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)
1Pekka 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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4HEALTH
- Important human value
- Important for social and economic development
5MAJOR CHALLENGE
- A major challenge of the Northern Dimension in
promoting public health is to CLOSE THE CAP - Between countries
- Within countries
6LIFE EXPECTANCY AT BIRTH, RUSSIA AND THE
EUROPEAN UNION, 19702000
6
7MORTALITY 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
9TRENDS 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)
11DEATHS AND DAILY LOST ATTRIBUTABLE TO 10
LEADING RISK FACTORS, 2002
12Alcohol poisonings and life expectancy at birth
Russia (MF) 1965-2006
R - 0.94
Source VM Shkolnikov
13HEALTH PROMOTION
- Entry points
- 1) Diseases, health problems
- 2) Risk factors (behavioural, biological)
- 3) Determinants
- DIFFERENT ENTRY POINTS ARE NEEDED!
14EFFECTIVE 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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16- THE MAIN CHALLENGE IS NOT WHAT TO DO, BUT HOW
TO DO!
17Combing 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
19WHAT POLICIES?
- HEALTH POLICY AND HEALTH IN ALL POLICIES
- Health impact assessment
- Finlands EU Presidency theme
- EUs new health strategy
20CONTENTS 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
22PARTNERSHIPS
- Governments (national, local)
- Civil society (NGOs)
- Private sector
- INTERNATIONAL COLLABORATION
23- PUBLIC HEALTH DOES CHANGE AND CAN BE CHANGED!
24SERUM CHOLESTEROL IN MEN AGED 2564 YEARS
mmol/l
North Karelia Kuopio Turku/Loimaa Helsinki/Vantaa
Oulu Lapland
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2531
26STRONG INTERACTION BETWEENDIFFERENT LEVELS NEEDED
Global Regional EU National Local
27HEALTH 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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29ELEVATED BLOOD PRESSURESystolic gt140 mmHg
30HEALTHY 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
31ECONOMIC 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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33SPECIFIC 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
34SHOULD WE TARGET
- CHILDREN OR ADULTS?
- BOTH they influence each other ultimately the
question is social change
35HEALTH 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!
37FINAL RECOMMENDATION
- DO THE RIGHT THINGS AND DO ENOUGH OF IT
- COMBINE LEADERSHIP WITH BROAD PARTNERSHIP
38THE NORTHERN DIMENSION IN PROMOTING PUBLIC HEALTH
- MANY CHALLENCES
- BUT
- MANY POSSIBILITIES AND GREAT POTENTIAL FOR HEALTH
OF OUR PEOPLES
3939
40THANK YOU
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St. Petersburg, Russia 11.-12.12.2007