Investments in HealthInvestments in Health

Social inclusion and combating povertySocial inclusion and combating povertyPromoting employment and supporting labour mobilityPromoting employment and supporting labour mobility

2014–2020 planning period

Informal consultation meeting

Riga, March 1, 2013

1

ContentContent

Planning frameworkCurrent situationObjectivesInstrumentsActivities and synergyExpected results

2

Planning frameworkPlanning framework((EU documents)EU documents)

Europe 2020Headline targets: Employment and Skills / Fighting Poverty

Council of EU conclusions: towards modern, responsive and sustainable health systems → Health sector should play an adequate role in the implementation of the Europe 2020 Strategy. Investments in health should be acknowledged as a contributor to economic growth. While health is a value in itself, it is also a pre-condition to achieve economic growth

EC Social Investment Package for Growth and Cohesion → EC urges Member States to better reflect social investments in the allocation of resources and the general architecture of social policy: (child)care, education, training, active labour market policies, housing support, rehabilitation and health services, as well as improve the sustainability of the health system

3

Planning frameworkPlanning framework(International(International documents) documents)

Tallinn Charter (WHO)- It is unacceptable that people become poor due to ill health- Major health challenges should be addressed in context of

demographic and epidemiological change- Health contributes to economic development and wealth

EU Strategy for the Baltic Sea Region (EUSBRS)EUSBSR Action Plan → To maintain and reinforce attractiveness of

the Baltic Sea region in particular through education and youth, tourism, culture and health:

- Fight health inequalities with improvement of primary healthcare

- Prevent lifestyle-related non-communicable diseases and ensure good social and work environments

4

Planning frameworkPlanning framework(National documents)(National documents)

National Development Plan for Latvia 2014-2020Priority: “Personal Resilience”Action: “Healthy and work-able person”

Defined tasks for the action:- Strengthening of healthy and active habits- Accessibility of health care- Improvement, planning and coordination of health care quality- Rehabilitation measures for maintaining and renewal of ability

to work

5

Planning frameworkPlanning framework(National documents)(National documents)

Public Health Strategy 2011 – 2017Headline target: To prolong number of healthy life years for

inhabitants of Latvia and to avoid premature death, thus maintaining, improving and renewing health

Targets- Reduce inequalities in health- Reduce mortality and morbidity from non-communicable

diseases- Improve mother and child health (reduce infant mortality)- Promote healthy life and working environment- Reduce morbidity of infection diseases- Promote effective health care system

6

Planning framework Planning framework ((Headline indicatorsHeadline indicators))

Europe 2020- Raise the employment rate of the population aged 20-64 from

the current 69% to at lease 75%- Reduce number of Europeans living below national poverty

lines by 25%, lifting 20 million people out of poverty

National Development Plan for Latvia 2014-2020- Decrease of potential years of life lost per 100 000 from 6 476

(in 2010) to 5 300 (in 2020)- Increase of healthy life years (average men / women) from

53,5 / 56,7 (in 2010) to 57 / 60 (in 2020)

7

Planning framework Planning framework ((Health role in social Health role in social inclusion and employmentinclusion and employment))

Health is one of the key factors to prevent poverty - if the breadwinner of a family dies or loses workability, whole family welfare is being put at the poverty risk.Survey – if one of the breadwinners in a family loses job or dies – 33% family's existing life standard could maintain for a month, while 56% of respondents – for three monthsSurvey – main fears of the members of society are connected with health status – 80% of respondents afraid to lose health, 78% - afraid to have no access to high quality health servicesHealth is a precondition for employment and sustainable development – reducing number of disabled persons and premature mortality ensures labour force and employment:MoE forecast - shortage of labour force in 2030 – 120 000According to statistics almost 70% of newly registered disabled people are non-working

8

Current situationCurrent situationHealthy life yearsHealthy life years

9

Current situationCurrent situationPotential years of life lost (0-69) and Potential years of life lost (0-69) and mortality (0-64) in EU (2010, per 100 mortality (0-64) in EU (2010, per 100 000 inhabitants)000 inhabitants)

10

Current situationCurrent situationPotential years of life lost (2011, per Potential years of life lost (2011, per 100 000 inhabitants) 100 000 inhabitants)

11

Current situationCurrent situationMortality by causesMortality by causes

12

Current situationCurrent situationMortality by causes (external causes)Mortality by causes (external causes)

- Life style related causes (use of alcohol, safety at work, at home, on roads etc.)

