The European Action Plan for Strengthening Public Health

1. The European Action Plan for Strengthening Public Health Health Promoting Networks 16th October 2012 Dr Joanna Nurse Senior Advisor, Public Health Services, Health Systems and Public Health Services WHO, European Region jnu@euro.who.int

2. Strengthening Public Health Services and Capacity across the European Region • Regional Committee Approval • Resolution • European Action Plan • Including 10 Essential Public Health Operations • Supported by Background Documents • Review of public health services and capacity • Review of Legal and Policy Tools and Instruments • Review of institutional models for delivering public health services VISION: Sustainable Health and Well being Promotion Protection Prevention PURPOSE: Strengthen integrated public health services and reduce inequalities

3. Public Health Challenges for the European Region – A Public Health Service for the 21st Century Inequalities and the Economic crisis Globalisation, migration and urbanisation and an ageing population Environmental degradation and Climate Change Public Health emergencies Changes in lifestyle behaviours and increasing prevalence of non-Communicable Diseases Emerging and re-emerging communicable diseases

4. Life expectancy in European country groups in 1950-2045: population health improvement and ageing Source: UN Population Division, World Population Prospects 2008

5. Clustering of Essential Public Health Operations (EPHOs) - to deliver Public Health services VISION: Sustainable Health & Well-Being ENABLER EPHOs CORE EPHOs Governance EPHO 6 PH Workforce EPHO 7 Funding EPHO 8 Communication EPHO 9 Research EPHO 10 SERVICE DELIVERY Health Promotion EPHO 4 EPHO 3 EPHO 5 Disease Prevention Health Protection INTELLIGENCE EPHO 1 + 2 Surveillance Monitoring Informing health assessments and plans

6. WHO European country assessments

7. Where there are greater health inequalities there are generally less well developed public health services and capacities

8. Estimate of coverage and quality of EPHOs across the WHO European Region EPHO 1 EPHO 2 EPHO 3 EPHO 4 EPHO 5 EPHO 6 Coverage Estimated percentage of countries that have some activities related to the EPHO EPHO 7 EPHO 8 Quality EPHO 9 NA Estimated degree to which activities fulfil the complete EPHO definition EPHO 10

9. Estimate of coverage and quality of EPHOs in NIS countries EPHO 1 EPHO 2 EPHO 3 EPHO 4 EPHO 5 EPHO 6 Coverage Estimated percentage of countries that have some activities related to the EPHO EPHO 7 EPHO 8 Quality Estimated degree to which activities fulfil the complete EPHO definition EPHO 9 NA EPHO 10

10. Number of Public Health policy and legal instruments classified in each EPHO Source: WHO Regional Office for Europe, 2012

11. The contribution of prevention and treatment related to the decline in global CHD morbidity Source: NEJM 2007: 2388

12. Estimated expenditure on prevention and public health as % of total health expenditure % Source: Derived from global health expenditure database, 2012.

13. Public Health Challenges in Europe and the EPHOs that especially need to be strengthened EPHO Strongest relevance Relevant Some relevance PH Challenges

14. Summary of Public Health Challenges and Solutions for 2050 Environmental Determinants CLIMATE CHANGE & DISASTERS: • Heatwaves • Fires • Drought • Floods • Mudslides • Chemical Spills • Food Security • Changes in Infectious disease habitat Health Outcomes NCDs LONGER LIFE EXPECTANCY Health System Implications INCREASED: DEMAND & COSTS DECREASED WORKFORCE Solutions SUSTAINABLE PREVENTION& PROMOTION PRIMARY HEALTH CARE PROTECTION Emergency preparedness INNOVATIVE WIN – WIN-WIN APPROACHES Social & Economic Determinants AGEING ECONOMIC DECLINE INEQUALITIES URBANISATION MIGRATION TECHNOLOGY Risks & Projections RESEARCH IMPLICATIONS Innovative solutions 15thEuropean Health Forum • Gastein, 5 October 2012

15. The contribution of Health Promoting Networks in delivering the EPHOs VISION: Sustainable Health & Well-Being ENABLER EPHOs CORE EPHOs Governance EPHO 6 PH Workforce EPHO 7 Funding EPHO 8 Communication EPHO 9 Research EPHO 10 SERVICE DELIVERY Health Promotion EPHO 4 EPHO 3 EPHO 5 Disease Prevention Health Protection INTELLIGENCE EPHO 1 + 2 Surveillance Monitoring Informing health assessments and plans

16. Networks take a systems approach Connected Mind Connected Mind & Body Connected Families Connected Communities Connected Environment

17. Sustainable approaches to wellbeing Common Problems Common Solutions Win Win Win

18. Common Solutions – Green Spaces http://i.treehugger.com/files/th_images/parkwheel-thumb.jpg

19. Improves mental health & well being Increases social contacts Increases physical activity & reduces obesity Reduces violence & abuse Reduces inequalities Increase Urban Green Space http://www.thedesignblog.org/images/mobile_green_space.jpg

20. Benefits for Adaptation & Mitigation Improves air quality – reduces pollutants & reduces CO2 Keeps Buildings Cool in Hot weather Green Roofs insulate against cold weather Assists in flood run- off Green Buildings - Japan http://www.metaefficient.com/images/fukuoka_green_roof.jpg

21. Points for discussion in Workshop Identifying areas in common and of synergy Identify gaps and how to address them Improving communications and collaborative working Formalisation of collaborative process Priority areas to collaborate on Next steps and ways forward

22. -From Values to Action - Thank You ! Division of Health Systems and Public Health