Nfhk2011 vesa korpelainen_parallel2

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Sustained population based prevention of NCDs: From North Karelia Project to North Karelia Center for Public Health. Vesa Korpelainen, North Karelia Center for Public Health

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Nfhk2011 vesa korpelainen_parallel2

  1. 1. SUSTAINED POPULATION BASED PREVENTION OF NCDs: From North Karelia Project to North Karelia Center for Public Health Vesa Korpelainen, MSc, MPH Executive Manager North Karelia Center for Public Health (North Karelia Project) Siltakatu 10 A FIN-80100 Joensuu, Finland vesa.korpelainen@kansanterveys.info Pekka Puska Tiina Laatikainen Erkki Vartiainen National Institute for Health and Welfare
  2. 2. North Karelia  population 166.000  14 municipalities  territory 21.585km2  water 3.803 km2 Finland
  3. 3. North Karelia in the beginning of 1970’s CHD mortality rates among men highest in the world, short life expectancy Increasing public discussion and attention to extremely high CVD mortality → North Karelia Project: Community-based action for CVD prevention
  4. 4. Community intervention model of North Karelia Project COMMUNITY action maintenance External project input Changes in health behavior and risk factors Changes in disease rates and health COMMUNITY ORGANIZATION -mass media -health and other services -other organizations -industry, business -legislation Opinion leaders -formal -informal Early adopters POPULATION -knowledge -motivation -skills -social support -environmental support influence diffusion
  5. 5. 6. COMMUNITY ORGANIZATION 5. ENVIRONMENTAL SUPPORT 4. SOCIAL SUPPORT 3. PRACTICAL SKILLS 2. PERSUASION 1. KNOWLEDGE BEHAVIOUR MODIFICATION MODEL (modified by P. Puska and A. McAllister) NORTH KARELIA PROJECT PRIVATE SECTOR POPULATION PUBLIC POLICY Media •Health and other •public services •NGOs •Industry, business •Legistlation
  6. 6. Change in age-adjusted mortality rates North Karelia, males aged 35–64 (per 100 000 population) •extension of the Project • nationally •start of the North Karelia Project •North Karelia -85% •All Finland -80% Rate per 100 000 1969- 1971 2006 Change from 1969- 1971 to 2006 All causes 1509 572 -62% All cardiovascular 855 182 -79% Coronary heart disease 672 103 -85% All cancers 271 96 -65% Coronary heart disease •Gain of nearly 10 healthy years • in North Karelian popupaltion
  7. 7. Effect of risk factors on decreasing CHD mortality in Finland 1982-1997 16 % 7 % 9 % 37 % 22 % 9 % Cholesterol Smoking Blood pressure Improved treatment Sec. Prevention Unknown Laatikainen et al. Am J Epid 2005
  8. 8. North Karelia Project has shown • Prevention of cardiovascular and many other NCDs is possible and pays off • Population based prevention is the most cost effective and sustainable public health approach to CVD control • Prevention calls for simple changes in some lifestyles (individual, family, community, national and global level action) • Influencing diet and especially quality of fat is a key issue • Many results of prevention occur surprisingly quickly (CVD, diabetes) and also at relatively late age • Comprehensive action, broad collaboration with dedicated leadership and strong government policy support are key elements for success
  9. 9. from NORTH KARELIA PROJECT to NORTH KARELIA CENTER FOR PUBLIC HEALTH
  10. 10. North Karelia PROVINCE OF HEALTHINESS Peoples’ health consciousness and health behaviour Health knowledge of decision-makers and commitment of stakeholders Evaluation Monitoring Information Indicators POHJOIS-KARJALAN KANSANTERVEYDEN KESKUS toiminnallinen ja fyysinen keskus, joka • kehittää • koordinoi ja • tekee terveyden edistämistyötä
  11. 11. Key stakeholders on regional level •POHJOIS-KARJALAN KANSANTERVEYDEN KESKUS toiminnallinen ja fyysinen keskus, joka • kehittää • koordinoi ja • tekee terveyden edistämistyötä Regional Council of North Karelia: Welfare plan Hospital district: Primary health care unit, professor of health promotion University of Eastern Finland, University of Applied Sciences Regional units of NGOs
  12. 12. Health prescription
  13. 13. Health prescription
  14. 14. REGIONAL GROUPS • SMOKEFREE • PA • NUTRITION • NGOs REGIONAL STAKEHOLDERS NORTH KARELIA CENTER FOR PUBLIC HEALTH MUNICIPAL DECISION-MAKING • evaluation of influences of decisions • common indicators MUNICIPAL HEALTH PROMOTION GROUP • action plan SUPPORTSYSTEM FOR NGOs • plan • training • feedback ENTERPRICES • wellbeing of employees • social responsibility MONITORING EVALUATION INFORMATION DATA/ KOWLEDGE Collaboration – community organisation - public health
  15. 15. Health promotion structure, municipal model Municipal management group Acts often as a steering group for health and welfare promotion Health services Social sector Education Culture and PA services Technical depart- ment Environ- ment Health and welfare promotion group - Chairman - coordinator Working group 1 Working group 2 Working group 3 •Modified: THL 2010, 15.
  16. 16. Electonic municipal welfare report
  17. 17. •Health and welfare How things are? •Mikä on väestön hyvinvoinnin ja palvelujen tila indikaattoritiedon valossa? •Virkamiesten kokoama ja tulkitsema hyvinvointitieto: kansallisesti sovitut indikaattorit ja muu täydentävä tieto. How they should be? •Mitä kehittämistarpeita hyvinvoinnin ja palvelujen tilasta nousee ja mitä tavoitteita asetetaan? •Poliittisten päättäjien sitoutuminen kehittä- miskohteisiin, tarvitta- viin lisäresursseihin, kehittämistyöhön, hankkeisiin. How the goal will be achieved? •Mitkä ovat hallintokuntien toimenpide-ehdotukset tavoitteisiin pääsemiseksi? •Hallintokuntien toimenpiteiden suunnittelu ja niihin sitoutuminen. Information Objective Action
  18. 18. goal action data evalua tion Electornic welfare report package of essential data for welfare planning and desicion making is prepared in collaboration with different administrative sectors in municipality easy to use structured same basic indicators in every municipality strenghtens intersectoral collaboration http://www.hyvinvointikertomus.fi/ demo demo -> health
  19. 19. Thank you!

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