Total Cancer CVD Respiratory Digestive Ill-defined External 2,8 2,4 3,5 2,3 4,7 2,2
Percentage 35 30 Fig. 4.14. Age-standardized percentage of people aged 15 years and older who have been limited in activities because of a health problem for at least 6 months by education in Poland and EU27, 2007 (authors calculation availing data from Eurostat ) 31,6 26,9 Males 30,1 28,7 Females 25 20 15 21,2 19,7 14,8 13,7 21,221,1 17,6 16,1 PL EU 10 5 0 Primary Secondary (upper) Tertiary (first stage) Primary Secondary (upper) Tertiary (first stage)
Early Diagnosing of Breast Cancer Screening Programm Percentage of people involved Goal-60% 1 January 2011 1 January 2012 Dane LOW NFZ w Zielonej Górze
Early Diagnosing of Cervical Cancer Screening Programm Percentage of people involved Goal-40% 1 January 2011 1 January 2012 Dane LOW NFZ w Zielonej Górze
New Project tackling health inequality open for public consultation since Jan 2012 (160 visits). A Project supported by Norwegian Structural Fund
LUBUSKIE VOIVODSHIP
Population Screening Programms Early Diagnosing of Breast Cancer Prevention and Early Diagnosing Cervical Cancer
Project Dental prophylaxis of children and youth from area of Gorzów Wielkopolski Dental sealant and fluoride varnish: - pupils of 0 classes from primary schools and from kinder gardens - pupils of gymnasium schools Fluoride varnish: - pupils of basic schools - pupils of secondary schools (over gymnasium) 19459 children Pupils of public and nonpublic educational institutions from Gorzowa Wlkp.
Programm of Prevention and Treatment of Faulty Posture Straightway to Health Screening tests (functional diagnosing) 7781 children DELOS Professional objective examines (posture control) 3500 children Medical consultations and diagnosing (specialists in orthopaedics, rehabilitation, radiology,pediatric neurology) Unifying workshops for teachers, school nurses, trainers of posture correction Individual therapy of children with education of parents 10 000 visits Purchase of medical diagnostic equipment Creating healthy playground
LUBELSKIE VOIVODSHIP
Tuberculosis incidence rate per 100 000 population in Lubelskie as a social indicator Poland 21.6 (2009) vs Lubelskie 30.2 (2010) Lublin county 4.8 City of Lublin 37.0 Krasnystaw county -41.4 Tomaszów county-62.4
Campaign of Lubelskie Governor Woman for Woman Purchase of cytomammobus for rural areas of region Cytommamobus visited 102 localities,performing 26 396 tests (July 2009 - September 2011); Increase the number of Pap tests performed from 24% in 2009 to 27% in 2011.The highest Increase of women attending in the Pap smears tests from 9% in 2009 to 24% in 2011 in rural Biłgoraj county; Increased number of performed mammographies from 36% in 2009 to 43% in 2011