![Page 1: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/1.jpg)
How to promote healthy policies – with special emphasis on CVD and NCD
WCC 2012
Dubai 18-21.4.2012
Pekka Puska, MD, PhD,MPolScDirector General, National Institute for Health and Welfare (THL)Past President, World Heart Federation (WHF)Vice President, Int. Ass. of National Public Health Institutes (IANPHI)
![Page 2: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/2.jpg)
Population based CVD prevention calls for changes in lifestyles related to major CVD risk factor
• Diet
• Physical activity
• Tobacco
• Alcohol
13/04/23 Pekka Puska, Director General 2
![Page 3: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/3.jpg)
Historical development:
Community and national perspectives
13/04/23 Pekka Puska, Director General 3
![Page 4: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/4.jpg)
Health education
13/04/23 Pekka Puska, Director General 4
![Page 5: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/5.jpg)
Health education Types of activities:
• Information dissemination
• Persuasion
• Teaching of practical skills
• Empowerment
• Etc.
13/04/23 Pekka Puska, Director General 5
![Page 6: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/6.jpg)
Important role of policies and private sector
13/04/23 Pekka Puska, Director General 6
![Page 7: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/7.jpg)
Health education
Health promotion
= health education + changing environments (Ottawa Charter)
13/04/23 Pekka Puska, Director General 7
![Page 8: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/8.jpg)
Development of evidence based policies and methods for the decisions and actions of policy-makes and the private sector
13/04/23 Pekka Puska, Director General 8
![Page 9: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/9.jpg)
How to influence policies and the private sector
• Directly through presenting rational arguments for evidence based policies and through identifying win-win situations
• Through populations: Opinions, intentions and behaviour changes of the population ultimately influence strongly politicians (”voters decide in democracy”) and the private sector (”the consumer is the king”)
13/04/23 Pekka Puska, Director General 9
![Page 10: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/10.jpg)
Complex change process with time
13/04/23 Pekka Puska, Director General 10
![Page 11: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/11.jpg)
Should we address supply or demand?
SUPPLY DEMAND
13/04/23 Pekka Puska, Director General 11
(Tobacco example)
![Page 12: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/12.jpg)
Supermarkets in the middle position in nutrition
13/04/23 Pekka Puska, Director General 12
![Page 13: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/13.jpg)
Social change process ”People pull policies and policies pull people”
The role of the health programme is to support this social change process for public health
Relates to many social theories (from social marketing to innovation diffusion)
13/04/23 Pekka Puska, Director General 13
![Page 14: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/14.jpg)
• There is rapidly increasing number of documents describing needed effective policies
• The key question is how to promote adoption and implementation of those policies
• We should try to promote a social change process to the desired direction
• Thus we should not blame the patient of blaim the politician!
13/04/23 Pekka Puska, Director General 14
![Page 15: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/15.jpg)
13/04/23 Pekka Puska, Director General 15
![Page 16: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/16.jpg)
Social change process:• Examples from Finland
13/04/23 Pekka Puska, Director General 16
![Page 17: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/17.jpg)
13/04/23 Pekka Puska, Director General 17
![Page 18: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/18.jpg)
Pekka Puska, Director General 18
Use of Butter on Bread (men age 30–59)
01020304050
60708090
100
1972 1977 1982 1987 1992 1997 2002
North Karelia
Kuopio province
Southwest Finland
Helsinki area
Oulu province
Lapland province
%
13/04/23
![Page 19: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/19.jpg)
Serum Cholesterol in Men Aged 30–59 Serum Cholesterol in Men Aged 30–59 YearsYears
FINRISK Studies 1997 & 2002
mmol/l
5
5,5
6
6,5
7
7,5
1972 1977 1982 1987 1992 1997 2002 2007
North Karelia
Kuopio
Turku/Loimaa
Helsinki/Vantaa
Oulu
Lapland
Pekka Puska, Director General13/04/23
19
![Page 20: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/20.jpg)
How to influence policies?
• Innovative use of media for advocacy (polls, patient stories etc)
• Organizational support (NGO’s etc)
• Win win situations
• Personal contacts: opinion leaders,
• Policy makers, private sector leaders, media representatives, etc.
13/04/23 Pekka Puska, Director General 20
![Page 21: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/21.jpg)
Comprehensive action and partnership for national NCD prevention
• Health services
• Governments (national, local)
• Civil society (NGOs)
• Private sector
• Media
• International collaboration
![Page 22: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/22.jpg)
Intersectoral work towards prevention- ”Health in all policies”
• People’s lifestyles are influenced by decisions in different sectors of society (much of them beyond the health sector)
• Health in general and NCD prevention in particular should be taken into account in decisions made by different sectors (health impact assessment)
• 8th WHO Conference on Health Promotion (Helsinki, June 2013): Health in All Policies in practice
Pekka Puska, Director General
![Page 23: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/23.jpg)
Pekka Puska, Director General 23
Complex Process of Social Change – Dynamic Change over Time
”Usually, environmental and policy decisions are key, but such can often be achieved only in health promotion activities that influence the public agenda and people’s intentions. At the same time, the human factor is crucial: persistent and dedicated work is needed, combining enthusiastic and credible leadership with also involvement of, and ownership by, the population.”
Puska 2005. In Coronary Hearth Disease Epidemiology (Marmot & Elliott, eds.)
13/04/23
![Page 24: How to promote healthy policies with special emphasis on cvd and ncd](https://reader035.vdocuments.net/reader035/viewer/2022062709/558ceca8d8b42a1e128b4571/html5/thumbnails/24.jpg)
Thank you