Prof. Dr. Reinhart WaneckSecretary of Health

Ministry of Health and Women

WHO: 1946

„Health is a state of complete physical, mental and social

well-being and not merely the absence of disease or infirmity ."

Health

• predominantly a feature of individuals

• postitive and integral health understanding

• from a psychological point of view

Health – Domestic Security - Education

Health Policy• Discussions about financial and administrative questions

• Subject matter discussions

The Austrian Health Plan• Unprecedented

• First of its kind in Europe

• Backlog within the EU

• Clear guidelines by the EU

• National and international realities

• Cross-border health-problems (Tuberculosis, drugs, HIV, Hepatitis)

• Austria has a good health system

• high solidarity rate (2/3 of the population)

• Austria and Denmark have the least differences in populations‘ income – Great Britain and Portugal show the highest differences

•Developments should not contrast with neighbouring EU states

•Idea of the European Peoples‘ Union (EU-projects, WHO)

•Establishing the most frequent diseases

•Action- and prevention planning guided by the 10 most frequent diseases

• Reducing the percentgae of frequency of cases of illness and mortality within 5 to 10 years maximum

•Reducing premature mortality and morbidity

Goals for the further development of the health system in Austria and the EU

• Life expectancy clearly improved

• „healthy years" HALE-Index

• „lost years"

• Human rights for all citizens guaranteed by the Council of Europe

•Free access to all necessary health facilities, regardless of social standing or status, - extensive covering for all ill and infirm people.

„Work-sharing" in health provision

• Citizens are to be tied to their patients‘ responsibility

• Personal responsibility for a healthier lifestyle

• Active part of all citizens within the health system

• Emotions, thoughts, sentiments and wishes

Prevention and health promotion• equal place of value as curative medicine

• Connection: Diseases and sentiments – healthy lifestyle

• New evaluation – premature mortality – weight, chronic diseases

Health relevant ways of life

• Nutrition

• Physical activity

• Work

• Alcohol

• Cigarette and drug consumption

• Risky and non-beneficial behaviour patterns

Concealed epidemic – Physical in-activity and false nutrition

•Cardio vascular diseases

• metabolic disorders

• Osteoporosis

15-39 % of coronary heart - diseases

33 % of strokes

12 % of hypertonies

12-35 % of diabetes

22-33 % of cancer of the colon

5-12 % of breast cancer

18 % of Osteoporosis related bone fractures

Potential of prevention

The most active men spend around 36%, and the most active women 23% days less in hospital than the most inactive persons.

Dosage-effect proportion of physical activity and health

In the past: strenuous exercises without breaks

Today: health-enhancing physical activity (HEPA) spread evenly throughout the day

Integrable activities

Monitoring of the population‘s physical activities

• only in a few cases on a routine basis and continuous

Physical Activity

Finnish Institute of Public Health (since 1978)

•Physical activities have become more frequent in the past 20 years.

•Increase by women: from 40 % to 60 %

•Plateauphase reached in the 90ies

•Less and less people walk or cycle to their place of work

•Today people train in fact more, but altogether have become less physically active.

• Well guided, well balanced and regular physical activity

• General well-being

•Physical activity helps to reduce stress and increases well-being

•2000 kcal/week through sports

•Clearly reduced risk of diseases caused by civilization

•At least 10 mins of physical activity per day are the basis for preventive effects

•Lack of physical activity means a higher risk of heart-attacks –and strokes, of high blood pressure, back pains, osteoporosis, excess weight and lipometabolic disorders as well as diabetes

•Physical activity has to be integrated in everyday life and leisure time

•Regular sport‘s activities, physical activity in everyday life, and sports during leisure time.

Nutrition

Nutrition accounts for health deficits• Diabetes

• High blood pressure

• Increased blood liquid concentration

• Certain cancers

• Arteriosclerosis

• Cardio- vascular diseases

• Increased uric acid levels

• Excess weight

Institute of Public Health in Sweden:

In EU countries because of nutritional deficits

4,5 % DALYs (disability adjusted life-years)

further

3,7 % respectively 1,4 %

Because of obesity and lack of physical activity and

false nutrition and lack of physical activity total

9,7 % DALYs

Smoking: 9% DALYs

Cardio-vascular diseases and diabetes: 30 % DALYs

Saturated fatty acids are responsible for the increase of the cholesterol level

Epidemic of the coronary heart disease – prevalent cause of mortality

Nutrition in Austria:

- high fat-content

- rich in calories

25-30 % of adults are overweight

11 % are obese

Excess weight and obesity become more and more frequent among children and adults.

Physical inactivity and excessive energy-intake• grave forms of co-morbidity

• non-insulin dependent diabetes

• cardio-vascular diseases

Obesity increases the risk of diabetes a hundredfold.

In most European countries 4% of the population suffer from diabetes.

Prevention is the best counteraction

• Change of nutritional habits

A person who regularly undergoes preventive medical check-ups has a good chance that risk-factors of

diseases and serious illnesses will be detected in good time!

• The preventive medical check-up is a typical scondary-preventive measure

• Early detection of diseases

Preventive medical check-ups

Utilization of the prevetion-programme:

850.000 (350.851 men, 505.959 women)= 13,6 % of insured people (figure has doubled since 1990)

East – West gradient:Vorarlberg 28,3 %Tyrol 26,7 %Salzburg 14,3 %Carinthia 20 %Upper Austria 11,6 %Styria 14,2 %Vienna 10,0 %Lower Austria 6,1 %Burgenland 17,7 %

Long-term securing of Financing

• Optimizing existing resources

• Entangling traverse financial flows

• Increasing efficiency-potentials

• Balancing of financial covering and required medical performance-levels

It is not predictable where medical progess will lead us to.

A society with a high performance- and development level is prepared

- not only to secure access

- but also to invest

Joint contribution

Cost sharing

Free use of medicine is no longer to be maintained.

Reforms

• on a structural level

• under no circumstances detrimental effects for patients

• sovereign activities for prevention strategies

• and best-practice models for certain very serious diseases such as AIDS, cancer and drug-addiction

Since 1972: „Mother – Child Pass“ (constantly further developed)

• Infants‘ mortality drastically reduced

• Without-a-gap stocktaking of juveniles‘ health up to school-leaving

•Continuing during occupational age, up to retirement age, combined with a „Recall-System"

A good health status is a basic requirement for social,

economical and personal development, and a vital part of

the quality of life.

Correlation

„Health and Life- expectancy "

Lifestyle and Prevention

Equal status of prevention and cure

Individual Preventive medical check-up

To essentially differentiate between „healthy“ and „ill“ persons

Future does not just happen,but is being prepared in the present.

Thank you very much for your attention

Prof. Dr. R. Waneck

Secretary of Health

Federal Ministry of Health and Women

STAATSSEKRETARIAT