the european action plan for strengthening public health dr joanna nurse senior advisor, public...
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The European Action Plan for Strengthening Public Health
Dr Joanna NurseSenior Advisor, Public Health Services,
Health Systems and Public Health ServicesWHO, European Region
Health Promoting Networks16th October 2012
Regional Committee Approval
•Resolution
•European Action Plan
•Including 10 Essential Public
Health Operations
Supported by Background Documents
•Review of public health services and
capacity
•Review of Legal and Policy Tools and
Instruments
•Review of institutional models for delivering public health services
Promotion
Strengthening Public Health Services and Capacity across the European Region
VISION: Sustainable Health and Well being
PURPOSE: Strengthen integrated public health services and reduce
inequalities
Protection Prevention
Public Health Challenges for the European Region – A Public Health Service for the 21st Century
• Inequalities and the Economic crisis
• Globalisation, migration and urbanisation and an ageing population
• Environmental degradation and Climate Change
• Public Health emergencies
• Changes in lifestyle behaviours and increasing prevalence of non-Communicable Diseases
• Emerging and re-emerging communicable diseases
Life expectancy in European country groups in 1950-2045: population health improvement and ageing
Source: UN Population Division, World Population Prospects 2008
Year
Life
exp
ecta
ncy a
t b
irth
(ye
ars
)
55
60
65
70
75
80
85
1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050
CIS countries
EU 12 countries
EU 15 countries
European Region
Other countries
GovernanceEPHO 6
PH WorkforceEPHO 7FundingEPHO 8
CommunicationEPHO 9
ResearchEPHO 10
Clustering of Essential Public Health Operations (EPHOs) - to deliver Public Health services
INTELLIGENCE
EPHO 1 + 2Surveillance
Monitoring
Informing
health assessments
and plans
EPHO 4
EPHO 3 EPHO 5
CORE EPHOs
Health Promotion
Disease PreventionHealth Protection
VISION: Sustainable Health & Well-Being
SERVICE DELIVERY
ENABLER EPHOs
WHO European country assessments
Where there are greater health inequalities there are generally less well developed public health services and capacities
Estimate of coverage and quality of EPHOs across the WHO European Region
CoverageEstimated percentage of countries that have some activities related to the EPHO
QualityEstimated degree to which activities fulfil the complete EPHO definition
NA
EPHO 2
EPHO 1
EPHO 4
EPHO 3
EPHO 5
EPHO 6
EPHO 7
EPHO 8
EPHO 9
EPHO 10
Estimate of coverage and quality of EPHOs in NIS countries
CoverageEstimated percentage of countries that have some activities related to the EPHO
QualityEstimated degree to which activities fulfil the complete EPHO definition
NA
EPHO 2
EPHO 1
EPHO 4
EPHO 3
EPHO 5
EPHO 6
EPHO 7
EPHO 8
EPHO 9EPHO 10
EPHO 1 2 3 4 5 6 7 8 9 10
Legally binding tools
21 12 306 31 2 41 3 1 0
0
Non legally binding
tools
37 25 90 39 15 259 11 5 5 2
Total
Number of tools
58 37 396 70 17 300 14 6 5 2
Number of Public Health policy and legal instruments classified in each EPHO
Source: WHO Regional Office for Europe, 2012
The contribution of prevention and treatment related to the decline in global CHD morbidity
Source: NEJM 2007: 2388Goldman USA, 1968-76
Beaglehole New Zealand, 1974-81
Hunink USA, 1980-90
IMPACT Scotland, 1975-94
IMPACT New Zealand, 1982-93
IMPACT England and Wales, 1981-2000
IMPACT USA, 1980-2000
IMPACT Poland, 1991-2005
IMPACT Czech, 1985-2007
IMPACT Sweden, 1986-2002
BMJ Finland, 1982-97
IMPACT Finland, 1982-97
IMPACT Iceland, 1981-2006
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
40
40
43
35
35
38
47
43
39
36
24
23
24
54
60
50
55
60
52
44
49
60
55
76
53
74
6
0
7
10
5
10
9
8
1
9
0
24
2
Treatments Risk factors Unexplained
%
Estimated expenditure on prevention and public health as % of total health expenditure
Source: Derived from global health expenditure database, 2012.
Public Health Challenges in Europe and the EPHOs that especially need to be strengthened
Strongest relevance
P
H C
hal
len
ges
EPHO
Relevant
Some relevance
EnvironmentalDeterminants
CLIMATE CHANGE
&DISASTERS:
•Heatwaves•Fires
•Drought•Floods
•Mudslides•Chemical Spills
•Food Security•Changes in
Infectious disease habitat
Social & Economic
Determinants
AGEING
ECONOMIC DECLINE
INEQUALITIES
URBANISATION
MIGRATION
TECHNOLOGY
Health Outcomes
NCDs
LONGERLIFE
EXPECTANCY
Health SystemImplications
INCREASED:DEMAND & COSTS
DECREASEDWORKFORCE
Solutions
SUSTAINABLEPREVENTION& PROMOTION
PRIMARYHEALTHCARE
PROTECTIONEmergency
preparedness
INNOVATIVEWIN – WIN-WIN APPROACHES
Risks & Projections RESEARCH IMPLICATIONS Innovative solutions
Summary of Public Health Challenges and Solutions for 2050
15th European Health Forum Gastein, 5 October 2012
GovernanceEPHO 6
PH WorkforceEPHO 7FundingEPHO 8
CommunicationEPHO 9
ResearchEPHO 10
The contribution of Health Promoting Networks in delivering the EPHOs
INTELLIGENCE
EPHO 1 + 2Surveillance
Monitoring
Informing
health assessments
and plans
EPHO 4
EPHO 3 EPHO 5
CORE EPHOs
Health Promotion
Disease PreventionHealth Protection
VISION: Sustainable Health & Well-Being
SERVICE DELIVERY
ENABLER EPHOs
Networks take a systems approach
ConnectedMind
ConnectedMind & Body
ConnectedFamilies
ConnectedCommunities
ConnectedEnvironment
Sustainable approaches to wellbeing
Win
Win
Win
Common Problems
Common Solutions
Common Solutions – Green Spaces
http://i.treehugger.com/files/th_images/parkwheel-thumb.jpg
Increase Urban Green Space
• Improves mental health & well being
• Increases social contacts
• Increases physical activity & reduces obesity
• Reduces violence & abuse
• Reduces inequalities
http://www.thedesignblog.org/images/mobile_green_space.jpg
Green Buildings - Japan
Benefits for Adaptation & Mitigation• Improves air quality – reduces pollutants & reduces CO2• Keeps Buildings Cool in Hot weather• Green Roofs insulate against cold weather• Assists in flood run- off
http://www.metaefficient.com/images/fukuoka_green_roof.jpg
Points for discussion in Workshop
• Identifying areas in common and of synergy
• Identify gaps and how to address them
• Improving communications and collaborative working
• Formalisation of collaborative process
• Priority areas to collaborate on
• Next steps and ways forward
-From Values
to Action -
Division of Health Systems and Public Health
Thank You !