Embed Size (px)
DESCRIPTION
EXPERIENCE OF DEVELOPED COUNTRIES. WHO CONCLUSION:. IT IS NOT THE RICHEST SOCIETIES THAT ENJOY HIGHEST LEVEL OF HEALTH BUT THOSE WHERE IS LOWEST DIFFERENCE BETWEEN RICH AND POOR. Health Promotion and Investment. Individuali rizika. Vilius GRABAUSKAS. FOOD SELECTION CRITERIA - PowerPoint PPT Presentation
Citation preview
Health Promotion and Investment
EXPERIENCE OF DEVELOPED COUNTRIES
IT IS NOT THE RICHEST SOCIETIES THAT ENJOY HIGHEST LEVEL OF HEALTH BUT THOSE WHERE IS LOWEST DIFFERENCE BETWEEN RICH AND POOR
WHO CONCLUSION:
Vilius GRABAUSKAS
Individuali rizika
Vilius GRABAUSKAS
8,32,4
66,8
16,1
6,4
Prevention Special diet Price Taste Food preference0
10
20
30
40
50
60
70
80
FOOD SELECTION CRITERIAIN LITHUANIAN POPULATION (BALTIC NUTRITIONAL SURVEY)
Vilius GRABAUSKAS
7 8
14
77
69
45
8
15
30
8 811
0
20
40
60
80 PreventionPriceTasteFood preference
FOOD SELECTION CRITERIAIN LITHUANIAN POPULATION BY FAMILY INCOME
(BALTIC NUTRITIONAL SURVEY)
LOW INCOME1TERTILE
MEDIUM INCOME2 TERTILE
HIHG INCOME3 TERTILE
COMPARISON OF MORTALITY OF POPULATION WITHCOMPARISON OF MORTALITY OF POPULATION WITH UNIVERSITY UNIVERSITY AND PRIMARY OR LOWER EDUCATION BY AGE AND PRIMARY OR LOWER EDUCATION BY AGE
(MORTALITY OF THE GROUP WITH UNIVERSITY EDUCATION=1)(MORTALITY OF THE GROUP WITH UNIVERSITY EDUCATION=1)
0
12
3
4
5
67
89
10
11
12
13
25 30 35 40 45 50 55 60 65 70+
Age, yearsMen Women
Ratio
Vilius GRABAUSKAS
PROPORTION (%) OF DAILY SMOKERS, BY EDUCATIONAL LEVEL
36.7
48.5**
68.0*
9.110.817.4*
0
10
20
30
40
50
60
70
Incomplete secondary Secondary University
Men Women
%
Vilius GRABAUSKAS
58.9*
48.143.5
10.4 11.2 10.0
0
10
20
30
40
50
60
70
Low income Average income High income
Men Women
PROPORTION (%) OF DAILY SMOKERS, BY FAMILY INCOME
%
Vilius GRABAUSKAS
LOW BIRTH WEIGHT (>2500 G.) PROPORTIONS BY EDUCATIONAL LEVEL OF MOTHERS
* p<0.001
%
Vilius GRABAUSKAS
0
12
3
45
6
7
89
10
1998199719961995
*** ****** ***
Pradinis
vidurinis
aukštasis
Primary
Secondary
University
V. GRABAUSKASV. GRABAUSKAS
RELATIVE RISK OF UNMARIED LITHUANIAN POPULATION BY AGE AS COMPARIED TO MARIED
(MARIED = 1)
25 30 35 40 45 50 55 60 65 70+0
0,5
1
1,5
2
2,5
3
3,5
4
Vyrai
Moterys
AGE
MalesFemales
LOW BIRTH WEIGHT (>2500 G.) PROPORTIONS BY MARITAL STATUS OF MOTHERS
* p<0.001
%
Vilius GRABAUSKAS
0
12
3
45
6
7
89
10
1998199719961995
Single/Divorsed/Widows
Maried
*** ****** ***
TOTAL MORTALITY LEVEL (PER 100 000 OF POPULATION) TOTAL MORTALITY LEVEL (PER 100 000 OF POPULATION) IN ADMINISTRATIVE AREAS OF LITHUANIA IN QUINTILES IN ADMINISTRATIVE AREAS OF LITHUANIA IN QUINTILES
(1996 YEAR DATA)(1996 YEAR DATA)
Vilius GRABAUSKAS
CARDIOVASCULAR MORTALITY IN ADMINISTRATIVE AREAS IN LITHUANIA IN QUINTILES
Vilius GRABAUSKAS
2000
LITHUANIA566
<1100<940<780<620<460No data
Min: 300
HEALTH EXPENDITURE IN ADMINISTRATIVE AREAS IN LITHUANIA IN QUINTILES
Vilius GRABAUSKAS
1997
LITHUANIA378
Upper2-a3-a4-aLowerNo data
Min: 75.44
LITHUANIAN NATIONAL HEALTH CONCEPTLITHUANIAN NATIONAL HEALTH CONCEPT
HEALTH LAWS
ACTIVE HEALTH POLICY AND STRATEGY
HEALTH PROMOTION
HEALTHY LIFE STYLES
HEALTH CARE
