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Facets of public health _Layout 1 24/06/ :23 Page 1 European Public health has had positive results in the last two centuries when it comes to reducing the impact and prevalence of infectious disease.
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Facets of public health _Layout 1 24/06/ :23 Page 1 European Public health has had positive results in the last two centuries when it comes to reducing the impact and prevalence of infectious disease. However, much remains to be done to reduce non-communicable diseases such as heart disease and cancer, which make up the major disease burden of the WHO European Region. This book takes a broad but detailed approach to public health in Europe and offers the most comprehensive analysis of this region currently available. It considers a huge range of key topics in public health and includes chapters on the following topics: In addition to these topics and themes the authors consider the existing public health structures, capacities and services across a range of European countries; identifying what needs to be done to strengthen public health action and improve public health outcomes. Reflecting the broad geographical scope of the entire WHO European region this book uses examples from a diverse range of countries to illustrate different approaches to public health. This book is essential reading for anyone studying or working in the field of public health, especially those with an interest in European practice. Bernd Rechel is Researcher at the European Observatory on Health Systems and Policies and an Honorary Senior Lecturer in the Department of Health Services Research and Policy at the London School of Hygiene and Tropical Medicine, UK. Martin McKee is Professor of European Public Health at the London School of Hygiene and Tropical Medicine and Research Director at the European Observatory on Health Systems and Policies. Facets of Public Health in Europe Rechel and McKee Screening Health Promotion social determinants of health Tackling Health Impact Assessment Public Health Workforce The Public Health Research Facets of Public Health in Europe Facets of Public Health in Europe Observatory on Health Systems and Policies Series Edited by Bernd Rechel and Martin McKee Facets of Public Health in Europe The European Observatory on Health Systems and Policies supports and promotes evidence- based health policy- making through comprehensive and rigorous analysis of health systems in Europe. It brings together a wide range of policy- makers, academics, and practitioners to analyse trends in health reform, drawing on experience from across Europe to illuminate policy issues. The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, the United Kingdom, and the Veneto Region of Italy, the European Commission, the World Bank, UNCAM (French National Union of Health Insurance Funds), the London School of Economics and Political Science, and the London School of Hygiene & Tropical Medicine. Facets of Public Health in Europe Edited by Bernd Rechel and Martin McKee 0 Open University Press Open University Press McGraw-Hill Education McGraw-Hill House Shoppenhangers Road Maidenhead Berkshire England SL6 2QL world wide web: and Two Penn Plaza, New York, NY , USA First published 2014 Copyright World Health Organization 2014 on behalf of the European Observatory on Health Systems and Policies. The views expressed by authors or editors do not necessarily represent the decisions or the stated policies of the European Observatory on Health Systems and Policies or any of its partners. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the European Observatory on Health Systems and Policies or any of its partners concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitations of its frontiers or boundaries. Where the designation country or area appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the European Observatory on Health Systems and Policies in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The European Observatory on Health Systems and Policies does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. Rights to translate into German, Spanish, French and Russian should be sought from WHO at WHO Regional Office for Europe, UN City, Marmorvej 51, DK Copenhagen, Denmark or by at Rights to translate into all other world languages should be sought from Open University Press. All rights reserved. Except for the quotation of short passages for the purpose of criticism and review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher or a licence from the Copyright Licensing Agency Limited. Details of such licences (for reprographic reproduction) may be obtained from the Copyright Licensing Agency Ltd of Saffron