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Prevention of Heart Diseases in Switzerland Gaudenz Silberschmidt Vice director and Head of International Affairs Swis

Prevention of Heart Diseases in Switzerland Gaudenz Silberschmidt Vice director and Head of International Affairs Swiss Federal Office of Public Health European Heart Network Annual Workshop, Geneva: 17.5.2006. Prevention of Heart Diseases in Switzerland Contents.

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Prevention of Heart Diseases in Switzerland Gaudenz Silberschmidt Vice director and Head of International Affairs Swis

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  1. Prevention of Heart Diseases in Switzerland Gaudenz Silberschmidt Vice director and Head of International Affairs Swiss Federal Office of Public Health European Heart Network Annual Workshop, Geneva: 17.5.2006

  2. Prevention of Heart Diseases in SwitzerlandContents 1. Prevention in Switzerland: A Challenging Task 2. Heart Diseases: A Public Health Challenge: Why? 3. Targets of Preventive Efforts 4. Many Actors: Remarkable Achievements 5. Conclusion: Why NGO’s matter

  3. Prevention of Heart Diseases in Switzerland 1. Prevention in Switzerland: A Challenging Task

  4. Switzerland Permanent population : ~ 7’200’000 : Swiss ~ 5’800’000 Foreigners ~ 1’400’000 (2001) Preventon in Switzerland: A Challenging Task26 Cantons = 26 Health systems

  5. German 65% French 18% Rumantsch 1% Italian 10% 1. Prevention in Switzerland: A Chllenging Task 4 languages

  6. Prevention in Switzerland: A Challenging TaskPreoccupations: Shaky Grounds for Prevention • Legal basis (prevention law) does not exist • Scattered responsibilities for prevention (federal, cantonal, communal level, semi-public organisations, NGO’s) • Predominance of health care in health system • Prevention represents only 2,1% of the Swiss health expenditures in 2003 • Strong pressure groups

  7. 1. Prevention in Switzerland: A Challenging Task Preoccupations: Health Costs - Nr. 2 in OECD countries

  8. Preoccupations: Life Style of Resident Population 1. Prevention in Switzerland: A Challenging Task • 36% of men and 25% of women are current smokers • 53% of men and 58% of women lack physical exercise. • 30% of women and 46% of men are overweight. • 13% of women and 17% of the men present high cholesterol levels. • 19% of the Swiss resident population have arterial hypertension • 4.2% of men and 3.7% of women over 15 years of age are affected by diabetes. Source: Swiss Health Survey 2002

  9. Prevention of Heart Diseases in Switzerland 2. Heart Diseases A Public Health Priority : Why?

  10. Basic Facts: 2. Heart Diseases: Public Health Priority Nr. 1 : Why • Cardiovascular diseases are the principal cause of mortality in Switzerland • Within the cardio-vascular diseases, myocardial infarction (MI) is the main cause of death. • With a prevalence of 9.2%, cardiovascular diseases constitute the main reason for hospitalization. (Swiss Hospital Statistics, 2002) • In Switzerland, 15% of the drugs delivered in premises, and 17% of pharmaceutical sales are associated with the treatment of cardiovascular diseases . (Statistics 2002, IHA-IMS Health) • Women wait 70’ longer than men after first signs of intense breast pain before they get hospitalised. Waiting time for women: 5 h, for men less than 4 hours (OBSAN 2005).

  11. Major Causes of mortality (%) in 1980 and in 2002 Cardio-vascular

  12. Deaths attributable to cardio-vascular diseases % of cardio vascular deaths CHD Cerebrovascular Blood vessels Other

  13. Prevention of Heart Diseases in Switzerland 3. Targets of Preventive Efforts

  14. 3.Targets of Preventive Efforts Risk and protective factors • Given Risk Factors • Genetic predisposition • Gender • Age • Family health • Past history of diseases • Personnal antecedents • Social Protective Factors • High Income • High Status • Job Security • Social Networks • Social Capital • Supportive Environment

  15. 3.Targets of Preventive Efforts Reduce Risk Factors Enhance Protective Factors • Physical Exercice • Moderate Alcohol Intake • Mediterranean Diet • Blood Sugar Monitoring • Early Diabetes Treatment • Cholesterol Monitoring • Access to Medical Care • Health Literacy • Work-Life Balance • Smoking • High Alcohol Consumption • Inedequate Diet • Diabetes • Arterial Hypertension • Delay of medical care • Stress

  16. 3.Targets of Preventive Efforts Redress Overweight and Obesity Overweight (BMI 25 – 29.9) Obesity (BMI >= 30) USA: Daten aus NHANES-Studien CH: Daten aus Gesundheitsbefragung

  17. 3.Targets of Preventive Efforts Adjust Nutrition Consumption of Fruits and Vegetables

  18. 3.Targets of Preventive Efforts Increase Physical Activity Caloric Intake and Physical Activity Caloric intake Physical Activity WHO, 2003, adapted

  19. Prevention of Heart Diseases in Switzerland 4. Many Actors: Remarkable Achievements

  20. 4. Many Actors: Remarkable Achievements Important Stakeholders NGO Medical profession Science Consumer organisation Prevention of Cardiovascular Diseases Confederation /Cantons Sport Organizations Pharmaceutical Industry Food Industry WHO/EU Media

  21. Encouraging developments in Swiss health system 4. Many Actors: Remarkable Achievements • A reduction in mortality due to cardio-vascular diseases since 1980 is noteworthy. • Health outcome indicators are among the best worldwide and continue to improve (exceptions: mental health, substance abuse) • High customer satisfaction, hardly any waiting times • No accumulated deficits • Health is one of the most important economic sectors • Excellent biomedical research

  22. Ongoing Initiatives 4. Many Actors: Remarkable Achievements • Preparations for a legislation to strengthen health promotion and prevention • Bologna Reform of health care education • OECD / WHO review of Swiss health system • Efforts to enhance Health Literacy • Important tobacco prevention efforts • Implementation of the WHO Global Strategy on Diet and Physical activity • Empowerment of NGO’s

  23. Prevention of Heart Diseases in Switzerland 5. Conclusion: Why NGO’s Matter

  24. 5. Conclusion: Why NGO’s matterAgenda Setting or what the Federal Office cannot do • Prevention of Cardiovascular Diseases Requires: • coordinated strong pressure groups • political and public lobbying • steady information of all health professionals • targeted information for vulnerable groups • support and participation in campaigns for a healthier lifestyle • support for new legislative efforts in prevention

  25. 5. Conclusion: Why NGO’s matterSpecial targets • Primary Prevention: • Increase Health Literacy in the General Public. • Support nutritional and physical activity initiatives • Promote cholesterol testing in vulnerable groups • Support national, cantonal and communal networking efforts • Secondary Prevention: • Reduce time lapse between signs of breast pain and hospitalisation. • Inform Health professionals about gender bias in the diagnosis of potential MI • Tertiary Prevention: • Offer follow-up of MI patients through commitment + contracting • Support voluntary follow-up testing

  26. 5. Conclusion: Why NGO’s matterGoals for the Future: • Longevity in better health is possible, if all stakeholders work together to prevent cardio-vascular diseases. • We need an international effort to learn from the experience and findings of others. • This congress provides a excellent opportunity to foster new efforts.

  27. 5. Conclusion: Why NGO’s matterConclusion The Federal Office of Public Health hopes that this congress will be remembered as a step forward in an European effort to prevent cardio-vascular diseases. Thank you.

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