Regional dif f erences in health socio economic determinants and life style
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REGIONAL DIF F ERENCES IN HEALTH, SOCIO-ECONOMIC DETERMINANTS AND LIFE STYLE. REPUBLIC OF SLOVENIA MINISTRY OF HEALTH. J. Maucec Zakotnik, M.D. State secretary, Ministry of Health, Slovenia. Content. Determinants of health

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REGIONAL DIF F ERENCES IN HEALTH, SOCIO-ECONOMIC DETERMINANTS AND LIFE STYLE

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Regional dif f erences in health socio economic determinants and life style

REGIONAL DIFFERENCES IN HEALTH, SOCIO-ECONOMIC DETERMINANTS AND LIFE STYLE

REPUBLIC OF SLOVENIA

MINISTRY OF HEALTH

J. Maucec Zakotnik, M.D.

State secretary, Ministry of Health, Slovenia

European Health Forum, Gastein 2002


Content

Content

  • Determinants of health

  • Regional differences in health and health determinants (Europe, Slovenia)

  • Activities carried out to tackle health burden related to food and nutrition (Slovenia)

  • Conclusions


Determinants of health

socialeconomic, cultural and environmental conditions

working and living conditions

social environment

lifestyle

age, gender, heredity

Determinants of health


Studies indicate

Studies indicate

  • Poor and less educated classes of inhabitants die earlier and more frequently in all age groups

  • Risk factors (RF)of unhealthy life style and for CND and also psychological disturbances are more frequent in less educated classes

  • Poor estimate their health status as worse than their “better standing” fellow inhabitants


Development and health are correlated

Development and Health are correlated

Social and economic

development

Improvement

of health


Big differences between w and e european countries in

Big differences between W and E European countries in:

  • Health indicators

  • Socio/economic development & Socio/economic determinants of health

  • Unhealthy life style and eating habits


Age standardized death rate in groups of european countries

Age standardized death rate in groups of European countries


Inequalities in slovenia

Inequalities in Slovenia

  • Inequalities in health indicators and socioeconomic determinants of health in different regions (W vs. E)

  • Inequalities in life style in:

    • Regions

    • Social groups

    • Gender

    • Age groups


Regional dif f erences in health socio economic determinants and life style

  • INEQUALITIES IN HEALTH INDICATORS

  • Age standardized mortality rate (per 100 000

  • inhabitants) in different regions of Slovenia (1999)

  • Life expectancy (years)

Murska Sobota

Ravne

999

72

Kranj

837

792

Maribor

885

72

Celje

Ljubljana

908

Nova Gorica

728

74.4

761

74.5

Novo mesto

Koper

912

769

75.5

SLOVENIA833

From: PHI and NOMEAD, RS, 1999


Regional dif f erences in health socio economic determinants and life style

  • INEQUALITIES IN SOCIOECONOMIC DETERMINANTS OF HEALTH

  • Level of unemployement (%, 1998)

  • Number of students per 1000 inhabitants

  • Gross domestic product (GDP - % of average)

Murska Sobota

19

18

78

Ravne

Kranj

Maribor

22

22

82

Celje

Nova Gorica

Ljubljana

9.2

24.7

98.6

11

28.5

129

Novo mesto

Koper

10.6

25.1

102

From: PHI and NOMEAD, RS, 1999


Regional dif f erences in health socio economic determinants and life style

INEQUALITIES IN EATING HABITS, PHYSICAL ACTIVITY AND BODY WEIGHT

  • Sampling:

    Stratified (by regions), random sample (CPR)

    Sample size: 15 379 (regional samples: 573 - 4576)

  • Age if inhabitants:

    25 - 64 years

  • Method of data collection:

    By post

  • Questionnaire:

    Questionnaire of WHO project - CINDI Health Monitor

Health Monitor Survey-

CINDI Slovenia 2001

Characteristics of the survey


Regional dif f erences in health socio economic determinants and life style

THE FOLLOWING DEMOGRAFIC AND SOCIOECONOMIC CHARACTERISTICS WERE ANALYSED REGARDING EATING HABITS, BODY WIEGHT (BMI) AND PHYSICAL ACTIVITY :

  • Gender (male, female)

  • Age groups (25 – 29, 30 – 39, 40 – 49, 50 – 59, ≥60)

  • Social class (lower, working, middle, upper middle, upper)

  • Place of living (city, suburbs, village)

  • Region (western, central, eastern)

HEALTHY EATING HABITS were defined as:

  • ≥3 meals per day

  • fruit/vegetables intake at least once per day

  • intake of fish and sea food at least once per week

PHYSICAL ACTIVITY was defined as:

  • INACTIVE - physical inactivity or at most irregular physical activity

  • ACTIVE - regular physical activity of any kind of intensity


Regional dif f erences in health socio economic determinants and life style

Eating habits of adult Slovene population

Healthy/unhealthy eating habits in all inhabitants (25-64 years)


