Pekka Puska, Professor Director General, National Public Health Institute (KTL) President Elect, World Heart Federation (WHF) Vice President, Int. Ass. of National Public Health Institutes (IANPHI) - PowerPoint PPT Presentation

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Pekka Puska, Professor Director General, National Public Health Institute (KTL) President Elect, World Heart Federation (WHF) Vice President, Int. Ass. of National Public Health Institutes (IANPHI)

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President Elect, World Heart Federation (WHF) Vice President, Int. Ass. ... MANY POSSIBILITIES AND GREAT POTENTIAL FOR HEALTH OF OUR PEOPLES. 39. THANK YOU ... – PowerPoint PPT presentation

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Title: Pekka Puska, Professor Director General, National Public Health Institute (KTL) President Elect, World Heart Federation (WHF) Vice President, Int. Ass. of National Public Health Institutes (IANPHI)


1
Pekka Puska, ProfessorDirector General, National
Public Health Institute (KTL)President Elect,
World Heart Federation (WHF)Vice President, Int.
Ass. of National Public Health Institutes
(IANPHI)
CHALLENGES OF THE NORTHERN DIMENSION IN PROMOTING
PUBLIC HEALTH
International Conference on Social Inclusion and
Promotion of Healthy Lifestyles
St.
Petersburg, Russia 11.-12.12.2007
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HEALTH
  • Important human value
  • Important for social and economic development

5
MAJOR CHALLENGE
  • A major challenge of the Northern Dimension in
    promoting public health is to CLOSE THE CAP
  • Between countries
  • Within countries

6
LIFE EXPECTANCY AT BIRTH, RUSSIA AND THE
EUROPEAN UNION, 19702000
6
7
MORTALITY DIFFERENCES AMONG PEOPLE 30 AND ABOVE
ACCORDING TO INCOME
(Finland)
Relative mortality
Women
Men
Highest
Lowest
Decade of income
(Source Martikainen P ym. Int J Epid
2001301397-1405)
8
  • Non communicable diseases and related health
    problems major determinants of contemporary
    public health
  • Cardiovascular
  • Cancer
  • Injury

9
TRENDS IN STANDARDIZED DEATH RATES FROM
DISEASES OF THE CIRCULATORY SYSTEM IN RUSSIA
AND EU-15 COUNTRIES
10
  • Lifestyles in key position!
  • Tobacco
  • Alcohol
  • Diet
  • Physical activity

(WHO)
11
DEATHS AND DAILY LOST ATTRIBUTABLE TO 10
LEADING RISK FACTORS, 2002
12
Alcohol poisonings and life expectancy at birth
Russia (MF) 1965-2006
R - 0.94
Source VM Shkolnikov
13
HEALTH PROMOTION
  • Entry points
  • 1) Diseases, health problems
  • 2) Risk factors (behavioural, biological)
  • 3) Determinants
  • DIFFERENT ENTRY POINTS ARE NEEDED!

14
EFFECTIVE INTERVENTIONS AVAILABLE
  • During the last few years there has been produced
    a great number of strategies and plans for
    evidence based, effective health promotion and
    health policies.
  • MANY IMPORTANT PRIORITIES HAVE BEEN IDENTIFIED.

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  • THE MAIN CHALLENGE IS NOT WHAT TO DO, BUT HOW
    TO DO!

17
Combing Personal and Public Responsibilities
  • Personal Responsibility
  • Nobody can take better care of your health than
    yourself
  • Public Responsibility
  • Make the healthy choices the easy ones
  • (Ottawa declaration)

18
  • PUBLIC RESPONSIBILITY
  • POLICY INTERVENTIONS

19
WHAT POLICIES?
  • HEALTH POLICY AND HEALTH IN ALL POLICIES
  • Health impact assessment
  • Finlands EU Presidency theme
  • EUs new health strategy

20
CONTENTS OF POLICIES
  • Stick Carrot
  • Restrictions and enabling actions
  • Restrictions e.g. alcohol and tobacco tax,
    smokefree areas
  • Enabling availability of healthy food e.g.
  • Good mix

21
POLICIES AND PRACTICAL ACTIVITIES NEEDED TO
DIMINISH INEQUALITIES IN HEALTH
  • WHOs Commission on Health Determinants raport in
    2008 will hopefully put further international
    and national emphasis on reduction of health
    inequalities
  • MANY NATIONAL STRATEGIES EU INTEREST

22
PARTNERSHIPS
  • Governments (national, local)
  • Civil society (NGOs)
  • Private sector
  • INTERNATIONAL COLLABORATION

23
  • PUBLIC HEALTH DOES CHANGE AND CAN BE CHANGED!

24
SERUM CHOLESTEROL IN MEN AGED 2564 YEARS
mmol/l
North Karelia Kuopio Turku/Loimaa Helsinki/Vantaa
Oulu Lapland
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STRONG INTERACTION BETWEENDIFFERENT LEVELS NEEDED
Global Regional EU National Local
27
HEALTH COLLABORATION BETWEEN FINLAND AND THE
REPUBLIC OF KARELIA
  • The Ministry of Health in the Republic of
    Karelia, and KTL and the North Karelia project in
    Finland started collaboration in 1991
  • Aim was to decrease mortality and morbidity due
    to chronic diseases and promote the health of
    population
  • Establishment and development of health
    monitoring systems
  • Planning and evaluation of interventions
  • Training

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ELEVATED BLOOD PRESSURESystolic gt140 mmHg

30
HEALTHY LIFESTYLES
  • FOR INDIVIDUAL
  • Effective Way to Prevent Diseases and
    Promote Health
  • FOR THE SOCIETY
  • A Cost Effective and Sustainable Way to
    Improve Public Health

MAJOR HEALTH GAINS CAN BE ACHIEVED BY MODEST
CHANGES IN LIFESTYLES IF THEY CONCERN MAJOR PARTS
OF POPULATION
31
ECONOMIC DRIVERS FOR DISEASE PREVENTION AND
HEALTH PROMOTION
  • Health expenditures not only costs but also
    investments
  • Healthier population Benefits to national
    economy and health care
  • Healthier worksite Benefits to private sector
    productivity
  • Special issues
  • Russia Demographic crises
  • Finland Labour force, growing older population

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SPECIFIC AND PRACTICAL ATTENTION TO
  • Alcohol policy (price availability)
  • Tobacco policy (ref. WHO/FCTC)
  • Nutrition information interaction with food
    industry
  • Physical activity promotion
  • Public health infrastructure institutional base
    and monitoring

34
SHOULD WE TARGET
  • CHILDREN OR ADULTS?
  • BOTH they influence each other ultimately the
    question is social change

35
HEALTH MONITORING
  • Power of monitoring
  • Need to emphasize risk factors, lifestyles,
    determinants
  • Feed back to people and decision makers
  • Communication for policy

36
  • Successful, effective health promotion calls for
    effective policies, but also for effective
    supportative structures and the necessary
    resources!

37
FINAL RECOMMENDATION
  • DO THE RIGHT THINGS AND DO ENOUGH OF IT
  • COMBINE LEADERSHIP WITH BROAD PARTNERSHIP

38
THE NORTHERN DIMENSION IN PROMOTING PUBLIC HEALTH
  • MANY CHALLENCES
  • BUT
  • MANY POSSIBILITIES AND GREAT POTENTIAL FOR HEALTH
    OF OUR PEOPLES

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THANK YOU
??????? ?? ????????!
St. Petersburg, Russia 11.-12.12.2007
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