1. National Health Promotion Conference Pisa, Italy 9 June 2000 INVESTMENT FOR HEALTH Dr Rüdiger Krech Technical Adviser, Health Promotion and Investment for Health

2. Investment for Health 1.Background to Investment for Health 2.Introduction to the Investment for Health Approach 3.Social and Economic Determinants of Health: an Evidence-based approach to Investment for Health 4.Principles for Strategy Development 5.Methodologies and Practical Experiences 6.Conclusions Investment for Health

3. Throughout history, the greatest improvements in people’s health have mainly arisen from social and economic improvements which also promote health Investment for Health

4. Where is health promoted and maintained in a given population? Which investment and strategies produce the largest population health gains? Which investment and strategies help reduce health inequities and are in line with human rights? Which investments contribute to economic and social development in an equitable and sustainable manner and result in high health returns for the overall population?

5. Investment for Health

6. Promoting the health of the population Lessons from the Past Lessons from the Present Investment for Health

8. Measles: Death rates Children under 15-England and Wales 0 200 400 600 800 1000 1200 1400 185018701880189019001910192019301940195019601970 Death rate per million children Immunization begun Investment for Health

9. Diphteria: Death rates Children under 15-England and Wales 0 100 200 300 400 500 600 700 800 900 1000 1870188018901900191019201930194019501960 Death rate per million children National immunization campaign beg a n Investment for Health

10. above a certain level of wealth, it is not necessarily the richer societies which have better health, but those that have the smallest income difference between rich and poor; increased inequality imposes economic, social and psychological burdens which reduce the well-being of the whole society;

11. Health Economic development Social development Investment for Health

12. Investment Criteria Social capital Social exclusion Economic security Individual and community coping resources Physical environment Community sense of frustration and failure Inequity Sustainability Investment for Health

13. Conclusions: what needs to be done political priority given to health accountability for health public understanding of health recognition of the trade-offs society skills incentives clear picture of what an IFH strategy can deliver new infrastructures willingness to learn