Six objectives for the Health 2020 - OggiScienza project

Six objectives for the Health 2020 – OggiScienza project

HEALTH – Adopted by the 53 Member States in 2012, the Health 2020 proposes political interventions based on the priorities established by the WHO and identifies intervention strategies adaptable to different European realities.

An effective and efficient health system is vital for the economic and social development of the region: the well-being of European citizens (900 million people) leads to a global improvement of our society and supports economic recovery. The analysis of parameters involves the collection of both quantitative (mortality, morbidity, disability) and qualitative data. This is because one of the main aims of the program is the evaluation of well-being as a multidimensional and indispensable concept for the individual and modern society. Health 2020, which has just passed the first half of the implementation period, is having good results: in fact, most Member States have taken measures to implement the principles proposed by the WHO for improving the health and well-being of their citizens. . Having said that, at present there are still many inequalities and uncertainties, which underline the need for careful and constant monitoring and implementation of community and state actions in order to achieve the intended goals. The uneven progress reflects the substantial differences between countries and within individual countries, between the sexes and between the age groups considered.

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Monitoring involves three main work areas, each with its own targets:

  • Area 1 – Analysis of the incidence of diseases and risk factors;
  • Area 2 – Assessment of well-being, social determinants and number of healthy people;
  • Area 3 – Implementation of health systems and governance.

Below is a summary of the data broken down for each target and reported by the “European Health Report 2018“, The document that presents, every three years, the European situation in the field of health and that this year sets out the progress and objectives of Health 2020.

Target 1 – Reduce premature mortality.

The leading cause of premature death in Europe is cardiovascular disease (44%), followed by cancer (21%) and external causes, including injury and poisoning (7%). The reduction in premature mortality is analyzed by considering data on non-communicable diseases, vaccine-preventable communicable diseases and other external causes.

European countries are in line with the Health 2020 goal of reducing premature mortality caused by the four main non-communicable diseases (cardiovascular disease, cancer, diabetes mellitus and chronic respiratory diseases) in people aged 30 by 1.5% per year. and 70 years old. Similar progress has also been made in the area of ​​deaths from external causes, which include traffic accidents, accidental falls, poisoning, suicides, self-harm and homicides. There are still significant inequalities in premature mortality rates, both in relation to sex and the home state of the subjects. The consequent risk of these inequalities could be a reversal of the positive trend if the necessary maintenance and improvement measures were lacking. Since 2000, vaccination coverage in Europe has increased steadily, but a careful analysis of the data relating to individual states reveals evident disparities and, in some cases, they still have a coverage of less than 90%. Health 2020 aims to eliminate some vaccine-preventable diseases (measles, polio and rubella) by increasing vaccination coverage and reducing inequalities.

Target 2 – Increase life expectancy at birth.

Average life expectancy has increased steadily in recent years and the gap in data, both between genders and between countries, is narrowing. The difference between the country with the highest life expectancy and the one with the lowest life expectancy is still greater than a decade, a sign that further actions and monitoring are needed.

Target 3 – Reduce inequalities.

In general, the differences between member countries in the indicators related to the social determinants of health (infant mortality, life expectancy, primary schooling, unemployment) are decreasing. Beyond the average values, the differences between individual states are very important, underlining the need for targeted interventions.

An encouraging fact is the increase in policies and strategies in place to reduce inequalities in the region: in 2010 they were activated in only 29 countries, while in 2016 in 42 countries out of 53. The data relating to premature deaths indicate a reduction, from 7.3 deaths per 1000 births in 2010 to 6.8 in 2015. Schooling follows the same trend, but the differences between states are considerable, with 0.1% of children not in school being the minimum and 10.1% as the maximum. The same trend can also be seen for unemployment rates, which hit a minimum of 0.5% and a maximum of 26.1% in 2015.

Target 4 – Encourage wellbeing.

The enhancement of well-being is a central objective of the Health 2020 policy. In this case, in addition to quantitative data, it is also necessary to take into account cultural factors such as traditions, popular beliefs and values. The data available for each country are highly variable and this is why life satisfaction is the only parameter reported. It is measured by answering the question “How satisfied are you with your life these days?” on a scale from 0 – not at all satisfied – to 10 – very satisfied – and the European average is 6, with values ​​in some cases below 5 and in others with values ​​among the highest in the world.

Target 5 – Right to health and achievement of universal health coverage.

Universal health coverage provides for the establishment of health systems in which essential services are available to all citizens at an acceptable cost. This is one of the priorities of the WHO’s overall work program 2019-2023, which aims to “reduce persistent obstacles to access to health services and make 1 billion people benefit from universal health coverage”.

Average health expenditure remained virtually unchanged from 2010 (8.3% of GDP) to 2014 (8.2% of GDP). The differences between the States are marked and the regional picture is mixed: some data are encouraging, others static and some show a contrary trend.

Target 6 – Interventions and objectives of the member countries.

Most Member States have shown that they want to achieve the Health 2020 goals by aligning national and European policies. In 2016, 38 out of 43 countries responded to a survey by the WHO Regional Office reporting that they had set goals to improve the health and well-being of their citizens or that they were planning them for the foreseeable future. 95% confirmed that they have developed, or want to develop, a health policy in line with the principles of Health 2020.

While much progress has been made in recent years, there is still a lot to do in achieving the Health 2020 goals and using the information gathered in policy making. Better communication in the health sector is a priority: the data provided by some countries are not complete – also due to increasingly stringent privacy regulations – and, consequently, estimates must be made with caution and constantly updated. Precisely for this reason, the WHO and all member countries are encouraging the collection of harmonized information, coming from health and non-health sources, to have a complete picture of the well-being of citizens.

Infographic: Rachele Mazzaracca

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