Analisi della situazione regionale

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Claudia Zanetti
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1 ASL NOVARA L ESPERIENZA DEL LABORATORIO SALUTE ANALISI DEGLI ASPETTI POSITIVI E DI QUELLI DA RIVEDERE Analisi della situazione regionale Novara - 9 ottobre 2013 Elena Coffano DoRS

2 "I fattori che nel contesto esterno (internazionale, nazionale, regionale) sono intervenuti negli ultimi anni (o potrebbero intervenire nel futuro) favorendo od ostacolando le azioni di promozione della salute"

anni (o potrebbero intervenire nel futuro) favorendo

3 Panorama della salute nella regione europea Health 2020 Complessità e incertezza Sfide molteplici per la salute, che richiedono il coinvolgimento attivo di tutti i livelli di governo (internazionale, nazionale e locale) Le persone vivono più a lungo e hanno meno figli Le malattie non trasmissibili dominano il carico di malattia Il controllo delle malattie infettive (HIV, TBC) resta un problema I sistemi sanitari affrontano costi crescenti Le persone migrano all interno dei e tra i paesi; le città diventano più grandi La depressione e le malattie di cuore sono le principali cause di perdita di anni di vita Emergono organismi antibioticoresistenti I sistemi di cure primarie sono deboli e mancano servizi di prevenzione

malattie infettive (HIV, TBC) resta un problema I sistemi sanitari affrontano costi crescenti Le persone migrano all interno dei e tra i paesi; le città diventano più grandi La

Cost of action versus inaction For all countries, the cost of inaction far outweighs the cost of taking action on noncommunicable diseases as recommended in this action plan.

5 Cost of action versus inaction For all countries, the cost of inaction far outweighs the cost of taking action on noncommunicable diseases as recommended in this action plan. There are interventions for prevention and control of noncommunicable diseases which give a good return on investment, generating one year of healthy life for a cost that falls below the gross domestic product (GDP) per person and are affordable for all countries. The total cost of implementing a combination of very cost-effective (USA population-wide 2010) and individual interventions, in terms of current health spending, amounts to 4% in lowincome countries, 2% in lower middle-income countries and less than 1% in upper middle-income and high-income countries. The cost of implementing the action plan by the Secretariat is estimated at US$ million for the eight-year period The above estimates for implementation of the action plan should be viewed against the cost of inaction. - perdita di produttività Continuing business as usual will result in loss of productivity and an escalation of health care costs in all countries. The cumulative output loss due to the four major noncommunicable diseases together with mental disorders is estimated to be US$ 47 trillion. This loss represents 75% of global GDP in 2010 (US$ 63 trillion).5 This action plan should thus be seen as an investment prospect, because it provides direction and opportunities for all countries to (i) safeguard the health and productivity of populations and economies; (ii) create win-win situations that influence the choice of purchasing decisions related inter alia to food, media, information and communication technology, sports and health insurance; and (iii) identify the potential for new, replicable and scalable innovations that can be applied globally to reduce burgeoning health care costs in all countries. Prospettiva di investimento Costo degli interventi sulle malattie non trasmissibili: meno dell 1% del PIL Costo della non-azione: 75% del PIL - escalation dei costi sanitari

domestic product (GDP) per person and are affordable for all countries.

6 Salute in tutte le politiche

7 La sfida La sfida per la promozione della salute all inizio del XXI secolo è sviluppare, ai diversi livelli di governance, la capacità di riuscire ad influenzare i determinanti chiave della salute: politici, sociali, economici, commerciali, ambientali e comportamentali, e contribuire alla crescita sostenibile e allo sviluppo Questo richiede nuove conoscenze, pensiero strategico, competenze, approcci e strumenti, all interno della salute e oltre Kickbush Helsinki 2013

commerciali, ambientali e comportamentali, e contribuire alla crescita sostenibile e allo sviluppo Questo richiede

8 sommario Da dove veniamo: le pietre miliari le parole della promozione della salute Dove andiamo: nuovi scenari nuovi paradigmi nuove strategie

9 L atto di nascita Contesto politico Health fields Promozione della salute Diseguaglianze prevalente contributo dei fattori socio-economici nel determinare la salute della popolazione World Health Assembly resolution WHA of 19 May 1977 salute per tutti entro l anno 2000 Principale obiettivo dei governi e dell OMS dovrà essere il raggiungimento entro l anno 2000 per tutti i popoli del mondo di un livello di salute che permetta loro di condurre una vita socialmente ed economicamente produttiva.

