Health promotion

Health Promotion Foundations funded through Tobacco Taxes
1| April 2010, Philippines


1

Deaths, by broad cause group and WHO Region, 2000

%
Noncommunicable
75 conditions

Injuries
Communicable diseases,
50 maternal and perinatal
conditions and nutritional
deficiencies

25

AFR EMR SEAR WPR AMR EUR



2


WESTERN PACIFIC
Deaths in 2000 attributable to selected leading risk factors

Number of deaths (000s)


3

Risk factors common to major
noncommunicable conditions

Risk factor Condition
Cardio- Diabetes Cancer Respiratory
vascular conditions**
disease*
Smoking √ √ √ √

Alcohol √ √
Nutrition √ √ √ √
Physical inactivity
√ √ √ √
Obesity
√ √ √ √
Raised blood pressure
√ √
Blood glucose
√ √ √
Blood lipids
√ √ √
* Including heart disease, stroke, hypertension
** Including chronic-obstructive pulmonary disease and asthma


10
Filipinos
die each hour from
tobacco-related disease


4

Second hand smoke is a carcinogen.

The following countries have classified SHS as a carcinogen:

  Germany

  Finland

  USA – SHS is a group A carcinogen with arsenic, asbestos,
benzene, radon and vinyl chloride


Philippines

10 | April 2010, Philippines

5

My first real lesson in public health

Total population

Healthy but at risk

Sick

Sick and needs
hospitalization

Sick, needs
hospitalization and
has access
res
nditu
f expe
90% o

Prevention and health promotion receive insignificant
funding in countries of the Western Pacific Region


6

What is health promotion?

“Health promotion is the process of enabling
people to increase control over, and improve
their health.”

The Ottawa Charter, 1986

Based on the principle that health is a resource for
living and a common good.

Health
Promotion
=
Health
Education


7

HEALTH PROMOTION ACTIONS

EDUCATION

SOCIAL MOBILIZATION

ADVOCACY


Health Promotion Objectives

  To enable individuals to modify behavioural risks to health on a daily basis
throughout the life course;
  To promote health in the settings where people live, work, learn and play
  To reduce vulnerability, risk, exposure and threats that are linked to
inequitable development, gender, socio-economic status, employment
conditions and place of residence;
  To empower collective action for healthier environments.


8

CHARACTERISTICS OF A HPF

  Primarily fund health promotion activities

  Are established under legislation

  Have long term and recurrent funding

  Are governed by an independent Board


HEALTH PROMOTION
FOUNDATIONS….

  Make decisions autonomously

  Allocate funds transparently and equitably

  Are politically non aligned

  Work with and across all sectors

Ref :International Network of Health Promotion Foundations 2002


9

What foundations can do

  Provide grants

  Proactive grants

  Plan and implement health promotion programs

  Use sport and arts activities to promote health messages

  Support health promotion research by offering grants

  Carry out health promotion research

  Fund community development

  Offer an alternative source of funds to prevent sponsorship from “unhealthy products” (tobacco, alcohol, fast-food)

  Social marketing

  Advocate for policy

  Build leadership and capacity in communities


Addressing tobacco primarily, but
reduce other unhealthy behaviours that
also leads to savings


10

Work in settings and
with partners to promote health
  Schools
  Childcare centres
  Hospitals
  Local government
  Universities
  Prisons
  Workplaces
  Shops
  Recreational settings
  Arts and cultural settings
  Homes
  Health services
  Pubs/clubs
  Catering/food supply outlets
  Restaurants
  ‘cyberspace’
  Markets
  Public toilets


HISTORY OF
HEALTH PROMOTION FOUNDATIONS

  1983 Western Australia increased tobacco taxes and 10% of the
increase was placed in the Tobacco Tax Fund. The Department of
Health used this for health promotion programs emphasising
tobacco control

  VicHealth established in 1987 , 24 years old

  Objectives to fund health promotion and research and to replace
tobacco advertising and sponsorship


11

International Network of Health Promotion
Foundations established in 1999

Members
  Austrian HPF

  ThaiHealth

  VicHealth(Australia)

  Health Promotion Switzerland

  Malaysian Health Promotion Board

  Healthway( Australia)


Associate Members
  British Columbian Coalition for HP

  TongaHealth *

  Mongolian HPF*

  Oman Health Promotion Initiative

  Health 21 Hungarian Foundation

  Polish HPF

  Ministry of Health and Family Welfare, India

  Management Centre for Health Promotion, Korea


12

Newest foundations

  Mongolia

  Malaysia

  Tonga

*All in the Western Pacific Region of WHO



13

Replace tobacco sponsorship


Replace tobacco advertising


14

Funding for Foundations
Austria VAT distributed by MOF

Vic Health Direct grant from Treasury

(formerly tobacco tax)
Healthway
Malaysia Triennial allocation from Govt based on application from
Board

Mongolia Govt budget plus non refundable aid and contributions from
other countries and orgs.

2% tobacco and alcohol tax
Switzerland Health insurance levy of around $ 2.25 per insured person
annually

Thailand 2% of alcohol and tobacco excise tax


4 models

  Invisible

  Embedded

  Attached

  Independent


15

“invisible”
General taxes

Ministry of Health

Health Ministry/
Department

Health Promotion partners


“embedded” Other sources

General taxes

Health Ministry/
Department

partners
Health Promotion


16

“attached” Other sources

General taxes

Health Promotion
partners

Health Ministry/
Department


Other sources “independent”
Health Promotion partners
autonomous
structure
Tobacco taxes

Health Promotion

Health Ministry/
Department


17

Why invest in promoting health and
reducing risks to health?
  PUBLIC HEALTH EFFICIENCY: Funds spent on keeping the population
healthy versus treating the sick, could improve efficiency within the same
level of resources;

  SOCIAL COHESION: The “wellness of all” can be a rallying point for
political and health sector reforms.

  COMMUNITIES AND FAMILIES CAN CHANGE THE NORM:
Behavior change in the Asian context is a collective endeavor.



18

Let us
move
forward.


19

Health promotion

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