Sustainable Development and Public Health Helmut Brand Professor of European Public Health...
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“Sustainable Development and Public Health”
Helmut BrandProfessor of European Public Health
Gro Harlem Brundtland, MD, MPH
74-79 Minister of the Environment of Norway
81 Prime Minister of Norway
87 “Our common future” (Brundtland Report)
86-89, 90-96 Prime Minister of Norway
98-03 Director General WHO
Photo: Harry Wad
Concepts for Sustainable Development and Public Health
Health sustainability challenges of 21st century societies:
1. Demographic and financial pressure through the ageing of societies
2. New epidemiological developments: increase in overweight and obesity, increase in mental health problems
3. Health system organisation and financing: from acute care to prevention
4. New and re-emerging infectious disaeses: SARS, HIV, Tb
5. Health inequalities
6. Health impact of global warming and climate change: interdependence of health sustainability and environmental sustainability
Kickbusch I. Policy Innovations for Health, Springer, 2009, p. 9
Obesity
1998
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1998, 2007
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2007
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% CDC 2009
The challenge of obesityin the WHO European Region and thestrategies for response, WHO 2007
?
Data from Northrhine Westphalia, Germany
Obesity at school entry
Data from Northrhine Westphalia, Germany
low medium high Educational level of parents
total
Obesity atschool entry
Inequalities
65
70
75
80
85
1970 1980 1990 2000 2010 2020
EU members before May 2004 EU members since 2004 or 2007CIS
Life expectancy at birth, in years
Between groups of countries
WHO HFA Database
65
66
67
68
69
70
71
72
73
74
75
1970 1980 1990 2000 2010
EstoniaLatviaLithuaniaEU members since 2004 or 2007
Life expectancy at birth, in years
In groups of countries
WHO HFA Database
Between groups in a country
Between groups in a city
Pandemics
Demographic Change
the ratio is the number of elderly persons aged 65 and over divided by the number of persons aged 15 to 64
“Medicalisation” or“Compression” of morbidity ?
Climate Change
Legend
0.00 - 0.120.12 - 0.180.18 - 0.270.27 - 0.410.41 - 0.620.62 - 0.780.78 - 0.850.85 - 0.910.91 - 0.970.97 - 1.041.04 - 1.101.10 - 1.161.16 - 1.231.23 - 1.271.27 - 1.311.31 - 1.351.35 - 1.391.39 - 1.591.59 - 1.881.88 - 2.322.32 - 2.992.99 - 3.983.98 - 5.475.47 - 7.707.70 - 11.05
Death Frequency on the 12th of August 2003 in comparison to expected values (yearly averages 1998-2002)
Robine JM, Cheung SL, Le Roy S, Van Oyen H, Griffiths C, Michel JP, Herrmann FR. The 2003 Heat Wave Project
70.000 excessdeaths in 2003
Temperature1% increase in temperature = 1-4% increase in mortalityFoodborne infectionsVector borne diseases
Ultraviolett radiationSkin cancerMalignant melanomaCataracts
WaterFloddingFaecal bacteriaHygienic problems
AirOzoneAllergic disorders (hay fever, asthma)
Increased migrationIntra country migrationHumanitarian assistanceDisplaced populations from non EU Member States
Vulnerable groupsSocio economic gradientElderlyChildren
Mental disaesesfollowing disaster experience
A good overview in: COMMISSION STAFF WORKING DOCUMENT,Accompanying document to the WHITE PAPER“Adapting to climate change:Towards a European framework foraction.”COM(2009)147 final
Health Impacts of Climate Change
Health Systems
WHO European Ministerial Conference on Health Systems:„Health Systems, Health and Wealth“.Tallinn, Estonia, 25-27 June 2008.
The contribution of regions to health and wealthTechnical report for the WHO European Ministerial Conference on HealthSystems: “Health Systems, Health and Wealth”, Tallinn, Estonia,25–27 June 2008
www.euro.who.int/Document/E91414.pdf
Prescription:Apply three times a day in caseof financialcrises !!
Health and wealth are interdependent.
HEALTH OUTPUT
Labourproductivity
Laboursupply
Education
Savings
From: Bloom DE, Canning D. The health and wealth of nations.
WHO 2007
0
2
4
6
8
10
12
1980 2000 2002 2004 2006
OECDUKGermany
Health Expenditure as % of GDP
OECD 2009
EU Health Strategy
Expanding EU:growing health gaps Ageing
Population
Climate Change, Pandemic and Bioterrorism Threats
Lifestyle Related Diseases
Migration &Cross Border
Healthcare
New Technology and Innovation
Globalisation
Citizens wantmore
control
White paper on Nutrition Communication on Alcohol
Tobacco control strategy
Health information and Health PortalProject HLS-EU
ECDC
Interactions with WHO
Health Services InitiativeProject EUREGIO II
Health investments through Structural Funds etcProject Euregio II/III
E-HealthPublic Health Genomics
Cross-sectoral work
EC 2007
“Sustainable Development and Public Health”
Helmut BrandProfessor of European Public Health
Faculty of Health, Medicine and Life SciencesMaastricht University, The Netherlands