Regional dif f erences in health socio economic determinants and life style

Eating habits of adult Slovene population

Healthy/unhealthy eating habits in DIFFERENT REGIONS


Regional dif f erences in health socio economic determinants and life style

Eating habits of adult Slovene population

Healthy/unhealthy eating habits in MEN AND WOMEN


Regional dif f erences in health socio economic determinants and life style

Eating habits of adult Slovene population

Healthy/unhealthy eating habits in DIFFERENT AGE GROUPS


Regional dif f erences in health socio economic determinants and life style

Eating habits of adult Slovene population

Healthy/unhealthy eating habits in DIFFERENT SOCIAL CLASSES


Regional dif f erences in health socio economic determinants and life style

Body weight of adult Slovene population

Body weight (BMI) in men and women


Regional dif f erences in health socio economic determinants and life style

Body weight of adult Slovene population

Body weight (BMI) in different age groups


Regional dif f erences in health socio economic determinants and life style

Body weight of adult Slovene population

Body weight (BMI) in different social classes


Regional dif f erences in health socio economic determinants and life style

Body weight of adult Slovene population

Body weight (BMI) in different regions


Regional dif f erences in health socio economic determinants and life style

CONCLUSION

INTERVENTIONS FOR DIFFERENT RISK FACTORS

SHOULD BE PRIMARILY AIMED AT:

  • DIETARY HABITS:

  • men

  • lower social classes

  • younger age groups

  • central and eastern parts of the country

  • BODY WEIGHT:

  • men

  • lower social classes

  • older age groups

  • eastern parts of the country

  • PHYSICAL ACTIVITY:

  • women

  • lower social classes

  • middle age groups

  • central and western parts ofthe country


Regional dif f erences in health socio economic determinants and life style

Led by Ministry of Health:

Intersectoral development of Food and Nutrition policy (good progress)

Integration of promotion of healthy life style (healthy nutrition and PA) in all policies and practices (RADENCI DECLARATION)

Development and testing methods and instruments for intersectoral collaboration (ISC) and for bringing health on others sectors agenda

Health Impact Assessment of the Agriculture, Food and Nutrition Policy ( WHO)

Development of HIA as a part of national and local HIA of policies, strategies and programs

Using HIA as main method for ISC and for involving Health in others sectors agenda

What is doing Slovenia to improve health and to lower differences in health related to Food and Nutrition?


Food and nutrition policy development in slovenia

Food and Nutrition Policy development in Slovenia

  • Support of the Government Of RS

  • Establishment of Food and Nutrition Council and Food and Nutrition Office in the MoH

  • Development of Food Safety Strategy in 2001(MoH and MAFF)

  • HIA of the Agriculture and FNP (with the aim to influence Agricultural Policy by evidence based results of HIA)


Food and nutrition policy development in slovenia1

Food and Nutrition Policy development in Slovenia

  • Food and Nutrition Action Plan 2003 to 2008 - Priorities

    • Changes in Agricultural policy

    • Strengthen collaboration and applying necessary instruments for achievement of Food Safety from stable to table

    • FBDG and NBDG development and implementation

    • Development of new curriculum in Food and Nutrition for professional and school curriculum

    • Education of the population

    • Special attention and programs for groups at risk and special needs


Promoting health trough pa and healthy nutrition

International conference on Promoting Health trough PA and Healthy Nutrition(Slovenia, Radenci, 18. to 21. April 2002)

THE RADENCI DECLARATION

integrated promotion of healthy nutrition and PA as healthy life style trough

international and national level

politicians, professionals, mass media, industry

public and private sector

Individuals and different groups trough whole life span

Development of

Food and Nutrition policy and action plan

National strategy and action plan for promotion HEPA

Integration of healthy life style in both

Promoting Health trough PA and Healthy Nutrition


Proje c t mura health and development

Project MURA – Health and Development

  • Less developed region with worst health indicators

  • Health – main potential for development of the region

  • Partnership for development at national and local level :

    • - agriculture/food

    • - tourism

    • - educational institutions

    • - environment

    • - kulture

    • - public health

    • - private sector and NGO


Project aim

Project aim

  • To identify and implement the best agreed sectoral and intersectoral activities and policies to achieve synergistic outcomes

    • To improve socio-economicindicators

    • To improve unhealthy life style and unhealthy eating habits

    • To improve health status

    • To lower inequalities in health

  • To develop and test methods and instruments for ISC at national and local level.


Conclusions 1

Conclusions 1

  • Big differences in health and socioeconomic development

  • We can improve health by influencing health determinants adequately

  • Need to develop and implement HIA as a method of assessing potential impact of different policies on health determinants

  • HIA good method to bring Health on others sectors agenda


Conclusions 2

Conclusions 2

  • Need to develop FNP and Action plan

  • Need to implement Promotion of Healthy Nutrition and PA as Healthy Life Style in all policies and practicies


Thank you for your attention

Thank you for your attention!


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