Sustainable Development and Public Health Helmut Brand Professor of European Public Health

Gro Harlem Brundtland, MD, MPH Minister of the Environment of Norway 81 Prime Minister of Norway 87 Our common future (Brundtland Report) 86-89, Prime Minister of Norway 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. Adults BRFSS, 1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 54 person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% 30% CDC 2009

The challenge of obesity in the WHO European Region and the strategies for response, WHO 2007

? Data from Northrhine Westphalia, Germany Obesity at school entry

Data from Northrhine Westphalia, Germany lowmedium highEducational level of parents total Obesity at school entry

Inequalities

Between groups of countries WHO HFA Database

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 Death Frequency on the 12th of August 2003 in comparison to expected values (yearly averages ) Robine JM, Cheung SL, Le Roy S, Van Oyen H, Griffiths C, Michel JP, Herrmann FR. The 2003 Heat Wave Project excess deaths in 2003

Temperature 1% increase in temperature = 1-4% increase in mortality Foodborne infections Vector borne diseases Ultraviolett radiation Skin cancer Malignant melanoma Cataracts Water Flodding Faecal bacteria Hygienic problems Air Ozone Allergic disorders (hay fever, asthma) Increased migration Intra country migration Humanitarian assistance Displaced populations from non EU Member States Vulnerable groups Socio economic gradient Elderly Children Mental disaeses following disaster experience A good overview in: COMMISSION STAFF WORKING DOCUMENT, Accompanying document to the WHITE PAPER Adapting to climate change: Towards a European framework for action. 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, June 2008.

The contribution of regions to health and wealth Technical report for the WHO European Ministerial Conference on Health Systems: Health Systems, Health and Wealth, Tallinn, Estonia, 25–27 June

Prescription: Apply three times a day in case of financial crises !!

Health and wealth are interdependent. HEALTH OUTPUT Labour productivity Labour supply Education Savings From: Bloom DE, Canning D. The health and wealth of nations.

WHO 2007

Health Expenditure as % of GDP OECD 2009

EU Health Strategy White paper on Nutrition Communication on Alcohol Tobacco control strategy Health information and Health Portal Project HLS-EU ECDC Interactions with WHO Health Services Initiative Project EUREGIO II Health investments through Structural Funds etc Project Euregio II/III E-Health Public Health Genomics Cross-sectoral work EC 2007

Sustainable Development and Public Health Helmut Brand Professor of European Public Health Faculty of Health, Medicine and Life Sciences Maastricht University, The Netherlands