1. Public Health in the Netherlands Marieke van der Waal, Executive Director Netherlands Public Health Federation

2. Public Health in The Netherlands Country facts Public Health Facts Public Health System Netherlands Public Health Federation

3. The Netherlands (facts) 41.526 km 2 (1,2 times smaller than Slovak) 300 km long and 200 km wide 16.2 million inhabitants (Slovak: 5,4 million) 8.0 million ♂ and 8.2 million ♀ 483 municipalities

4. Population density

5. Death and its main cause 141.936 people died (2003) 62% died on Cardiovascular Diseases - Cancer Life expectancy at birth: ♀ 80.7 years and ♂ 76.0 years (2002) Absolute numbers: Cardiovascular diseases (46.942) Cancer (39.867) Infectious diseases (1.892) Problems at pregnancy/birth (8) Perinatal Mortality (≥ 24 weeks) 8.8 per 1000 births

6. Avoidable causes of Death (1) Smoking: 15%

7. Avoidable causes of Death (2) Overweight and Obesity: 6%

8. Avoidable causes of Death (3) High Blood Pressure: 6%

9. Avoidable causes of Death (4) Not enough exercise: 6%

10. Avoidable causes of Death (5) Saturated fatty acids: 5%

11. Avoidable causes of Death (6) Eating not enough vegetables and fruits: 5%

12. Other problems that effects your chances on an early death Social inequalities: education and income Deprived area’s in large cities Environmental factors Type of work Ethnicity

13. Unfortunately Once in a lifetime you have to die

14. Our wishes We like to get as old as possible We don’t like to get a disease We like to die in our sleep We don’t want to die because of war, anthrax, smallpox's, BSE, chickenpox’s We don’t want to die because of water/air/soil pollution

15. How to full fill our wishes Individual: live healthy and make the healthy choice Local level: safe roads, vaccinations, health education (Regional level: safe drinking water, safe roads, safe dikes) National level: acts (tobacco smoking, collective prevention etc), screening programs

16. National Public Health System (1)  Minister of Health and his ministry  Health Care and Protection Inspectorate  Advisory councils (research, policymaking, infectious diseases, food safety)  National NGO’s (Health Promotion and Education, Food, Consumer Safety)  Associations of Community Services, Professional Workers, Municipalities  School of Public Health  Research institutes / universities

17. National Level: Ministry of Health

18. Ministry of Health Acts on tobacco control, collective prevention, food safety etc. National Screening Programmes National Vaccination Programmes Public Health Policy Document Based on Public Health Forecast of RIVM (Friday) Intersectional policy making

19. Public Health System Local level or the Municipality (1) Involved are:  483 Majors and alderman of health  40 Community services and there professionals  Home care organisations  (Local Health Care Professionals like GP’s, dentists, physiotherapists etc)

20. National Vaccination campaign Meningitis C: local implementation

21. Local Public Health System (2)  Implementation of Law on Collective Prevention (major revision in 2003) Local public health policy document Epidemiology Preventive Health Care for 0-18 year old children Vaccination (influenza, meningitis, DTKP) Health promotion and education Stimulation of cooperation between public health workers and curative professionals Screening of breast cancer, cervix cancer, PKU & CHT (baby’s) Mental health Diminish social inequalities Infrastructure and environment

22. Financing Public Health System Tax (raised on national and local level) General Exeptional Medical Expenses Act (AWBZ)

23. Public Health in the Netherlands Shared responsibility of national and local government Many different organisations involved Lack of coordination within knowledge transfer Quality and Quantity of Public Health Workers is not guaranteed

24. Netherlands Public Health Federation Founded in 2000 34 members: →14 associations of public health workers →20 public health institutes Six board members Two employees Annual budget 2004 approx € 150.000,-

25. President of the NPHF

26. Goals NPHF Lobbying and influencing politics More money and attention for Public Health issues Sharing information and knowledge Improving Public Health System

27. Activities Public Health policy program Press releases on policy documents of National Government Advising Ministry of Health Organising conferences, lectures and workshops EUPHA project (SAVEZ) Public Health Magazine Fundraising Website

28. NPHF desk at 2-day conference

29. Money from fundraising Empowerment of public health system (World Health Day, Week of the Public Health, Two-day National Conference on Public Health) Manpower Planning Incorporating Public Health Activities in Curative Settings Improving Knowledge Transfer

30. Thank you for your attention!