- Mental health

13

Current situationCurrent situationNewly recognized disabilityNewly recognized disability

14

Current situationCurrent situationAmbulatory health effectivenessAmbulatory health effectiveness

15

* Health care guidelines of EU Employment and Social Affairs Committee define indicator diagnosis, which show the gaps in ambulatory health care . Patients with these diagnosis usually would have to be treated in ambulatory health care by splitting the competencies among specialists in primary and secondary health care.

Smoking pattern by sex (%)

16

Current situationCurrent situationLife style related habitsLife style related habits

BMI and respondent’s perception of his/her weight (%)

17

Current situationCurrent situationLife style related habitsLife style related habits

Leisure time activities, by sex (%)

18

Current situationCurrent situationLife style related habitsLife style related habits

Use of seat belt on the front and back seat (%)

19

Current situationCurrent situationLife style related habitsLife style related habits

Current situationCurrent situationGDP loss from potential years of life GDP loss from potential years of life lost lost

20

Current situation Current situation World experienceWorld experience

Evidence shows that wide spread and purposeful 30 years health promotion programmes can reduce mortality from cardiac and circulatory diseases by 80%

80% of cases of circulatory diseases are connected with unhealthy food, insufficient physical activity and smoking

Smoking limitation reduce heart attack frequency by 17 % in 1 year and by 36% in 3 years

Increase of life expectancy at birth by 10% promotes annual economic growth by 0,3-0,4%

Strong ambulatory health care provides faster diagnostics and sooner treatment, thus – better health, reduced consequences of health related problems

Only complex measures through coordinated collaboration of health care levels can address the particular health related welfare risks

2003 data in USA shows that per 25 million calls to EMS, a one minute reduction in response saves more than 300 000 lives

21

ObjectivesObjectives

22

Objective 1To make society’s life style more healthy, thus tackling illness, mortality and disability factors and prolonging human life

Objective 2To strengthen role of early diagnostics and ambulatory health care, thus improving accessibility and quality of health care services, reducing number of situations when health care is unavailable

Objective 3To implement special measures aimed at tackling circulatory, oncology and prenatal mortality and disability, thus reducing mortality and disability from main factors

Objective 4To improve accessibility of mental health outpatient care, thus supporting treating and integration of mental ill persons

23

Instruments for objective 1Health promotion - Addiction prevention, Healthy food, Physical activity, Reproductive health, Injuries, Infection prevention, Mental health etc.

InstrumentsInstruments

Instruments for objective 2Development of ambulatory health servicesDevelopment of emergency services

Instruments for objective 3Development of cardiac and circulatory health care networkDevelopment of oncology health care networkDevelopment of prenatal health care networkDevelopment of rehabilitation services

Instruments for objective 4Development of ambulatory mental health care

Activities and synergyActivities and synergy

24

Synergy-ICT development-Development of transport accessibility in regions- Health in prisons- Life-long learning – training of persons involved in health sector- Supporting of deinstitutionalization

ActivityImprovement of health care services and quality

SynergyHealth promotion infrastructure measures:

- Publicly available sports infrastructure for recreational sport - Integration of sports and recreational sport activities in

nature trails

ActivityPurposeful health promotion measures

Support in 2007-2013Support in 2007-2013Challenges in 2014-2020Challenges in 2014-2020

Reforms aimed at health system optimisation were implemented Fewer but stronger secondary health care institutions More accessible ambulatory and emergency health care

Complex measures aimed at coordinated and efficient performance of tasks of each health sector player in order to address health related social exclusion and poverty issues

Health promotion – role of individual responsibility about health

Health care – role of ambulatory, stationary and emergency health

2007-2013

2014-2020

25

Expected resultsExpected resultsWhat should be done to increase What should be done to increase healthy life years and reduce healthy life years and reduce potential years of life lost? potential years of life lost? (1)(1)

Educate people and make them feel responsible

about their health

Reduce illness, mortality and disability, thus prolonging human life and reducing risk of social exclusion

26

Reduce spread of smoking habit

among 15 years olds by 4,9%

Reduce use of alcohol - risky use per year reduction

by 5,7%

Physical activity increase – 30 minutes a day

regular exercising increase by 8,1%

Expected resultsExpected results What should be done to increase What should be done to increase healthy life years and reduce healthy life years and reduce potential years of life lost? potential years of life lost? (2)(2)

27

Increase accessibility to high quality health services

Reduce illness, mortality and disability, thus prolonging human life and reducing risk of social exclusion

Decrease of mortality from

circulatory diseases (age 0-64) per 100 000 inhabitants (from

162 to 135)

Decrease of mortality from

oncology diseases (age 0-64) per 100 000 inhabitants (from

110 to 99)

Decrease of mortality from

prenatal mortality per 1000 live

born and stillborns (from

9,3 to 6,9)

28