6 per day –health and health economy consequences of 6 per day program The Danish case study Gabriel Gulis

Description of the case study 6 per day – a national campaign targeting increase of fruit and vegetable consumption in Denmark Collaboration of Danish Cancer society, Ministry of food safety and food consumption (Fødeværedirektorat) and Center of advanced economic studies of University of Southern Denmark (CAST) Campaign launched in 1999, the study conducted in

Interviewees CAST – 2 persons who did the assessment Danish Cancer Society – 1 person, who initiated, administered and co-sponsored the assessment Danish Heart Association – 1 person, who at the time of the study represented the Ministry of food safety and consumption Ministry of food safety and consumption – 1 person expected, who was involved as political person from the ministry.

Methodological issues No formal HIA methodology followed Steering group of 5 people (interviewees), 4-5 meetings Duration 1.5 years Timing – concurrent Results presented at a conference organized by the Ministry and attended by the Minister and other members of the government and Danish parliament

Aim of the assessment To present health economy benefits and increase in life expectancy of the increased fruit and vegetable consumption Did show health benefits, but failed to show economy benefits or savings for health care system

Effectiveness Did not influence the decision or conduct of the campaign, but raised awareness among politicians – “…the Minister long time after the presentation of the results, until she left for Brussels, always referred to positive results of the assessment…” “Confidence” effectiveness – declared by three out of four already interviewed persons. The assessment enormously increased their ability and confidence to advocate for life style, behavioral changes concerning health both among public health experts, politicians and public. On other side it proved their and the Danish data collection system ability to conduct such analysis, assessment

General comments Similar assessments would be highly required There is no legal obligation in Denmark – it might help to implement HIA There is no political controversy concerning HIA, it requires more work in public health system and culture Use of formal model unlikely Good data collection systems enhance use of HIA – “…not having the data, and access to Danish public and health databases we would not be able complete the job…”