House, 6-10 Kirby Street, London EC1N 8TS. A catalogue record of this book is available from the British Library ISBN- 13: (pb) ISBN- 10: eisbn: Library of Congress Cataloging- in- Publication Data CIP data applied for Typesetting and e- book compilations by RefineCatch Limited, Bungay, Suffolk Fictitious names of companies, products, people, characters and/or data that may be used herein (in case studies or in examples) are not intended to represent any real individual, company, product or event. European Observatory on Health Systems and Policies Series The European Observatory on Health Systems and Policies is a unique project that builds on the commitment of all its partners to improving health systems: World Health Organization Regional Office for Europe Government of Austria Government of Belgium Government of Finland Government of Ireland Government of Norway Government of Slovenia Government of Sweden Government of the United Kingdom Veneto Region of Italy European Commission World Bank UNCAM London School of Economics and Political Science London School of Hygiene & Tropical Medicine The series The volumes in this series focus on key issues for health policy- making in Europe. Each study explores the conceptual background, outcomes, and lessons learned about the development of more equitable, more efficient, and more effective health systems in Europe. With this focus, the series seeks to contribute to the evolution of a more evidence- based approach to policy formulation in the health sector. These studies will be important to all those involved in formulating or evaluating national health policies and, in particular, will be of use to health policy- makers and advisers, who are under increasing pressure to rationalize the structure and funding of their health system. Academics and students in the field of health policy will also find this series valuable in seeking to understand better the complex choices that confront the health systems of Europe. The Observatory supports and promotes evidence- based health policy- making through comprehensive and rigorous analysis of the dynamics of healthcare systems in Europe. Series Editors Josep Figueras is the Director of the European Observatory on Health Systems and Policies, and Head of the European Centre for Health Policy, World Health Organization Regional Office for Europe. Martin McKee is Director of Research Policy and Head of the London Hub of the European Observatory on Health Systems and Policies. He is Professor of European Public Health at the London School of Hygiene & Tropical Medicine as well as a co- director of the School s European Centre on Health of Societies in Transition. Elias Mossialos is the Co- director of the European Observatory on Health Systems and Policies. He is Brian Abel- Smith Professor in Health Policy, Department of Social Policy, London School of Economics and Political Science and Director of LSE Health. Richard B. Saltman is Associate Head of Research Policy and Head of the Atlanta Hub of the European Observatory on Health Systems and Policies. He is Professor of Health Policy and Management at the Rollins School of Public Health, Emory University in Atlanta, Georgia. Reinhard Busse is Associate Head of Research Policy and Head of the Berlin Hub of the European Observatory on Health Systems and Policies. He is Professor of Health Care Management at the Berlin University of Technology. European Observatory on Health Systems and Policies Series Series Editors: Josep Figueras, Martin McKee, Elias Mossialos, Richard B. Saltman and Reinhard Busse Published titles Regulating entrepreneurial behaviour in European health care systems Richard B. Saltman, Reinhard Busse and Elias Mossialos (eds) Hospitals in a changing Europe Martin McKee and Judith Healy (eds) Health care in central Asia Martin McKee, Judith Healy and Jane Falkingham (eds) Funding health care: options for Europe Elias Mossialos, Anna Dixon, Josep Figueras and Joe Kutzin (eds) Health policy and European Union enlargement Martin McKee, Laura MacLehose and Ellen Nolte (eds) Regulating pharmaceuticals in Europe: striving for efficiency, equity and quality Elias Mossialos, Monique Mrazek and Tom Walley (eds) Social health insurance systems in western Europe Richard B. Saltman, Reinhard Busse and Josep Figueras (eds) Purchasing to improve health systems performance Josep Figueras, Ray Robinson and Elke Jakubowski (eds) Human resources for health in Europe Carl- Ardy Dubois, Martin McKee and Ellen Nolte (eds) Primary care in the driver s seat Richard B. Saltman, Ana Rico and Wienke Boerma (eds) Mental health policy and practice across Europe: the future direction of mental health care Martin Knapp, David McDaid, Elias Mossialos and Graham Thornicroft (eds) Decentralization in health care Richard B. Saltman, Vaida Bankauskaite and Karsten Vrangbæk (eds) Health systems and the challenge of communicable diseases: experiences from Europe and Latin America Richard Coker, Rifat Atun and Martin McKee (eds) Caring for people with chronic conditions: a health system perspective Ellen Nolte and Martin McKee (eds) Nordic health care systems: recent reforms and current policy challenges Jon Magnussen, Karsten Vrangbæk and Richard B. Saltman (eds) Diagnosis- related groups in Europe: moving towards transparency, efficiency and quality in hospitals Reinhard Busse, Alexander Geissler, Wilm Quentin and Miriam Wiley (eds) Migration and health in the European Union Bernd Rechel, Philipa Mladovsky, Walter Devillé, Barbara Rijks, Roumyana Petrova- Benedict and Martin McKee (eds) Health systems, health, wealth and societal well-being: assessing the case for investing in health systems Josep Figueras and Martin McKee (eds) Success and failures of health policy in Europe: four decades of divergent trends and converging challenges Johan P. Mackenbach and Martin McKee (eds) Health system performance comparison: an agenda for policy, information and research Irene Papanicolas and Peter C. Smith (eds) European child health services and systems: lessons without borders Ingrid Wolfe and Martin McKee (eds) Contents List of contributors List of tables, figures, and boxes Foreword I Foreword II Acknowledgements List of abbreviations ix xv xix xxi xxiii xxv one Facets of public health in Europe: an introduction 1 Bernd Rechel, Martin McKee two The changing context of public health in Europe 11 Martin McKee, Bernd Rechel, Hans Kluge, Ted Tulchinsky three Monitoring the health of the population 23 Marieke Verschuuren, Peter W. Achterberg, Pieter G. N. Kramers, Hans van Oers four The health security framework in Europe 43 Francisco Santos- O Connor, Jukka Pukkila, Carmen Varela Santos, Cristiana Salvi, Dennis Faix, Thomas Van Cangh, Josep Jansa, Phillip Zucs, Paolo Guglielmetti, Massimo Ciotti, Guénaël Rodier viii Contents five Occupational health and safety 71 Rokho Kim, Jorma Rantanen, Suvi Lehtinen, Wiking Husberg six Environmental health 93 Giovanni Leonardi, Bernd Rechel seven Food security and healthier food choices 113 João Breda, Trudy Wijnhoven, Mojca Gabrijelčič, Louise Sigfrid eight Healthcare public health 135 Martin McKee, Bernd Rechel, Reinhard Busse nine Screening 153 Martin McKee, Bernd Rechel ten Health promotion 171 Bernd Rechel, Martin McKee eleven Tackling the social determinants of health 183 EuroHealthNet twelve Intersectoral working and Health in All Policies 199 Matthias Wismar, Jose M. Martin- Moreno thirteen Health impact assessment 217 Nichola Davies, Paul Lincoln fourteen Organization and financing of public health 233 Bernd Rechel, Helmut Brand, Martin McKee fifteen Developing the public health workforce 255 Christoph Aluttis, Claudia Bettina Maier, Stephan Van den Broucke, Katarzyna Czabanowska sixteen Developing public health leadership 267 Elke Jakubowski, Liam Donaldson, Jose M. Martin- Moreno seventeen Public health research 285 Stefania Boccia, Ilmo Keskimäki, Walter Ricciardi eighteen Knowledge brokering in public health 301 Cristina Catallo, John N. Lavis, and the BRIDGE Study Team nineteen Drawing the lessons 317 Bernd Rechel, Martin McKee Index 335 List of contributors Peter Achterberg is Senior Advisor at the Department for Public Health Forecasting, National Institute for Public Health and the Environment (RIVM), Bilthvoven, the Netherlands Christoph Aluttis is researcher at Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, Department of International Health, Maastricht, the Netherlands Stefania Boccia is Associate Professor of Hygiene and Preventive Medicine and Deputy Director of the Section of Hygiene of the Institute of Public Health, Faculty of Medicine, Università Cattolica del Sacro Cuore (UCSC), Rome, Italy Helmut Brand is Jean Monnet Chair in European Public Health and Head of the Department of International Health, Research School CAPHRI, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, the Netherlands João Breda is Programme Manager for Nutrition, Physical Activity and Obesity at the Division of Noncommunicable Diseases and Life- course, WHO Regional Office for Europe, Copenhagen, Denmark Reinhard Busse is Associate Head of Research Policy and Head of the Berlin Hub of the European Observatory on Health Systems and Policies and Professor of Health Care Management at the Berlin University of Technology, Berlin, Germany x List of contributors Cristina Catallo is Associate Professor at the Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University Toronto, Toronto, Canada Massimo Ciotti is Head of the Country Preparedness Support