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Nfhk2011 jurate klumbiene_parallel finnbalt

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Policy and research to reduce health inequalities. Jurate Klumbiene, Lithuanian University of Health Sciences.

Policy and research to reduce health inequalities. Jurate Klumbiene, Lithuanian University of Health Sciences.

Published in: Health & Medicine, Education

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  • 1. Policy and research to reduce health inequalities Jurate KLUMBIENE Lithuanian University of Health Sciences The 10th Nordic Public Health Conference, 24-26 August 2011, Turku, Finland
  • 2. HEALTH INEQUALITIEScan be defined as differences in health status or in thedistribution of health determinants between differentpopulation groups. World Health Organization
  • 3. Socio-economic determinants of health• Level of education• Place of residence• Marital status• Income• Occupation
  • 4. INEQUALITIES IN MORTALITY
  • 5. Life expectancy of Lithuanian urban and rural population in 2000 -20108078767472 Urban women70 Urban men Rural women68 Rural men66646260 2000 2005 2006 2007 2008 2009 2010
  • 6. Mortality from major causes of death among Lithuanian men with university education and primary or no education (mortality of the group with university education = 1) 5 * * 4 3 * * * * 2 * 1 0 All causes Cardiovascular Cancer External causes diseases 1989 2001* p<0.05 vs the group with university education Source - R.Kalediene, J.Petrauskiene, Public Health (2005) 119
  • 7. Mortality from major causes of death among Lithuanian women with university education and primary or no education (mortality of the group with university education = 1) 7 * 6 5 4 * * 3 * * * 2 * 1 0 All causes Cardiovascular Cancer External causes diseases 1989 2001* p<0.05 vs the group with university education Source - R.Kalediene, J.Petrauskiene, Public Health (2005) 119
  • 8. INEQUALITIES IN SUBJECTIVE HEALTH (Finbalt Health Monitor project)
  • 9. Proportion of men, who assessed their own health status to be good or reasonable good by level of education in 1994-2010 66 70 65 58 59 64 56 56 60 49 51 52 50 42 41 51 42 37 37 40 31% 30 25 20 Secondary University 10 0 1994 1996 1998 2000 2002 2004 2006 2008 2010
  • 10. Proportion of women, who assessed their own health status to be good or reasonable good by level of education in 1994-2010 80 66 70 56 63 69 57 55 60 51 50 50 43 34 35 38 40% 40 34 40 30 21 22 19 20 Secondary University 10 0 1994 1996 1998 2000 2002 2004 2006 2008 2010
  • 11. Proportion of persons, who assessed their own health status to be good or reasonable good in 1994 and 2010 by place of residence 60 56 53 50 46** 44* 46** 42 40 35* 31* % 30 1994 2010 20 10 0 Rural Urban Rural Urban MEN WOMEN *p<0.05, compared to 2010 **p<0.05, compared to urban population in 2010
  • 12. INEQUALITIES IN HEALTH BEHAVIOUR (Finbalt Health Monitor project)
  • 13. Proportion of daily smoking men in 1994 – 2010 by level of education 65 Secondary University 56 53 55 50 49 47 48 48 45 40% 41 35 35 35 32 31 25 25 25 21 21 21 15 1994 1996 1998 2000 2002 2004 2006 2008 2010
  • 14. Proportion of daily smoking women in 1994 – 2010 by level of education 25 Secondary University 18 20 20 19 20 16 14 13 15 13% 14 10 9 12 10 8 9 11 6 6 5 5 0 1994 1996 1998 2000 2002 2004 2006 2008 2010
  • 15. Relative index of inequality (RII) in smoking by education in 1994 and 2010 MEN WOMENStudy year RII 95 % CI RII 95 % CI1994 2.4 1.3-4.1 0.7 0.2-1.92010 4.1 2.3-7.3 2.7 1.5-4.9
  • 16. Prevalence of regular wine consumption and odds ratios (OR)* by sex and level of education Education MEN WOMEN level % OR 95 % CI % OR 95 % CI University 14.4 1 18.6 1 Vocational 9.3 0.59 0.47-0.74 8.8 0.47 0.4-0.57 Secondary 7.4 0.47 0.37-0.59 4.5 0.25 0.2-0.31* - age, level of education, place of residence and marital status were included into themodel of logistic regression
  • 17. Prevalence of regular beer consumption and odds ratios (OR)* by sex and place of residence Place of MEN WOMEN residence % OR 95 % CI % OR 95 % CI Cities 53.7 1 15.4 1 Towns 49.0 0.83 0.74-0.93 12.7 0.79 0.69-0.92 Villages 49.3 0.84 0.75-0.94 12.9 0.81 0.70-0.95* - age, level of education, place of residence and marital status were included into the modelof logistic regression
  • 18. Prevalence of daily consumption of fresh vegetables during the last week among men by education in 1996-2010 30 27 26 22 23 20 20 17 14 14% 12 12 15 14 10 12 10 3 3 Secondary University 0 1996 1998 2000 2002 2004 2006 2008 2010
  • 19. Prevalence of daily consumption of fresh vegetablesduring the last week among women by education in 1996-2010 32 33 35 30 27 27 30 22 24 25 22 20 19 17 15 20% 14 16 15 10 7 5 Secondary University 5 0 1996 1998 2000 2002 2004 2006 2008 2010
  • 20. Prevalence of daily consumption of fresh vegetablesduring the last week by sex and place of residence 30 25.3 25 20.9 17.9 18.3* 20 15.7 13.9* Cities % 15 Towns Willages 10 5 0 MEN WOMEN* p<0.05 compared to cities
  • 21. International research projects on health inequalities in Lithuania• WHO project “Health Inequalities” (1997) – Report “Equity in health and health care in Lithuania. A situation analysis” (1998)• Tackling health inequalities in Europe. An integrated approach - EUROTHINE (2004-2007)
  • 22. The use of Finbalt Health Monitor data on social differences in health behaviour in Lithuania• The assessment of the implementation of Lithuanian Health programme• The reports of National Health Board• State Food and Nutrition Strategy and Action Plan for 2003-2010• National alcohol and tobacco control programmes; the laws on tobacco and alcohol control
  • 23. Health policy formulation addressing health inequalities in Lithuania• Lithuanian Health Programme for 1998 – 2010 – general objective on equity in health and health care• New Lithuanian Health Programme for 2011-2020 – great emphasis on reduction of inequalities in health
  • 24. Policy addressing socio-economic determinants of health in Lithuania• National programme on tackling poverty and diminishing social gap in Lithuania (2000).• The strategies and the plans of specific measures were developed in 2002, 2004, 2006, 2008. – Reduction of unemployment – Improvement of access to high quality social service – Strengthening support for families and children – More attention to education of socially disadvantaged groups
  • 25. Summing-upFinbalt Health Monitor study was an importantvehicle for evaluation of social differences andtrends in health behaviour. The data are useful toguide policy making and to support the evaluationof strategies to reduce health inequalities.

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