43 of 19 May 1977 salute per tutti entro l anno 2000 Principale obiettivo dei governi e dell OMS dovrà essere il

10 Un salto di paradigma

11 I nostri primi quarant anni

12 Documenti European Declaration on the Health of Children and Young People with Intellectual Disabilities and their Families Better health, better lives: children and young people with intellectual disabilities and their families, Bucharest, Romania, November 2010 Parma Declaration on Environment and Health Fifth Ministerial Conference on Environment and Health, Parma, Italy, March 2010 Tallinn Charter: Health Systems for Health and Wealth WHO European Ministerial Conference on Health Systems: Health Systems, Health and Wealth, Tallinn, Estonia, 27 June 2008 Berlin Declaration on Tuberculosis WHO Ministerial Forum "All Against Tuberculosis", Berlin, Germany, 22 October 2007 European Charter on Counteracting Obesity WHO European Ministerial Conference on Counteracting Obesity, Istanbul, Turkey, 16 November 2006 Mental Health Declaration for Europe WHO European Ministerial Conference on Mental Health: Facing The Challenges, Building Solutions, Helsinki, Finland, 14 January 2005 Children's Environment and Health Action Plan for Europe Fourth Ministerial Conference on Environment and Health, Budapest, Hungary, 25 June 2004 Declaration of the Fourth Ministerial Conference on Environment and Health Fourth Ministerial Conference on Environment and Health, Budapest, Hungary, 25 June 2004 Warsaw Declaration for a Tobacco-free Europe WHO European Ministerial Conference for a Tobacco-free Europe, Warsaw, Poland, 19 February 2002 Declaration on Young People and Alcohol WHO European Ministerial Conference on Young People and Alcohol, Stockholm, Sweden, 21 February 2001 Munich Declaration: Nurses and Midwives: a Force for Health Second WHO Ministerial Conference on Nursing and Midwifery in Europe, Munich, Germany, June 2000 Declaration of the Third Ministerial Conference on Environment and Health Third Ministerial Conference on Environment and Health, London, United Kingdom, 18 June 1999 Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes Third Ministerial Conference on Environment and Health, London, United Kingdom, 17 June 1999 Charter on Transport, Environment and Health Third Ministerial Conference on Environment and Health, London, United Kingdom, 16 June 1999 HEALTH21 health for all in the 21st century Introduction to the health for all policy framework for the WHO European Region Athens Declaration for Healthy Cities International Healthy Cities Conference, Athens, Greece, 23 June 1998 The Ljubljana Charter on Reforming Health Care, 1996 Ljubljana Charter on Reforming Health Care, Ljubljana Conference, 1996 European Charter on Alcohol, 1995 European Conference on Health, Society and Alcohol, Paris, France, December 1995 The Copenhagen Declaration on Health Policy, 1994 European Health Policy Conference: Opportunities for the Future, Copenhagen, Denmark, 5 9 December 1994 Environmental Health Action Plan for Europe, 1994 Second European Conference on Environment and Health, Helsinki, Finland, June 1994 Helsinki Declaration on Action for Environment and Health in Europe, 1994 Second European Conference on Environment and Health, Helsinki, Finland, June 1994 Vienna Statement on Investing in Women's Health in the Countries of Central and Eastern Europe, 1994 Women's Health Counts: Conference on the Health of Women in Central and Eastern Europe, Vienna, Austria, February 1994 The Milan Declaration on Healthy Cities, 1990 Healthy Cities Conference, Milan, Italy, 5 6 April 1990 European Charter on Environment and Health, 1989 First European Conference on Environment and Health, Frankfurt-am-Main, Germany, 7 8 December 1989 The Charter Against Tobacco, 1988 European Conference on Tobacco Policy, Madrid, Spain, 7 11 November 1988 Vienna Declaration on Nursing in Support of the European Targets for Health for All, 1988 European Conference on Nursing, Vienna, Austria, June 1988 Ottawa Charter for Health Promotion, 1986 First International Conference on Health Promotion, Ottawa, Canada, November 1986 Declaration of Alma-Ata, 1978 International Conference on Primary Health Care, Alma-Ata, USSR, 6 12 September 1978

10 12 March 2010 Tallinn Charter: Health Systems for Health and Wealth WHO European Ministerial Conference on Health Systems: Health Systems, Health and Wealth, Tallinn, Estonia, 27 June 2008 Berlin

13 Un glossario che si amplia - Carta di Ottawa

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