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

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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  1. 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

  2. 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

  3. socialeconomic, cultural and environmental conditions working and living conditions social environment lifestyle age, gender, heredity Determinants of health

  4. 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

  5. Development and Health are correlated Social and economic development Improvement of health

  6. 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

  7. Age standardized death rate in groups of European countries

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. Eating habits of adult Slovene population Healthy/unhealthy eating habits in all inhabitants (25-64 years)

  14. Eating habits of adult Slovene population Healthy/unhealthy eating habits in DIFFERENT REGIONS

  15. Eating habits of adult Slovene population Healthy/unhealthy eating habits in MEN AND WOMEN

  16. Eating habits of adult Slovene population Healthy/unhealthy eating habits in DIFFERENT AGE GROUPS

  17. Eating habits of adult Slovene population Healthy/unhealthy eating habits in DIFFERENT SOCIAL CLASSES

  18. Body weight of adult Slovene population Body weight (BMI) in men and women

  19. Body weight of adult Slovene population Body weight (BMI) in different age groups

  20. Body weight of adult Slovene population Body weight (BMI) in different social classes

  21. Body weight of adult Slovene population Body weight (BMI) in different regions

  22. 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

  23. 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?

  24. 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)

  25. 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

  26. 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

  27. 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

  28. 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.

  29. 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

  30. 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

  31. Thank you for your attention!

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