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Investments in HealthInvestments in Health
Social inclusion and combating povertySocial inclusion and combating povertyPromoting employment and supporting labour mobilityPromoting employment and supporting labour mobility
2014–2020 planning period
Informal consultation meeting
Riga, March 1, 2013
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ContentContent
Planning frameworkCurrent situationObjectivesInstrumentsActivities and synergyExpected results
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Planning frameworkPlanning framework((EU documents)EU documents)
Europe 2020Headline targets: Employment and Skills / Fighting Poverty
Council of EU conclusions: towards modern, responsive and sustainable health systems → Health sector should play an adequate role in the implementation of the Europe 2020 Strategy. Investments in health should be acknowledged as a contributor to economic growth. While health is a value in itself, it is also a pre-condition to achieve economic growth
EC Social Investment Package for Growth and Cohesion → EC urges Member States to better reflect social investments in the allocation of resources and the general architecture of social policy: (child)care, education, training, active labour market policies, housing support, rehabilitation and health services, as well as improve the sustainability of the health system
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Planning frameworkPlanning framework(International(International documents) documents)
Tallinn Charter (WHO)- It is unacceptable that people become poor due to ill health- Major health challenges should be addressed in context of
demographic and epidemiological change- Health contributes to economic development and wealth
EU Strategy for the Baltic Sea Region (EUSBRS)EUSBSR Action Plan → To maintain and reinforce attractiveness of
the Baltic Sea region in particular through education and youth, tourism, culture and health:
- Fight health inequalities with improvement of primary healthcare
- Prevent lifestyle-related non-communicable diseases and ensure good social and work environments
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Planning frameworkPlanning framework(National documents)(National documents)
National Development Plan for Latvia 2014-2020Priority: “Personal Resilience”Action: “Healthy and work-able person”
Defined tasks for the action:- Strengthening of healthy and active habits- Accessibility of health care- Improvement, planning and coordination of health care quality- Rehabilitation measures for maintaining and renewal of ability
to work
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Planning frameworkPlanning framework(National documents)(National documents)
Public Health Strategy 2011 – 2017Headline target: To prolong number of healthy life years for
inhabitants of Latvia and to avoid premature death, thus maintaining, improving and renewing health
Targets- Reduce inequalities in health- Reduce mortality and morbidity from non-communicable
diseases- Improve mother and child health (reduce infant mortality)- Promote healthy life and working environment- Reduce morbidity of infection diseases- Promote effective health care system
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Planning framework Planning framework ((Headline indicatorsHeadline indicators))
Europe 2020- Raise the employment rate of the population aged 20-64 from
the current 69% to at lease 75%- Reduce number of Europeans living below national poverty
lines by 25%, lifting 20 million people out of poverty
National Development Plan for Latvia 2014-2020- Decrease of potential years of life lost per 100 000 from 6 476
(in 2010) to 5 300 (in 2020)- Increase of healthy life years (average men / women) from
53,5 / 56,7 (in 2010) to 57 / 60 (in 2020)
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Planning framework Planning framework ((Health role in social Health role in social inclusion and employmentinclusion and employment))
Health is one of the key factors to prevent poverty - if the breadwinner of a family dies or loses workability, whole family welfare is being put at the poverty risk.Survey – if one of the breadwinners in a family loses job or dies – 33% family's existing life standard could maintain for a month, while 56% of respondents – for three monthsSurvey – main fears of the members of society are connected with health status – 80% of respondents afraid to lose health, 78% - afraid to have no access to high quality health servicesHealth is a precondition for employment and sustainable development – reducing number of disabled persons and premature mortality ensures labour force and employment:MoE forecast - shortage of labour force in 2030 – 120 000According to statistics almost 70% of newly registered disabled people are non-working
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Current situationCurrent situationHealthy life yearsHealthy life years
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Current situationCurrent situationPotential years of life lost (0-69) and Potential years of life lost (0-69) and mortality (0-64) in EU (2010, per 100 mortality (0-64) in EU (2010, per 100 000 inhabitants)000 inhabitants)
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Current situationCurrent situationPotential years of life lost (2011, per Potential years of life lost (2011, per 100 000 inhabitants) 100 000 inhabitants)
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Current situationCurrent situationMortality by causesMortality by causes
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Current situationCurrent situationMortality by causes (external causes)Mortality by causes (external causes)
- Life style related causes (use of alcohol, safety at work, at home, on roads etc.)
