1. Food and nutrition action plan – lessons learnt and ways forward Mojca Gabrijelčič Blenkuš National Institute of Public Health of the R of Slovenia PREVACT - ACTION FOR PREVENTION Conference on Member States’ Activities on Nutrition, Physical Activity and Smoking related health issues Budapest, 30th – 31st May 2011

2. Outline of the presentation 1. What do weknow? - inequalities in health – relevancefornutritionandphysicalactivity - evaluationofthe FNAP 2005-10 2. Whatcanwe do? - preventionprogrames - promotionprogrames Nutritionandhealth in allpolicies 3. Waysforward

3. Outline of the presentation 1. What do weknow? - inequalities in health – relevancefornutritionandphysicalactivity - evaluationofthe FNAP 2005-10 2. Whatcanwe do? - preventionprogrames - promotionprogrames Nutritionandhealth in allpolicies 3. Waysforward

4. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.2 Infant mortality in the EU and Slovenia per 1000 live births, 2006 (WHO, HFA 2010; NIPH Database of deaths 2004-2008).

5. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.5. Percentage of children by the number of hours of physical activity during a week relative to the family’s socioeconomic status, Slovenia, 2006 (HBSC, 2006).

6. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.6. Percentage of overweight and obese individuals relative to socioeconomic status, Slovenia, 1997 and 2008(Koch, 1997; Gabrijelčič et al., 2009).

7. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.8. Percentage of inhabitants with good or very good self-assessed general health status relative to education and age, Slovenia, 2007 (NIPH EHIS, 2007).

8. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.9. Prevalence of cardiovascular disease relative to social class, population group aged 45–64 years, Slovenia, 2008(CINDI Slovenia, 2008).

9. Health inequalities in Slovenia. NIPH, 2011 Fig. 2.18. Premature mortality (0–64 years) from liver cirrhosis in groups of municipalities relative to income tax base per capita by gender, Slovenia, 2004–2008 (NIPH Database of deaths 2004-2008).

10. Foods and food groups in daily nutrition in adult population in Slovenia, by self-estimated SES Souce: Gabrijelčič Blenkuš et all, 2009

11. Foods and food groups in daily nutrition in adult population in Slovenia, by age groups Souce: Gabrijelčič Blenkuš et all, 2009

16. Evaluationresults – Slovene FNAP 2005-10

17. Outline of the presentation 1. What do weknow? - inequalities in health – relevancefornutritionandphysicalactivity - evaluationofthe FNAP 2005-10 2. Whatcanwe do? - preventionprogrames - promotionprogrames Nutritionandhealth in allpolicies 3. Waysforward

19. Researchandpreventionofmortalityandmorbidity

20. Researchandpreventionofriskfactors

22. Researchqualityoflife, increasewellbeing, populationlevel (exist in vocabularyof “ordinary” people)

23. Researchandencouragingofprotectivefactors (exist in vocabularyofothersectors - HiAP)

24. Indicatorsofpositivehealth (indicatorofhappines – OECD)Interlinked, harmonizedactivities

25. Diseasepreventionprogrames, with HP components Nationaldiseasepreventionprogrames in Slovenia Diabetes Cancer, includingcancerscreening Cardiovasculardiseases Holisticapproach to thepatient at theprimaryhealthlevel ChronicdiseasesstrategyforSlovenia Jointactionforcancer at EU level – outcomeofSlovenepresidency 2008 Healthcaresystem

29. Mainchallengesforhealthpromotion in nutritionandphysicalactivity STRUCTURAL LEVEL Createsupportiveenvironmentsforphysicalactivity – schools (PA as a vital part ofschoolcurricula at alllevels), urban planning, transport … Createsupportiveenvironmentsforhealthynutrition – reformulationoffoodproducts, regulationofspecificnutrients (TFA), fiscalemeasures, reducingpressure in marketing foodandbeverages to children, … INDIVIDUAL LEVEL Segmentation, subpopulationgroupspecificapproaches

30. Outline of the presentation 1. What do weknow? - inequalities in health – relevancefornutritionandphysicalactivity - evaluationofthe FNAP 2005-10 2. Whatcanwe do? - preventionprogrames - promotionprogrames Nutritionandhealth in allpolicies 3. Waysforward

32. AAMRDThe SFS is implemented by: AAMRD – Agency for Agricultural Markets and Rural Development Health: - M.of Health, - IPH Education: - M.of Educ. Source: Report of Slovene MAFF to DG AGRI, Feb 2010

33. SchoolFruitScheme 73 %ofallSlovene primaryschoolsinvolved Allkidsfrom 6 – 15 yearsof age, additional fundingfromSlovenegovernment 517 tonsoffruitandvegetables used in schools (2009/10)

34. HiAP in SEE Third Health Ministers Forum: Health in All Policies in South-eastern Europe: “A Shared Goal and Responsibility”, Banja Luka (BIH), 13 - 14 October 2011– Political Declaration to be adopted (South-eastern Europe Health Network (SEEHN) members: Albania,Bulgaria, Bosnia and Herzegovina, Croatia, FYR Macedonia, Moldova, Montenegro, Rumania, Serbia) For more info on SEEHN and Ministerial Forum please visit: http://seehnsec.blogspot.com/p/third-see-ministers-of-health-forum.html Preparatory process-all SEEHN countries prepared the overview of the HiAP approach within respective countries

35. Outline of the presentation 1. What do weknow? - inequalities in health – relevancefornutritionandphysicalactivity - evaluationofthe FNAP 2005-10 2. Whatcanwe do? - preventionprogrames - promotionprogrames Nutritionandhealth in allpolicies 3. Waysforward

36. CAPACITY BUILDING COMUNICATION Food safety Localsustainable foodsupply Healthyand balancednutrition & physicalactivity in lifecycle HEALTH AND SOCIAL CARE SYSTEM SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY RESEARCH, MONITORING AND EVALUATION

37. FNAP 2012-20 - challenges Continuity, based in presentknowledge, achievements, lessonslearnt. Harmonized/integratedwithotherhealthpromotionanddiseasepreventionprogrames; focus: health, wellbeingforallandsustainability. Institutionalizedmeasures, health in allpoliciesapproach. Participativenes, specialfocus to subpopulationgroups. Transparent andindependatmonitoringandevaluation. Provide evidence. Workingtogether: EC – HLG, definingcommonframeworks at the EU level WHO – 1st and 2nd FNAP, actionnetworks, monitoringandevaluation; Networks as – EHN (EU policies, SDH/HI) SEE HN (regionalrelevance) Specialimportanceofharmonizedcommonactivities at thenationallevels in theglobalenvironment.