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From «normal» health to PUBLIC HEALTH Health and W ealth in Palestine Palestinian Red Crescent Society HQ, Al Bireh 12 May 2014. Camilla Stoltenberg Director General Norwegian I nstitute of P ublic Health Professor, MD, PhD. … the full title is.
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From «normal» health to PUBLIC HEALTHHealth and Wealth in PalestinePalestinian Red CrescentSocietyHQ, Al Bireh12 May 2014 Camilla Stoltenberg Director General Norwegian InstituteofPublic Health Professor, MD, PhD
…the full title is • Taking the step from “normal” health to public health for a nation • Challenges and opportunities
Agenda • The step from “normal” health to public health • Why and how: has been addressed with excellence by the previous speakers • The big four • Risk factors for non-communicable diseases • A story from Norway on tobacco control • What role can a national institute of public health play? • A vision
How canweshiftemphasisto publichealth? • Engagement • Non-governmental and governmental organisations, academia, private sector, population • Science • Data, scientific evidence • Law • Laws and regulations at a national and international level: Tobacco, International Health Regulations • Economy • Fiscal policies as a lever to curb non-communicable diseases and injuries
The bigfourrisk factors for non-communicablediseases • Smoking • Unhealthy diet • Physical inactivity • Alcohol and other drugs
Steps survey in Palestine2010-2011 MoH and WHO • 23% of Palestinians smoke tobacco daily • 43% of men and 3% of women • 79% are not engaged in vigorous physical activity • 76% are overweight and 43% are obese • 46% have elevated blood pressure • 11 % have diabetes. • 86% eat less than 5 servings of fruits and vegetables per day • Alcohol – not a problem • What about legal and illegal drugs?
A story from Norway ontobaccocontrol1953 - 2014 • Laws and regulations • Attitudes and behaviour • Taxes
Tobaccouse in Norway Men Women Percentageofthepopulation (men and women) between 16-74 yearsoldwhosmokedaily
Tobaccousein Norway Daily Periodically Percentageofthepopulation 16-74 yearsoldwhosmokedaily or periodically
Tobaccouse in Norway Daily Periodically Percentageofthepopulation 16-74 yearsoldwhousewettobaccodaily or periodically
Anti tobaccolaw Tove Strand Minister ofSocialAffairs 1986-1989 Dagfinn Høybråten Minister of Health 1997-2000/2001-2004
2009: Excuseme, Dagfinn Høybråten Painting by Bjørn Algrim
Aimsfor publichealthpoliciesin Norway • Norway shall be amongthethreecountries in theworldwiththehighestlifeexpectancy • Aiming at sharingthis rank with all otherpopulations • The populationshallexperience more lifeyears in goodhealth and well-being • Weshallcreate a societywhich promotes health for all and reduceshealthinequity
Institute of public health - Tasks • Emergency preparedness • Health analysis and research • Evidence based advice • Infrastructure for knowledge • Data: Registries, health studies • Communication and dissemination
Health analysis and research • How many? Who? • How many are at risk, how many are suffering or dying, at what age? Who are they? • Prevalence and distribution of diseases, risk factors and health promotion • What are the causes and consequences? • What works? • Assessing effects of interventions, policies and events (“natural experiments”)
A vision • Prevention of non-communicable diseases and injuries shall be as obvious and “normal” as for infectious diseases • Health promotion and prevention shall be as important as clinical treatment and care • Health shall be recognized in all policies