Francesca Racioppi: Using "Health in all policies" framework to integrate safety
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Presentation by Francesca Racioppi, WHO, Denmark at Safety 2016 World Conference, 18-21 September 2016, Tampere, Finland #Safety2016FIN
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Francesca Racioppi: Using "Health in all policies" framework to integrate safety
- 1. Safety2016 19 September 2016, Tampere, Finland 1 Using âHealth in all policiesâ framework to integrate safety Francesca Racioppi WHO Regional Office for Europe with thanks to Dinesh Sethi, WHO Regional Office for Europe Heather Adair-Rohani, WHO Headquarters
- 2. Safety2016 19 September 2016, Tampere, Finland 2 What this talk is about âą Health/Safety in all policies âą Make it happening â Change accountability frameworks â The âco-benefitâ argument: build on other sectoral agendas âą Energy, âą Air pollution âą Climate change â The 2030 agenda for Sustainable Development: a new entry point â The role of the safety community
- 3. Safety2016 19 September 2016, Tampere, Finland 3 Injury deaths: 755 000 in 2000 544 000 in 2012 0 50 100 150 200 1980 1985 1990 1995 2000 2005 2008 2009 2010 2011 2012 2013 European Region EU CIS Deaths from Injuries, All ages in European Region Deathsper100000 More needs to be done reduce injuries for a safer and more equitable Europe
- 4. Safety2016 19 September 2016, Tampere, Finland 4 From âHealth in all policiesâ to âSafety in all policiesâ Health in all policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health and health systems implications of decisions, seeks synergies and avoids harmful health impacts, in order to improve population health and health equity 2006 2013
- 5. Safety2016 19 September 2016, Tampere, Finland 5 Taking HiAP forward in Europe: Health 2020 Intersectoral action for health Whole-of- government Health in all Policies Governance for Health
- 6. Safety2016 19 September 2016, Tampere, Finland 6 In which policy domains? Safety in All Policies Transport Environment Land use Housing Leisure Sport Education Justice Social policy Labour Industry Health Road traffic injuries Fire-related injuries Poisonings Drownings Falls Occupational injuries Interpersonal Violence Child abuse and neglect
- 7. Safety2016 19 September 2016, Tampere, Finland 7 Integrating safety in other policies: recognizing opportunities Increasing efficiency Enhancing sectoral performance Reducing inequalities Reducing preventable loss Making safety an integral part of sectoral performance
- 8. Safety2016 19 September 2016, Tampere, Finland 8 Changing accountability frameworks road traffic injury prevention - 1 2004 20132009 20152011 The transport sector introduced monitoring and public reporting on progress against quantitative road safety targets
- 9. Safety2016 19 September 2016, Tampere, Finland 9 European facts and Global status report on road safety 2015 Age-standardised road traffic injury mortality rates by quintiles, WHO European Region 2013 85 000 8 8.1% Road traffic injuries are the leading cause of death in young people aged 5-29 years Increase efforts to reach target of 50% reduction by 2020 Changing accountability frameworks: road traffic injury prevention - 2
- 10. Safety2016 19 September 2016, Tampere, Finland 10 Goals in transport policy Sectoral Interest Reduce emissions of: âair pollutants; âgreenhouse gases; âNoise Environment Health Energy Reduce congestion Transport Reduce road traffic injuries Transport, Health Reduce investments in infrastructure Transport, Land use Improve accessibility and quality of urban life Transport, Health Complement improvements to vehicles and fuels Transport Increase physical activity through active mobility Health âDecarbonizeâ transport Environment, Energy Improve transport efficiency Transport, Economy, Energy Promote tourism Tourism and leisure industry Creation of new jobs Economy, welfare, labour Bridging across diverging agendas: Developing the âco-benefitâ argument
- 11. Safety2016 19 September 2016, Tampere, Finland 11 The âco-benefit argumentâ: Example -1 Fighting indoor air pollution: Kerosene replacement âą An estimated 265 000 deaths every year are caused by burns âą Burns occur mainly in the home and workplace, mostly âin low- and middle-income countries. âą Kerosene is a leading cause of burns and poisonings in low and middle income countries âą Kerosene is a major source of air pollution in and around the home, emitting high levels of health-damaging pollutants like fine particulates (including black carbon), PAHâs, CO, NO2, SO2, etc âą Many households still rely on kerosene for cooking, heating and lighting âą New WHO figures estimate around 200 million people still rely primarily on kerosene for cooking along and many homes, particularly AFRO rely mainly on kerosene for lighting
- 12. Safety2016 19 September 2016, Tampere, Finland 12 Percentage of population relying on kerosene as main lighting fuel in three WHO Regions
- 13. Safety2016 19 September 2016, Tampere, Finland 13 WHO Indoor Air Quality Guidelines: defining âcleanâ for health? Normative guidance found in the WHO Guidelines for indoor air quality: household fuel combustion: âą Provides emission rate targets for PM2.5, and CO that determine whether fuel and technology combinations are âcleanâ for health âą Provides guidance on the policy in transition to the sustained adoption of clean fuels (e.g. LPG) and technologies âą Recommendations made against kerosene and unprocessed coal use âą Emphasizes importance of addressing all main household energy end uses for health benefits
- 14. Safety2016 19 September 2016, Tampere, Finland 14 Source: World Health Organization, 2011. Health co-benefits of climate change mitigation - Transport sector, The âco-benefit argumentâ: Example - 2 Mitigating climate change: Promoting cycling and walking
- 15. Safety2016 19 September 2016, Tampere, Finland 15 The âco-benefit argumentâ: Example - 3 Adapting to climate change: preparing for and preventing the effects of extreme weather events â from reacting to managing risks Credit: UNDP/Ljubo Stefanov Credit: UNDP/Ljubo Stefanov
- 16. Safety2016 19 September 2016, Tampere, Finland 16 The 2030 agenda for Sustainable Development: a new entry point for âSafety in all policiesâ
