CVD prevention/ Tiina Laatikainen 4th International Seminar on the Public Health Aspects of Noncommunicable Diseases Lausanne, 7-12 March 2011 Practical examples for proposed action concerning the WHO NCD Strategy Action Plan objectives Dr. Tiina Laatikainen, Director 15/10/2017 CVD prevention/ Tiina Laatikainen

Objective 1: To raise the priority accorded to noncommunicable disease in development work at global and national levels, adn to integrate prevention and control of such diseases into policies across all government departments

Health in All Policies – The Finnish Initiative

What is Health in All Policies (HiAP) approach? Horizontal, complementary policy related strategy The core of HiAP is to examine determinants of health -> are mainly controlled by policies of sectors other than health Addresses policies in the context of policy-making at all levels of governance (global, European, national, regional and local levels) The ultimate aim of HiAP is to improve evidence informed policy-making Health in all policies is closely related to other terms with similar agenda, such as healthy public policies and intersectoral action for health Ståhl et al. (eds) 2006

Focusing on policies Key concern: policies The broad economic, social, environmental and cultural health determinants are the bridge between policies and health outcomes For example, alcohol policy (tax) influences the price of alcohol that has an effect on alcohol consumption that (alcohol abuse) in turn has an effect on harms, both health and social Less concerned with single programmes and projects alcohol policy tax on alcohol alcohol consumption health and social harms

Broad determinants of health Social, economic, structural, environmental, cultural Present everywhere in the society Often beyond the control of individuals Same determinants are linked with many major public health problems (nutrition, physical activity, tobacco, alcohol, psychosocial situation, stress) Mostly a responsibility of other government sectors Impossible to target effectively through sectorial health policies alone

Intersectoral mechanisms/tools for implementing HiAP Formal consultations on e.g. legislation Horizontal public health committees Ad hoc committees on specific initiatives Cross-sectorial programmes Public health reporting (with co-operation of other sectors) Formal communication between sectors (e.g. bilateral meetings of Permanent Secretaries) Informal contacts at desk level EU co-ordination Health impact assessment Stahl T (2009) Is health recognized in the EU's policy process? An analysis of the European Commission's impact assessments. The European Journal of Public Health 2009; doi: 10.1093/eurpub/ckp082

Objective 2: To establish and strengthen national policies and plans for the prevention and control of noncommunicable diseases

Prevention and management of cardiovascular disease Action Plan for Promoting Finnish Heart Health

Prevention of type 2 diabetes From clinical trial to National Programme and Action Plan

Asthma Programme 1994-2004 Focus: (1) inflammation, (2) early intervention, (3) guided self-management, and (4) networking Haahtela T, et al. Thorax 2006 National Allergy Programme 2008 -2018 – time to act and change the course Finn Med J 2008,Suppl 14:1-22; Allergy 2008;63:634-645; Allergy 2008;63:631-633, Editorial; Allergy 2009;64:678-701 In association with the WHO GARD Programme = Global Alliance against Respiratory Diseases Focus: (1) children, young people, (2) from treatment to prevention, (3) tolerance, (4) diagnostic quality, and (5) early intervention to control severe allergies Ministry of Health; National Public Health Institute; NGOs: Allergy & Asthma Federation, Finnish Lung Health Association, Finnish Pulmonary Association HELI 11

Objective 3: To promote interventions to reduce the main shared modifiable risk factors for noncommunicable diseases: tobacco use, unhealthy diets, physical activity and harmful use of alcohol

www.sydanmerkki.fi

Objective 4: To promote research for the prevention and control of noncommunicable diseases

Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability OBJECTIVE: To reduce cognitive impairment in an at risk population through a 2-year multi-domain life-style intervention including: Nutritional guidance Strength training and aerobic exercise Cognitive training, increased social activity Intensive monitoring and management of metabolic and vascular risk factors: hypertension, dyslipidemia, obesity, impaired glucose tolerance Funding from the special Public Health Programme of Academy of Finland 15/10/2017

Objective 5: To promote partnerships for the prevention and control of noncommunicable diseases

POPULATION PUBLIC POLICY PRIVATE SECTOR HEALTH PROGRAMME

Objective 6: To monitor noncommunicable diseases and their determinants and evaluate progress at the national, regional and global levels

Systolic blood pressure in women (30–59 y) mmHg North Karelia project evaluation and FINMONICA and the National FINRISK Studies 1972 - 2007

National FINRISK Study every five years since 1972 risk factors of cardiovascular diseases, diabetes, cancer and astma and allergy stratified random samples from population register population aged 25-64 years stratified by age and sex sample size 8000 – 12 000 / survey participation rate 67 – 88 % questionnaire, anthropometrics and laboratory analyses

BMI by education, women 25-64 years kg/m2

Alueellinen terveys- ja hyvinvointitutkimus, ATH www.terveytemme.fi Lisätiedot Painike avaa valitun osoittimen lisätiedot uuteen ikkunaan Teemakartta Teemakartta esittää osoittimen arvot väri- sävyinä kartan alueilla Tulosta Painike avaa tulostuksen esikatselun Luokittelu Painike avaa valikon, josta voi valita kartalla käytettävän luokittelun ja väripaletin Ohje Painike avaa käyttöohjeen Luokkarajat Esittää kartalla ja pylväskaaviossa käytetyn luokittelun ja värityksen Lähde Tietoaineisto, jonka perusteella osoitin on muodostettu Vertailualueet Esittää osoittimen arvot muilla kuin kartan alueilla Valitse vertailualue klikkaamalla Aloita tästä Osoittimet Painike avaa Osoittimet-valikon Valitse valikosta osoitin, väestöryhmä ja aikajakso Osoittimen arvot tulevat nyt näkyviin Valitun osoittimen nimi näkyy kartan yläpuolella Taulukko Järjestä taulukon rivit klikkaamalla sarakeotsikkoja Avaa osoittimen ryhmävertailu klikkaamalla pientä dokumentti-kuvaketta Korosta haluttu alue hiirellä osoittamalla Valitse haluttu alue hiirellä klikkaamalla Terveyden ja hyvinvoinnin laitos (THL) Terveytemme-projektiryhmä terveytemme@thl.fi Aikasarja Klikkaa haluttua aluetta, osoittimen aikatrendi tulee näkyviin aikasarjakuvaajaan Vertaile eri alueita valitsemalla useampi alue tai vertailualue aktiiviseksi Pylväskaavio Pylväät esittävät osoittimen arvot eri alueilla suuruusjärjestyksessä Luottamusvälit esittävät tulosten virhemarginaalin 15.10.2017 Alueellinen terveys- ja hyvinvointitutkimus, ATH 22