ENVIRONMENTAL PROTECTION
DEVELOPMENT OF ENTIRE HEALTH SYSTEM
WHO“HEALTH FOR ALL” PRINCIPLES
Vilius GRABAUSKAS
TRENDS IN PROPORTION OF BUTTER ON TRENDS IN PROPORTION OF BUTTER ON BREAD USERS IN LITHUANIAN BREAD USERS IN LITHUANIAN
POPULATION AGED 20-64 POPULATION AGED 20-64 BETWEEN 1994 -2000BETWEEN 1994 -2000
71,2
56*
38*37,6*
66,3
50,6*
40,6*38,2*
0
10
20
30
40
50
60
70
80
Males Females
1994199619982000
* p<0.05 compared with year 1994 Vilius GRABAUSKAS
TRENDS IN PROPORTION VEGETABLE OIL FOR COOKING TRENDS IN PROPORTION VEGETABLE OIL FOR COOKING USERS IN LITHUANIAN POPULATION AGED 20-64 USERS IN LITHUANIAN POPULATION AGED 20-64
BETWEEN 1994 - 2000BETWEEN 1994 - 2000
31,1
54*
73,5* 73,1*
47,7
68,8*
86,5* 88,4*
010
2030
405060
708090
100
Males Females
1994199619982000
* p<0.05 compared with year 1994 Vilius GRABAUSKAS
TRENDS IN PROPORTION OF FRESH VEGETABLE TRENDS IN PROPORTION OF FRESH VEGETABLE USERS AT LEAST ON 3 DAYS DURING THE LAST USERS AT LEAST ON 3 DAYS DURING THE LAST
WEEK BETWEEN 1996 - 2000WEEK BETWEEN 1996 - 2000
* p<0.05 compared with year 1996
18,1
36,8*
43,6*
24,8
50* 51,6*
0
10
20
30
40
50
60
Males Females
1996
1998
2000
Vilius GRABAUSKAS
TRENDS PROPORTION OF DAILY SMOKERS TRENDS PROPORTION OF DAILY SMOKERS IN LITHUANIAN POPULATION AGED 20-64 IN LITHUANIAN POPULATION AGED 20-64
BETWEEN 1994 - 2000BETWEEN 1994 - 2000
43,347,3
48,5* 51,2
6,3 9,412,5*15,8*
0
10
20
30
40
50
60
Males Females
1994199619982000
* p<0.05 compared with year 1994 Vilius GRABAUSKAS
TRENDS IN PROPORTION OF STRONG TRENDS IN PROPORTION OF STRONG ALCOHOL USERS AT LEAST ONCE A WEEK ALCOHOL USERS AT LEAST ONCE A WEEK IN LITHUANIAN POPULATION AGED 20-64 IN LITHUANIAN POPULATION AGED 20-64
BETWEEN 1994 - 2000BETWEEN 1994 - 2000
31,2 28,7*27,1*
33,9
5,5* 6,6*6,7*
11,5
0
5
10
15
20
25
30
35
40
Males Females
1994
1996
1998
2000
* p<0.05 compared with year 2000 Vilius GRABAUSKAS
PROPORTION OF BEER USERS AT LEAST ONCE PROPORTION OF BEER USERS AT LEAST ONCE A WEEK IN LITHUANIAN POPULATION A WEEK IN LITHUANIAN POPULATION
AGED 20-64 BETWEEN 1994 - 2000AGED 20-64 BETWEEN 1994 - 2000
* p<0.05 compared with year 1994
43,539,4
48,9*55,8*
7,1 8,1
12,9*18,3*
0
10
20
30
40
50
60
Males Females
1994199619982000
Vilius GRABAUSKAS
19931987 1999MALES FEMALES
HYPERCHOLESTERO-LEMIA ( 5,0 mmol/l )
OVERWEIGHT ( BMI 25 )
HYPERTENSION ( 140/90 or on treatment
)
TRENDS IN AGE STANDARDIZED PREVALENCE OF SOME BIOLOGICAL RISK FACTORS TRENDS IN AGE STANDARDIZED PREVALENCE OF SOME BIOLOGICAL RISK FACTORS IN LITHUANIAIN LITHUANIAN POPULATION AGED 25-64 (LITHUANIAN – CINDI DATA BASE)N POPULATION AGED 25-64 (LITHUANIAN – CINDI DATA BASE)
59,3
57,9
62,3
30405060708090
60,9
56,2
65,3
30405060708090
61,6
79,1
30405060708090
42,1
52,4
51,2
30 40 50 60 70 80 90
64,4
65,6
71,8
30 40 50 60 70 80 90
***
**
63,2
80
83,1
30 40 50 60 70 80 90
***
***
***
***
**
*p<0.05
**p<0.01
***p<0.001
Comparing with 1987
84,9
Vilius GRABAUSKAS
TOTAL MORTALITY TRENDSTOTAL MORTALITY TRENDS IN LITHUANIAN IN LITHUANIAN MALEMALESS AGED 0-64 AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
500
600
700
800
900
1.000
-2.7%/year, n.s.