- 17. Safety2016 19 September 2016, Tampere, Finland 17 Safety in all policies supports the attainment of SDGs. SDGs support safety in all policies implementation Safety in all policies 1.5 By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure and vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters 3.2 End preventable deaths of children under 5 years by 2030 3.5 Prevention and treatment of substance abuse and harmful use of alcohol 3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents 4.a Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all 5.2 Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation 5.3 Eliminate all harmful practices, such as child, early and forced marriage, and female genital mutilations 7.1 By 2030, ensure universal access to affordable, reliable and modern energy services 8.8 Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, in particular women migrants, and those in precarious employmen 9.1 Develop quality, reliable, sustainable and resilient infrastructure, including regional and transborder infrastructure, to support economic development and human well-being, with a focus on affordable and equitable access for all 11.1 By 2030, ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums 11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons 13.1 Strengthen resilience and adaptive capacity to climate- related hazards and natural disasters in all countries 16.1 Significantly reduce all forms of violence and related death rates everywhere 16.2 End abuse, exploitation, trafficking and all forms of violence against and torture of children 17.16 Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the sustainable development goals in all countries, in particular developing countries
- 18. Safety2016 19 September 2016, Tampere, Finland 18 The role of the safety community âą Provide the evidence: â Of the magnitude of the burden of violence and injury â Of the links to risk factors and protective factors â Of effective policies and interventions âą Advocate âSafety in all policiesâ â Understand other sectors agenda â Identify and leverage on âco-benefitsâ â Promote sectoral accountability â Use the economic and development argument âą Build capacities for âSafety in all policiesâ â Public health approach to violence and injury prevention â Risk assessment and management
- 19. Safety2016 19 September 2016, Tampere, Finland 19 In conclusion âą âHealth in all policiesâ approaches are amenable to âsafety in all policiesâ âą Health 2020 and the 2030 Sustainable Development Agenda support and offer entry points to âsafety in all policiesâ âą Implementing âsafety in all policiesâ will benefit from: â Shifting sectoral accountability and integrating safety goals in performance appraisals â Understanding sectoral policies agendas â Identifying opportunities for âco-benefitsâ â Demonstrating the economic and development benefits of safety in all policies approaches
- 20. Safety2016 19 September 2016, Tampere, Finland 20 To get in touch with us: sethid@who.int racioppif@who.int http://www.euro.who.int/en/health-topics/disease- prevention/violence-and-injuries
Notas do Editor
- Now I will consider injuries specifically. WHO has championed the public health approach to the prevention of injuries through a series of World Health Assembly resolutions on violence, road safety and child injury prevention. A decade ago Europe was one of the first regions to champion a resolution on the prevention of injuries (RC55/R9 in 2005). Strong progress has been made in the last decade in Europe where there has been a decline of 28% in deaths (755,000 injury deaths in 2000 to 544,000 in 2012). However, as this slide shows the European Region remains a very unequal place. Rates in the Commonwealth of Independent States are nearly three times higher than the EU countries. The good news is that: 1) mortality is falling showing that injuries are preventable and 2) there is convergence between the EU and CIS countries. However more needs to be done to reduce this leading cause of inequality and premature mortality.
- Finnish Presidency of the EU 2006 8th Global Conference on Health Promotion, 2013 - Helsinki
- Intersectoral action is a political choice and requires political commitment. Implementing intersectoral action for health and well-being, however, is challenging. Addressing the determinants of health and well-being means addressing complex, challenging issues. Bringing together different sectors means navigating the specificities of different bureaucratic systems, unequal distribution of resources, and even at times conflicts of interest within government. This requires a determined effort. The working document uses the term intersectoral action to cover a wide range of bilateral and multilateral cooperation among sectors, as well as the broader Health in All Policies and whole-of-government approaches. Although some terms are more accepted in specific contexts and political systems, it is important to point out that all of them have legitimacy and justification, and are dependent on the context and issues that they seek to promote.
- Road traffic crashes are the leading cause of death in children and young people aged 5-29 years in the European Region. In total road traffic injuries kill 85 000 people of all ages in the Region, a significant proportion of the 1.2 million killed globally. The good news that there has been a 8.1% decrease in road crash deaths since 2010. Less favorable is that there are large inequalities in road traffic deaths occurring across the Region. It is of particular concern that 8 countries have reported more deaths in 2013 than in 2010 Greater efforts will have to be made if the Decade of Action for Road Safety and also the SDG target 3.6 for a 50% reduction in road traffic deaths and injuries by 2020 is to be met. There are examples of good practice countries such as Sweden and this conference gives an opportunity to debate how better implementation of evidence based practices could be achieved
- AFR lighting derived from data from 25 countries Right is a graph showing the mix of different lighting fuels being used ânoting the large fraction that kerosene and oil contributes to the mix for the different regions
- In response to the urgent need to address the global health crisis from household fuel combustion, in November 2014, WHO released its first-ever normative guidance on household fuel combustion. These guidelines provide practical evidence based guidance on what fuels and technologies used in the home can be considered clean including: Recommendations on what fuels can be âdirtyâ for health including kerosene and unprocessed coal. Recommendations on the needed performance of clean fuels and technologies in the home in the form of emission rate targets Recommends about the importance of addressing all household energy uses, partiuclary cooking, heating and lighting to ensure benefits for health and the environment.