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I’m a tree. Please, think me so.

Italian Institute for Quality of Life Health Production, Healthy Ageing and Chronic Disease in Europe: financing what, who,why and how . This is the problem Chronic Disease & Health Management Bucharest Oct. 8 2009. I’m a tree. Please, think me so.

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I’m a tree. Please, think me so.

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  1. Italian Institute for Quality of LifeHealth Production, Healthy Ageing and Chronic Disease in Europe: financing what, who,why and how .This is the problemChronic Disease & Health ManagementBucharest Oct. 8 2009

  2. I’m a tree. Please, think me so.

  3. Europroject Redefine budgets to produce health for local health authorities BEST – RC BEfore Squeezing Toothpaste tube Remove Cap

  4. COMMISSION OF THE EUROPEANCOMMUNITIESBrussels, 10.12.2008COM(2008) 725 finalGREEN PAPEROn the European Workforce for Health • Health promotion and disease prevention are not only important in their own right, but can significantly reduce future demand for treatment and care services.

  5. COMMISSION OF THE EUROPEANCOMMUNITIESBrussels, 10.12.2008COM(2008) 725 finalGREEN PAPEROn the European Workforce for Health • The public health workforce throughout the EU must be properly skilled and have sufficient capacity to be able to carry out these activities effectively, and this needs to be built into training and recruitment plans.

  6. COMMISSION OF THE EUROPEANCOMMUNITIESBrussels, 10.12.2008COM(2008) 725 finalGREEN PAPEROn the European Workforce for Health • In addition, some € 5.2 billion will be invested in health infrastructure by the European Regional Development Fund.

  7. Financial opportunities • European Plan for Health 2008-2013 • European Regional Development Fund (€ 5.2 Billions for health infrastructures and formation) • European Social Fund 2007-2013 (€ 75 Billions) • European Structural Fund 2007-2013 • Long Life Learning Funds (€ 13 Billions) • National, Regional Funds • All data from OPEN DAYS CoR debate (Oct. 5-8 2009

  8. Health Production • Health Production: possibility, potentiality and criticality of common planning on a large scale with local municipalities • Proposal and implementation of pilot "Models of Promotion and Production of Health” MPPH in the European context. • Health Production is a science based on old actors in a new pathway : enviroment, nutrition, spa, physical activitiy, brain fitness etc. • Health Production in a large scale is the natural Drug & Hospital brake : now 50% of all health costs are for old people

  9. In Chronic Care does innovation promote responsibitity? • the keyrole of local healthauthorities and local municipalitiescooperation • the socalledpredictablediseases • HTA, EMEA : the future • large numbers and small budgets • producinghealth on a large scale • healthinequalities • health GPS

  10. what can we do ? • horizon scanning ? • panorama scanning? • tip of the shoes scanning?

  11. Healthy Ageing • Healthy Ageing means to give life to the years • Healthy Ageing is the next great appointment for mankind , involving millions and millions of people looking for better and longer life • South and East Europe will intercept these needs and wealth (welfare + health) economy will grow

  12. Life style, health and longevity • Laurel Yates (Hospital Boston) presented in 2008 a study on 2367 male doctors 72 years old (average) at the time of the survey, which started in 1980

  13. Life style, health and longevity • 970 (41%) reach the 90 years • The goal was thus achieved: Removed all the risk factors = 54% Remaining only inactive lifestyle + = 44% Remaining only hypertension + = 36% Remaining only obesity + '= 26% Remaining only obesity + smoke = 22% Remaining inactive lifestyle + obesity + diabetes = 14% In the presence of all the previous risk factors = 4%                                                                 Laurel Yates (Hospital Boston), 2008

  14. Regular physical activity and constant reduction of cardiovascular risk(Mora et al, Circulation 2007, 116:2110-2118) Study on 27,055 women followed for 10.9 years (average period). Emerges the significant part (32.6% of total) that exercise has in influencing inflammatory and haemostatic factors responsible for vascular damage

  15. ) Regular physical activity and constant reduction of cardiovascular risk (Mora et al, Circulation 2007, 116:2110-2118) • Linear increase of the ratio of the intensity 'of activity' physical and cardiovascular risk • 200-599 Kcal/week = - 27% • 600-1499 Kcal/week = - 32% • >1500 Kcal/week = - 41%

