Dr Roberto Bertollini -Fit for Work Europe Summit 2013.pdf

7/22/2019 Dr Roberto Bertollini -Fit for Work Europe Summit 2013.pdf

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Investing in Healthcare: breaking down

the silos

Brussels, 16 October 2013

With the endorsement of the Lithuanian Presidency of the Council of the EU

In partnership with the European Economic and Social CommitteeCo-chaired by Antonyia Parvanova MEP & Gianni Pittella, Vice-President, EP

Follow us on Twitter @FfWEurope

Check our website www.fitforworkeurope.euTake a look at our blog www.blog.fitforworkeurope.eu
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2/17

Investing in Healthcare: breakingdown the silos

In t roducto ry remarks

Roberto Bertollini MD MPHChief Scientist and

WHO Representative to the EUWHO Regional Office for Europe

16 October 2013,Brussels


3/17

Overall health improvement (+ 5 years life expectancy)

but with an important divide in the Region

CIS: Commonwealthof Independent StatesEU12: countriesbelonging to theEuropean Union (EU)after May 2004EU15: countriesbelonging to the EUbefore May 2004

Source: European

Health for Alldatabase.Copenhagen, WHORegional Office forEurope, 2010.


4/17

Health inequalities within countries:life expectancy in Sweden by education level


5/17

Burden of disease in Europe in 2010 and %change between 1990 and 2010

http://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramAccessed on October 14 2013
http://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramhttp://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramhttp://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramhttp://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramhttp://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagramhttp://www.healthmetricsandevaluation.org/gbd/visualizations/gbd-arrow-diagram


6/17

Health

Proximal causes

Airpollution

Water,

sanitation

Chemicals

Vectorbreeding sites

Radiation

etc.

Causes of the causes

Trade

Degradedecosystems

MigrationDesertification

Climatechange

Social factors not related toenvironment

Genetic factors

Transport

Injuries

Physicalinactivity

Respiratorydiseases

Cardiovasc.diseases

Diabetes

Breast cancer

Malaria

DengueLeishmaniasis

etc.

Malaria

Cardiovasc.diseases

Injuries

etc.

Malnutrition

Diarrhoea

Diarrhoea

MalnutritionDrownings

Intestinalparasites

etc.

Lung cancer

Respiratoryinfections

Lung cancer

COPD

Environment-society-individual interaction on health


7/17

Cost-effective policies using fiscal policy to

improve health outcomes

TobaccoA 10% price increase intaxes could result in up to

1.8 million fewer prematuredeaths at a cost of between

US$ 3 and US$ 78 perDALY in eastern Europeanand central Asian countries

AlcoholIn England, benefits closeto600 million in reducedhealth and welfare costsand reduced labor and

productivity losses, at animplementation cost of lessthan0.10 per capita

Source: McDaid D, Sassi F, Merkur S, eds. The economic case for publichealth action. Maidenhead, Open University Press (in press).
http://localhost/var/www/apps/conversion/tmp/scratch_3//upload.wikimedia.org/wikipedia/commons/c/c8/Zigaretten.JPGhttp://localhost/var/www/apps/conversion/tmp/scratch_3//upload.wikimedia.org/wikipedia/commons/5/57/Port_wine.jpg


8/17

Cost-effective policies (cont`d)

-Healthy eating;-Prevention of depression;-Action across the life course;-Early action in childhood;

-Prevention of road traffic accidents;-Tackle environmental chemical hazazards;-Investment in education is investment in health.

Going upstream is compell ing !(social determ inants, prevent ion, heal th p rom otion )


9/17

The economic case for health promotion anddisease prevention

Cardiovasculardisease

Alcohol relatedharm

Cancer

Road trafficinjuries

Obesity relatedillness (including

diabetes and CVD)

169 billion annually in the EU; healthcareaccounting for 62% of costs

125 billion annually in the EU, equivalentto 1.3% of GDP

Over 1% GDP in the US; between 1-3% ofhealth expenditure in most countries

6.5% of all health care expenditure inEurope

Up to 2% of GDP in middle and highincome countries

Sources: Leal (2006), DG Sanco (2006), Stark (2006), Sassi (2010), WHO (2004)


10/17

Improving governance for health

Supporting whole-of-government and whole-of-society approaches

Learning from a wealth ofexperience with

intersectoral action andhealth-in-all-policies (HiAP)work in Europe and beyond

Two studies on governance for health led by Professor Ilona Kickbusch (2011,2012)

Intersectoral governance for HiAP, by Professor David McQueen et al.


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We need wide-ranging prevention strategiesaddressing multiple determinants of healthacross social groups A combination of

individual and community behaviours andconducive policy and regulatory environmentis required to make the healthy choice the

easy choice!


12/17

Health 2020 books published


13/17

New evidence informing Health 2020

Governance for health in the 21st century

Supporting Health 2020: governance for health in the 21stcentury

Promoting health, preventing disease: the economic case

Intersectoral governance for health in all policies:structures, actions and experiences

Report on social determinants of health and the healthdivide in the WHO European Region

Review of the commitments of WHO European MemberStates and the WHO Regional Office for Europe between1990 and 2010


14/17

People enabled and supported in achieving their fullhealth potential and well-being (value-driven)

Investing inhealth

through lifecourse and

empoweringpeople

P

Tackling theRegion's

major healthchallenges

PStrengthening

Patient-centredhealth systems

Creatingresilient

communitiesand

supportiveenvironment

s

Adding value through partnership

Reducing inequalities

and improving governance for health

Health 2020 strategic objectives and

priorities for policy action


15/17

Reduce health inequities: biggest

challenge

For richer, for poorer

Growing inequality is one of thebiggest social, economic and

political challenges of our time. Butit is not inevitable

The Economist Special Edition October 13th 2012


16/17

Equity as a measure of progress

Reducing health inequities should becomeone of the main criteria to measure:

Health systems performance;

Performance of the Government.


17/17

Thank you for attending the Fit for Work

Summit 2013.

Follow us on Twitter @FfWEurope

Check our website www.fitforworkeurope.euTake a look at our blog www.blog.fitforworkeurope.eu
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Documents

Dr Roberto Bertollini -Fit for Work Europe Summit 2013.pdf