Contemporary health policy context in Europe: some opportunities - PowerPoint PPT Presentation

Contemporary health policy context in Europe: some opportunities and challenges Dr Zsuzsanna Jakab WHO Regional Director for Europe 8 March 2017, Israel

What hat i is H Heal ealth h 2020? 2020? Heal ealth i h is a a pol political cal c choi hoice ce • Concerted government action is needed to improve health status and reduce inequalities. • Action should be targeted through health determinants: political, economic and social environments; lifestyle; environment; trade; and culture. • These are part of other "key" ministries with wide and different portfolios – addressing them requires a high level of commitment.

Heal ealth h 2020 and t 2020 and the he 2030 A 2030 Agenda genda

Loc Local alizat zation on of of the he 2030 2030 Agenda genda

The he list of of maj major or c chal hallenge enges Reducing existing differences in health status (leaving no one behind) Addressing the social determinants of health intersectorally Ensuring an adequate level of public funding for universal health coverage Strengthening the health system

The he list of of maj major or c chal hallenge enges Reducing existing differences in health status (leaving no one behind) Addressing the social determinants of health intersectorally Ensuring an adequate level of public funding for universal health coverage Strengthening the health system

Prem emat atur ure e morta tality ity Health 2020 target: A 1.5% relative annual reduction in overall (four causes combined) premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases until 2020 The European Region is well on track to achieve health objectives set in Health 2020 of reducing premature mortality. The most important opportunities are in addressing social determinants and risk factors and in strengthening health systems.

Regi egional onal t trends ends 1200 Indicator: age-standardized mortality Deaths per 100 000 population per 100 000 population aged 30–69 1000 years for combined causes of death from aged 30–69 years cardiovascular disease, cancer, diabetes 800 and chronic respiratory diseases 600 400 200 0 2000 2005 2010 2015 2020 Minimum value European Region average Maximum value

Deaths per 100 000 population aged 30–69 years The The lat 100 200 300 400 500 600 700 800 0 Switzerland Israel ates Sweden Norway est dat Cyprus Luxembourg data f Iceland Spain France Finland a from f Italy Malta caus Portugal ausing Netherlands Austria Belgium four Ireland our m United Kingdom g prema Albania Germany maj Denmark Greece ajor Slovenia matu San Marino or nonc Turkey Czech Republic ture Croatia noncommuni re m Estonia European Region average morta Bosnia and Herzegovina Poland Slovakia Georgia rtality Montenegro Romania Armenia ty Serbia nicab Kazakhstan Lithuania MKD* able di Azerbaijan Latvia e diseas Hungary Bulgaria Tajikistan Uzbekistan Republic of Moldova eases Kyrgyzstan Belarus Ukraine Turkmenistan Russian Federation

Tar arget 1. 1. Redu educe pr prem emature mor orta tality ty rate ate in n Eu Europe EURO EURO EURO EURO

Target get 2. Increas ease e life e expec pectanc ancy i in E Europe ope EURO

Tar arget 3. 3. Redu educe ineq equities in n Eur Europe EURO EURO

Tar arget 4. 4. Enh Enhance the the wel ell-bei being ng of the Europ opea ean n popul pulat ation on EURO

Ta Target 5. Un Univ ivers rsal l heal alth h cov overage and and th the r right ght to hea to health EURO EURO EURO EURO

Publ ublic heal c health h res espon ponses of ses of Israel ael • Israel has many good public health and intersectoral initiatives for health. • These have been achieved through political commitment and continuing collaboration with the public health community: a coherent approach to health as a contributor to overall development and well-being.

Fur urthe her ac action ons: s: i in n cont ontinuum nuum: Reducing existing differences in health status (leaving no one behind) Addressing the social determinants of health intersectorally Ensuring an adequate level of public funding for universal health coverage Strengthening the health system

Impor mportant ant r rol ole e of of soci ocial al det eter ermina nants s of of heal ealth Health 2020 objective: to reduce the gaps in health status and social determinants-related differences in European populations The 2020 health indicators related to social determinants of health are infant mortality, life expectancy, primary school enrolment and rate of unemployment. The distance between the highest and lowest regional values ​declined in recent years, but the absolute differences between countries are still significant.

The he gap has gap has been r been reduc educed ed Infant mortality 60 Infant deaths per 1000 live births 50 Life expectancy 40 85 30 Primary school enrolment 20 80 (non-enrolment rate) 10 75 Years 25 0 70 1990 1995 2000 2005 2010 2015 20 Year 65 15 % 10 60 Minimum value European Region Maximum value 1990 1995 2000 2005 2010 2015 5 Year 0 1995 2000 2005 2010 2015 Minimum value European Region Maximum value Year Minimum value European Region Maximum value

Managing the social determinants of health can significantly improve the state of health In Estonia a man with a university degree In the Netherlands the population aged over 25 years can live 13 years morbidity and mortality of 25–50% longer than less educated could be reduced if levels of mortality contemporaries. and morbidity among poorly In Slovakia the newborn and adult mortality educated men were similar to those rate in disadvantaged regions is almost twice of graduates. as higher as in developed regions . In Israel there is strong potential for In Italy there is a difference in life leading on policy and governance for expectancy of 10 years for men health and well-being towards managing Konferencia a gyermekek the social determinants of health; this can between different social groups. egészséges környezethez való significantly improve the state of health in jogáról 2013. június 27. the country.

Bui uildi ding on ng on adv advant antage ages i s in n Isr srael ael • Strong political commitment – Equity is enshrined in legislation – Health inequalities are high on the policy agenda • Strong technical potential for: • leading on policy and governance for health and well-being • action on social determinants • Policies and interventions have broad scope (e.g. reductions in cost-sharing, incentives for professionals, development of service delivery)

Israel ael i is not not al alone one The European Region is on track to implement the Health 2020 targets, but there are still many untapped opportunities to improve health status and reduce health inequalities.

Fur urthe her ac action ons: s: i in n cont ontinuum nuum: Reducing existing differences in health status (leaving no one behind) Addressing the social determinants of health intersectorally Ensuring an adequate level of public funding for universal health coverage Strengthening the health system

Uni niver versal al heal ealth h cover overage age (UHC) C) All people should get access to needed health services of sufficient quality to be effective (including prevention, promotion, treatment, medicine, rehabilitation and palliative care) without the risk of being exposed to financial hardship

Popul opulat ation c on cover overage by age by ins nsur uran ance does ce does not not mean mean hous househol eholds ar s are e pr prot otect ected financ nancial ally Households with catastrophic out-of- pocket payments in selected European countries where population coverage is 100% Sources : Population coverage for selected countries in 2013 using Organisation for Economic Co-operation and Development (OECD) data; data on catastrophic out-of-pocket payments for 2013 or closest year available using estimates prepared by the WHO Barcelona Office for Health Systems Strengthening

Our goal is a European Region free of an impov overi erishing ng level of out-of-pocket payments 0%

Breaki eaking t ng the he vici cious c ous cycl ycle t e thr hrough bet ough better er health heal h financ nancing pol ng policies es Poor Poverty health High level of out-of- pocket payments