  16. relationship betwen lifestyle and genic expression • The study was conducted on 30 men with minimal risk of prostate cancer, and subjected to three months to a new lifestyle with a diet balanced with lots of fruits and vegetables, whole foods, vegetables and products soybean, and led a life less sedentary with more exercise and walk for half an hour to an hour of ,all integrated for at least an hour a day of meditation: in three months of treatment, patients have achieved a level of telomerase in the blood more high by 29%. • The Lancet sept. 2009dr. Dean Ornish, Head of the Preventive Medicine Research Institute in Sausalito, California, sept. 2009

  17. Financial opportunities • European Plan for Health 2008-2013 • European Regional Development Fund (€ 5.2 Billions for health infrastructures)) • European Social Fund 2007-2013 (€ 75 Billions) • European Structural Fund 2007-2013 • Long Life Learning Funds (€ 13 Billions) • National, Regional Funds

  18. 1/Some concrete experiences • “Citta’ di Itaqua” project is a network of “Health Villages” born for healthy ageing programs as part of Producing Health Public Italian Network (a project proposed by National Health Institute involving 3.000.000 people in 3 Regions) • More than 5000 little towns in Italy are involved • University of Rome organized a Master for Old Villages Management • University of Bologna organized a Master for Health Manager

  19. 2/Some concrete experiences • Ferpa, Age Platform, Epha, Efgcp, Ces are involved in the discussion about alliance between healthy ageing programs and therapeutical potencial of internal areas • Italian Ministry of Health is studying specific agreements with other EU Ministries to improve healthy ageing programs through “Village of Health” network

  20. 3/Some concrete experiences In Open Health Forum 2008 was discussed health budget new philosophy: A) Look beyond health budgets EU and National B) Redefine budgets to include health C) Rebalance budgets D) Financial Crisis as an opportunity for new pathway

  21. proposals • To make Health “chronical” • To tackle Nations and Regions to a better use of financial resource to build hardware & software for Healthy Ageing programs • To join scientific , enterprise , institutional, social world towards the most important public work in human history : to produce Health on a large scale

  22. How? • Networking, disseminating, discussing, participating • Producing models involving institutions, private, social world to give scientific evidence • Changing health public budgets to include health

  23. Who ? • European Network of Local Wealth Authorities producing Health on a Large Scale

  24. Network Asl produrre salute su larga scala • Asl FG, BAT, RME, RMD, BO, RN • 64 Comuni provincia di Foggia • Unibo, Uniba, Uniroma 3 • Censis • Epha, Efgcp, Age Platform, Euregha • Federsanita’ Anci • Agenas • ISS * • CCM * • *= mentoring

  25. Network Asl produrre salute • Principali azioni ad oggi LS • Modello di produzione della salute su larga scala “ Wealthfare OCM based” • Master “Manager Produrre Salute” Unibo, Asl BO • Corso Formazione 600 MMG Asl FG, BAT • Attivita’ motoria come terapia Asl BAT, RN • MIVOGLIOBENECLUB Asl RME, RMD • Frutta&Verdura 6000 anziani fragili Asl FG • Distretto = eccellenza del territorio

  26. Conclusions :let’s look at the horizon, organize panorama and control the tip of our shoes • 1. resources allocated immensely more large if compared to the past (ESF tripled, share training ERDF etc.) • 2. evidence of the effectiveness of the philosophy of the great “drainage” and Local Authorities Cooperation • 3. fresh energy close to new roles of Cinderella and against the Karstic truths

  27. These smiles can make us understand what is the most important and urgent things: have a budget for health production on a large scale and one for clinical care, separate and competing

  28. These smiles can make us understand what will be the most important public work of the future: producing health

  29. Acknowledgements • The Region Apulia - Department of Health Policies, leader and leader of the Network Health Asl Producing large-scale • The LHA of Foggia pioneering role since 2001 • To all general managers of local health and to the Members of the Network for the courage and foresight • To the 64 municipalities of the province of Foggia for the official accession to the principles and criteria of this initiative • To Over 300 volunteers in Italy and in Europe that make possible this "impossible dream" • To Robert Madelin, Director General DG SANCO • To Donato Greco, especially

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