6.7%/year, p=0.0001
-6.9%/year, p=0.007
Vilius GRABAUSKAS
TOTAL MORTALITY TRENDSTOTAL MORTALITY TRENDS IN LITHUANIAN IN LITHUANIAN FEMALES AGED 0-64FEMALES AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
200
250
300
350
-2.2%/year, n.s.
3.4%/year, p=0.002
-6.3%/year, p=0.02
Vilius GRABAUSKAS
CVD MORTALITY TRENDSCVD MORTALITY TRENDS IN LITHUANIAN IN LITHUANIAN MALEMALESS AGED 0-64 AGED 0-64
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
180
200
220
240
260
280
300
2.6%/year, n.s.
5.8%/year, p=0.0004
-6.6%/year, p=0.04
SDR / 100 000
Vilius GRABAUSKAS
CVD MORTALITY TRENDSCVD MORTALITY TRENDS IN IN LITHUANIAN FEMALELITHUANIAN FEMALESS AGED 0-64 AGED 0-64
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
50
60
70
80
90
100
- .5%/year, n.s.
3.0%/year, p=0.02
- 8.1%/year, p=0.03
SDR / 100 000
Vilius GRABAUSKAS
CHD MORTALITY TRENDS IN LITHUANIAN CHD MORTALITY TRENDS IN LITHUANIAN MALES AGED 0-64MALES AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
100
120
140
160
180
200
2%/year, n.s.
5.4%/year, p=0.0004
-10%/year, p=0.02
Vilius GRABAUSKAS
CHD MORTALITY TRENDS IN LITHUANIAN CHD MORTALITY TRENDS IN LITHUANIAN FEMALES AGED 0-64FEMALES AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
0
10
20
30
40
50
60
70
- .6%/year, n.s.
3.6%/year, p=0.01
- 15.6%/year, p=0.01
Vilius GRABAUSKAS
CAN MORTALITY TRENDS IN LITHUANIAN MALES AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
125
130
135
140
145
150
155
160
1.4%/year, p=0.0001
1%/year, n.s.
-2.7%/year, p=0.04
Vilius GRABAUSKAS
CACANN MORTALITY TRENDS MORTALITY TRENDS IN IN LITHUANIAN FEMALELITHUANIAN FEMALESS AGED 0-64 AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
50
60
70
80
90
100
-0.3%/year, n.s.
Vilius GRABAUSKAS
LUNG CANCER MORTALITY TRENDSLUNG CANCER MORTALITY TRENDS IN IN LITHUANIAN MALELITHUANIAN MALESS AGED 0-64 AGED 0-64
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
35
40
45
50
55
60
1.8%/year, p=0.02
0.2%/year, p=0.73.
-4.2%/year, p=0.003
SDR / 100 000
Vilius GRABAUSKAS
EXTERNAL CAUSE EXTERNAL CAUSE MORTALITY TRENDSMORTALITY TRENDS IN IN LITHUANIAN MALELITHUANIAN MALESS AGED 0-64 AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
100
150
200
250
300
350
-6.7%/year, p=0.01
10%/year, p=0.0002 -6.5%/year, p=0.01
Vilius GRABAUSKAS
EXTEXTERNALERNAL CAUSE CAUSE MORTALITY MORTALITY IN IN LITHUANIAN FEMALELITHUANIAN FEMALESS AGED 0-64 AGED 0-64
SDR / 100 000
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
0
25
50
75
100
- 4.5%/year, p=0.04
7.8%/year, p=0.0003 - 6.1%/year, p=0.02
Vilius GRABAUSKAS
CONCLUSIONSCONCLUSIONS LITHUANIAN EXPERIENCE DEMONSTRATES THAT SCIENCE BASED NATIONAL HEALTH POLICY DEVELOPMENT IS MOST IMPORTANT TOOL FOR PLANNING, IMPLEMENTATION, MONITORING AND EVALUATION OF HEALTH SYSTEM REFORM PROCESSES
NATIONAL HEALTH INFORMATION SYSTEM THAT COMBINES NATIONAL STATISTICS, RESEARCH AND INTERNATIONAL DATA BASES EFFECTIVELY SERVES THE ABOVE
MORE SPECIFICALLY, LITHUANIAN HEALTH BEHAVIOUR MONITORING SYSTEM GIVES CLEAR INDICATION AND GUIDANCE WHICH AREAS OF LITHUANIAN HEALTH BEHAVIOURS REQUIRE SUBSTANTIAL IMPROVEMENTS IN HEALTH POLICY IMPLEMENTATION
Vilius GRABAUSKAS