Section and Deputy Head of the Public Health Capacity and Communication Unit at the European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden Katarzyna Czabanowska is Assistant Professor at the Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands Nichola Davies is Cardiac Community Manager at the Heart Foundation New Zealand, and was a Senior Policy Researcher at the United Kingdom Health Forum at the time of writing Liam Donaldson is Professor of Health Policy at Imperial College, London, United Kingdom EuroHealthNet is the European Partnership for improving health and equity, based in Brussels, Belgium Dennis Faix is Medical Officer, Alert and Response Operations, Division of Communicable Diseases, Health Security & Environment, WHO Regional Office for Europe, Copenhagen, Denmark Mojca Gabrijelčič is Senior Advisor at the Centre for Health Promotion and Disease Prevention at the National Institute of Public Health and Lecturer at the Medical Faculty, University of Ljubljana, Ljubljana, Slovenia Paolo Guglielmetti is Administrator in the Health Threats Unit of the Health and Consumer (SANCO) Directorate General of the European Commission Wiking Husberg is Ministerial Adviser at the Department of Occupational Safety and Health, Ministry of Social Affairs and Health, Helsinki, Finland Elke Jakubowski is Acting Programme Manager for public health services at the WHO Regional Office for Europe, Copenhagen, Denmark, Research Associate at the European Observatory on Health Systems and Policies, and Lecturer on Comparative Public Health and Health Systems at the Hannover Medical School, Hannover, Germany Josep Jansa is Head of the Section on Epidemic Intelligence and Response at ECDC, Stockholm, Sweden Ilmo Keskimäki is Research Professor at the National Institute for Health and Welfare (THL), Division of Health and Social Services, Helsinki, Finland, List of contributors xi and Professor of Health and Social Policy at the School of Health Sciences, University of Tampere, Tampere, Finland Rokho Kim is Specialist in Environmental and Occupational Health at the WHO Western Pacific Regional Office and former Scientist in Occupational Health at the WHO Regional Office for Europe Hans Kluge is Director of the Division of Health Systems and Public Health, WHO Regional Office for Europe, Copenhagen, Denmark, and Special Representative of the WHO Regional Director to prevent and combat M/ XDR- TB in the WHO European Region Pieter Kramers is a freelance senior consultant on public health monitoring and reporting, and was formerly affiliated at the Institute for Public Health and the Environment (RIVM), the Netherlands John Lavis is Director of the McMaster Health Forum, Associate Director of the Centre for Health Economics and Policy Analysis, Professor in the Department of Clinical Epidemiology and Biostatistics, and Associate Member of the Department of Political Science, McMaster University, Hamilton, Ontario, Canada. He is also Adjunct Professor of Global Health, Department of Global Health and Population, Harvard School of Public Health, Cambridge, MA, United States of America Suvi Lehtinen is Chief of International Affairs at the Finnish Institute of Occupational Health, Helsinki, Finland Giovanni Leonardi is Head of the Epidemiology Department, Public Health England, Centre for Radiation, Chemical, and Environmental Hazards, and Honorary Senior Lecturer, London School of Hygiene and Tropical Medicine, London, United Kingdom Paul Lincoln is Chief Executive of the United Kingdom Health Forum Martin McKee is Professor of European Public Health at the London School of Hygiene & Tropical Medicine, and Research Director at the European Observatory on Health Systems and Policies, London, United Kingdom Claudia Bettina Maier is Programme Analyst at UNAIDS, Geneva, Switzerland and was Technical Officer at the European Observatory on Health Systems and Policies at the time of writing Jose M. Martin- Moreno is Professor of Preventive Medicine and Public Health at the University of Valencia, Valencia, Spain, and the coordinator of the Quality Unit at the University Clinical Hospital, as well as Adviser to the WHO Regional Office for Europe xii List of contributors Jukka Pukkila is Programme Manager, Alert and Response Operations, Division of Communicable Diseases, Health Security & Environment, WHO Regional Office for Europe, Copenhagen, Denmark Jorma Rantanen is Chairman of the Board, University of Jyväskylä, Jyväskylä, Finland, Director General and Professor Emeritus of the Finnish Institute of Occupational Health, and Past President of the International Commission on Occupational Health Bernd Rechel is Researcher at the European Observatory on Health S
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