The state of health in Europe: and what are the major threats for the future? / Stan zdrowia publicznego w europie. Quo vadis? Najwazniejsze problemy w najblizszych latach

Professor John Middleton
President of Faculty of Public Health
Stan zdrowia publicznego w europie. Quo
vadis? Najwazniejsze problemy w najblizszych
latach

Professor John Middleton
President of Faculty of Public Health
The state of health in Europe: and what are the
major threats for the future?

John Middleton Polish Public Health Association Conference,
December 1st 2017
Salus populi..
Suprema lex esto

Where there is no
vision, the
people suffer
Andrija Stampar,
Yugoslavian Public
health pioneer and
WHO founding father
After Proverbs/29-18.
John Middleton Polish Public Health Association
Conference, December 1st 2017

Inequalities in health
Burden of long term conditions
Role of multinational anti-health interests in
Role of technological change
Role of consumer demand
Environmental degradation and climate change
The rise of right wing forces, nationalism,
Terrorism and and international conflict

Public health is :
The science, and art, of promoting health,
preventing disease and prolonging life, through the
organised efforts of society
Acheson 1988, after Winslow 1920, WHO 1948

Global burden of disease

(true also for Europe)
Improving global position, esp through improvements in child
health and reductions in infectious disease
But increases in inequalities- between and within countries
Increases in mental ill health- particularly Alzheimers
Increases in violence
Increases in obesity and diabetes

A global ‘table diagram’ of
causes of death – and 4
Polish examples

Global burden of disease – the
role of multinationals …

These 10 Corporations Control Almost Everything We Eat
John Middleton Polish Public Health Association Conference,
December 1st 2017

Burden of disease attributable to 20 leading risk factors in 2010
expressed as a percentage of global disability-adjusted life-years
Global Burden of Disease Group. www.thelancet.com 2012 380 2245
Diet ≈ 40%

http://www.bing.com/videos/search?q=youtube+advert+for+c
amel+cigarettes&&view=detail&mid=70789494855D72F0D8B
D70789494855D72F0D8BD&FORM=VRDGAR
J Middleton Polish Public Health Association Conference, December
1st 2017

http://www.bmj.com/
content/358/bmj.j444
3?sso=

Global burden of disease – the challenges for health
services
• Living with long term conditions
• The need for integrated health and social
care including housing
• The need for secondary prevention
• The need for Health services to produce
better outcomes - ‘value driven’
interventions : saving more lives, preventing
more disability, promoting independence

Technological change:
Genomics
Personalised medicine
Robotics
Digitalisation
Access to health information
Control of health records

Inequalities in health,
economic recession and
austerity policies

John Middleton, Polish Public Health Association Conference, 1/12/2017

Rockefeller Lancet
Planetary Health
commission

Lancet Rockefeller Commission on Planetary
Health Lancet, 2015

Interconnectness: Loss of agricultural land through
global warming, crop failure, migration of farmers,
food riots, Arab Spring, Syrian war, mass migration,
European political crisis, rise of right wing nationalist
governments

The rise
of the far
right

The first refugees from Sarajevo, Split Harbour, Croatia, May
1992
Middleton J:
Refugee for a
day. BMJ
personal view
November
1992.

Sandwell
Express and
Star ,
November
1992

Interconnectness
:
Climate change
refugees

From Alcamo and Heinrichs, 2002. In: Dialogue on Water and Climate, 2003.
Water critical regions
Medium water stress today & future increase in stress plus HDI>0.8
A2 scenario, ECHAM4, 2020s

Public health and the EU post
Brexit
A country fit to live in…
where
 Britain can power itself ? and
 House itself ? and
 Employ itself ?
http://www.campaigncc.org/sites/data/files/Docs/
one_million_climate_jobs_2014.pdf

‘Protecting
resources from
one generation
to the next’
The Welsh
Wellbeing of
Future
Generations Act,
2015

William Beveridge designed
a welfare state for the UK in
the deepest point of the
Second World War.
‘We should regard want,
idleness , ignorance,
squalor and disease as
enemies of us all. That is
the meaning of a social
conscience; that we
refuse to make our
separate peace with evil.’

Thank you
Dziekuje
John Middleton
President, United Kingdom Faculty of Public Health
president@fph.org.uk

Who we are and what we do
• The United Kingdom Faculty of Public Health is a faculty of the three
Royal Colleges of Physicians of London, Edinburgh and Glasgow
(Physicians and Surgeons)
• FPH is a membership organisation for nearly 4,000 public health
professionals across the UK and around the world
• We also have a growing number of student, associate and international
members in more than 80 different countries
To improve and protect the public’s health: through
standards, advocacy, training and knowledge
www.fph.org.uk

The state of health in Europe: and what are the major threats for the future? / Stan zdrowia publicznego w europie. Quo vadis? Najwazniejsze problemy w najblizszych latach

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The state of health in Europe: and what are the major threats for the future? / Stan zdrowia publicznego w europie. Quo vadis? Najwazniejsze problemy w najblizszych latach