- Mental health
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Current situationCurrent situationNewly recognized disabilityNewly recognized disability
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Current situationCurrent situationAmbulatory health effectivenessAmbulatory health effectiveness
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* Health care guidelines of EU Employment and Social Affairs Committee define indicator diagnosis, which show the gaps in ambulatory health care . Patients with these diagnosis usually would have to be treated in ambulatory health care by splitting the competencies among specialists in primary and secondary health care.
Smoking pattern by sex (%)
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Current situationCurrent situationLife style related habitsLife style related habits
BMI and respondent’s perception of his/her weight (%)
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Current situationCurrent situationLife style related habitsLife style related habits
Leisure time activities, by sex (%)
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Current situationCurrent situationLife style related habitsLife style related habits
Use of seat belt on the front and back seat (%)
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Current situationCurrent situationLife style related habitsLife style related habits
Current situationCurrent situationGDP loss from potential years of life GDP loss from potential years of life lost lost
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Current situation Current situation World experienceWorld experience
Evidence shows that wide spread and purposeful 30 years health promotion programmes can reduce mortality from cardiac and circulatory diseases by 80%
80% of cases of circulatory diseases are connected with unhealthy food, insufficient physical activity and smoking
Smoking limitation reduce heart attack frequency by 17 % in 1 year and by 36% in 3 years
Increase of life expectancy at birth by 10% promotes annual economic growth by 0,3-0,4%
Strong ambulatory health care provides faster diagnostics and sooner treatment, thus – better health, reduced consequences of health related problems
Only complex measures through coordinated collaboration of health care levels can address the particular health related welfare risks
2003 data in USA shows that per 25 million calls to EMS, a one minute reduction in response saves more than 300 000 lives
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ObjectivesObjectives
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Objective 1To make society’s life style more healthy, thus tackling illness, mortality and disability factors and prolonging human life
Objective 2To strengthen role of early diagnostics and ambulatory health care, thus improving accessibility and quality of health care services, reducing number of situations when health care is unavailable
Objective 3To implement special measures aimed at tackling circulatory, oncology and prenatal mortality and disability, thus reducing mortality and disability from main factors
Objective 4To improve accessibility of mental health outpatient care, thus supporting treating and integration of mental ill persons
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Instruments for objective 1Health promotion - Addiction prevention, Healthy food, Physical activity, Reproductive health, Injuries, Infection prevention, Mental health etc.
InstrumentsInstruments
Instruments for objective 2Development of ambulatory health servicesDevelopment of emergency services
Instruments for objective 3Development of cardiac and circulatory health care networkDevelopment of oncology health care networkDevelopment of prenatal health care networkDevelopment of rehabilitation services
Instruments for objective 4Development of ambulatory mental health care
Activities and synergyActivities and synergy
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Synergy-ICT development-Development of transport accessibility in regions- Health in prisons- Life-long learning – training of persons involved in health sector- Supporting of deinstitutionalization
ActivityImprovement of health care services and quality
SynergyHealth promotion infrastructure measures:
- Publicly available sports infrastructure for recreational sport - Integration of sports and recreational sport activities in
nature trails
ActivityPurposeful health promotion measures
Support in 2007-2013Support in 2007-2013Challenges in 2014-2020Challenges in 2014-2020
Reforms aimed at health system optimisation were implemented Fewer but stronger secondary health care institutions More accessible ambulatory and emergency health care
Complex measures aimed at coordinated and efficient performance of tasks of each health sector player in order to address health related social exclusion and poverty issues
Health promotion – role of individual responsibility about health
Health care – role of ambulatory, stationary and emergency health
2007-2013
2014-2020
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Expected resultsExpected resultsWhat should be done to increase What should be done to increase healthy life years and reduce healthy life years and reduce potential years of life lost? potential years of life lost? (1)(1)
Educate people and make them feel responsible
about their health
Reduce illness, mortality and disability, thus prolonging human life and reducing risk of social exclusion
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Reduce spread of smoking habit
among 15 years olds by 4,9%
Reduce use of alcohol - risky use per year reduction
by 5,7%
Physical activity increase – 30 minutes a day
regular exercising increase by 8,1%
Expected resultsExpected results What should be done to increase What should be done to increase healthy life years and reduce healthy life years and reduce potential years of life lost? potential years of life lost? (2)(2)
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Increase accessibility to high quality health services
Reduce illness, mortality and disability, thus prolonging human life and reducing risk of social exclusion
Decrease of mortality from
circulatory diseases (age 0-64) per 100 000 inhabitants (from
162 to 135)
Decrease of mortality from
oncology diseases (age 0-64) per 100 000 inhabitants (from
110 to 99)
Decrease of mortality from
prenatal mortality per 1000 live
born and stillborns (from
9,3 to 6,9)
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