The European Journal of Public Health Advance Access originally published online on August 8, 2006
The European Journal of Public Health 2006 16(5):458-459; doi:10.1093/eurpub/ckl118
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Viewpoints |
Ten statements on the future of public health in Europe
Walter RicciardiProfessor and Chair of Hygiene and Public Health, Catholic University of the Sacred Heart, Rome, Italy, tel: 0039 06 35019534, fax: 0039 06 35019535, e-mail: wricciardi{at}rm.unicatt.it
The notion of public health started some 400 years ago with disease control to prevent the further spread of diseases. Since then, public health has evolved and these days includes health promotion as well as health protection.
Now, as we stand on the verge of the 21st century, public health professionals are aware of the imbalance between the global magnitude of factors that affect human health and the inadequate structures in place to address them. Global integration is moving at a rapid pace, fuelled by faster communication and greater movement of people and ideas, yet the world continues to use nineteenth century structures based on individual nation states. These changes require new solutions, with effective international co-operative action, with devolved decision making that ensures implementation.
Effective policies to ameliorate them will require concerted international action and public health professionals can make a difference to this process, as researchers identifying the health effects of these factors, as advocates for action, and as agents for communicating to the public the nature and scale of threats to health.
If the ‘new’ public health defines health as an investment factor for a good community life focusing on the behaviour of individuals and the conditions of life that influence behaviour the questions where we stand now and how we are going to achieve this ‘new’ public health need answering.
The European Public Health Association (EUPHA) is an umbrella organisation for public health associations in Europe and at the moment it has 48 members from 38 countries and includes more than 10 000 public health experts from Europe. In order to answer the question of how public health will be implemented/practised, and researched in the future EUPHA started the project, the future of public health in Europe.
The main asset of the project was the organisation of five workshops for different public health groups (policymakers, researchers, practitioners).
The kick-off workshop was held in November 2002, in Dresden, Germany during the EUPHA annual conference. The aims of this workshop were to clarify the questions to be taken into account during the project, to get EUPHA members interested and involved in the project and to identify key persons for the workshops which were to follow about 80 public health experts participated in this workshop.
The second workshop was organised in May 2003 in Utrecht, the Netherlands and addressed the theme of bridging the gap between research, policy and practice. The aim was to arrive at practical recommendations: for public health researchers on how to be more effective in communicating and implementing their results, and for EUPHA on how to facilitate the dissemination and actual use of public health research: 10 experts participated in this workshop.
The third workshop was held in June 2003 in Bergen, Norway and looked at the future of public health in Europe from the policymaker's point of view. The aim was to identify, for policy makers, the future health problems and directions for public health.
This workshop was organised as a satellite workshop at the International Health Conference on 400 years of Public Health in Norway; around 100 experts participated in this workshop.
The fourth and the fifth workshops ‘Public Health Practice in Europe—Perspectives and Challenges’ were held in November 2003 in Rome, Italy during the 11th EUPHA annual conference. In the fourth workshop organised by the EUPHA, in the Section on Public Health Practice and Policy, the outcome of a survey on public health services in European countries, as reported by EUPHA advisers, was presented.
In the final workshop, the preliminary outcomes of the project were presented; followed by a critical analysis and a general discussion.
A report will describe in details the full project but 10 statements concerning immediate action can be released in advance.
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1 Future public health can only be achieved if the whole society invests in it: building partnerships is essential here |
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1 Future public health...
2 The long-term benefits...Public health is and should be seen as an integrated problem, as it touches all aspects of society and should be included at all levels, settings and aspects of a society. Bridges are necessary not only between policy, practice, and research, but especially between different disciplines.
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2 The long-term benefits of public health should be taken seriously by policymakers |
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Public health has been on the agenda of policymakers for a long time, but is not seen as a priority. This is mainly due to the long-term focus of public health: the benefits of any intervention/policy cannot be measured in the near future. ‘New public health’ should therefore encourage researchers to examine the long-term benefits of public health interventions.
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3 Public health should form an integral part of the political agenda in all fields |
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Public health should be included and form an integral part in all policy decisions. Population health should be presented as human capital, which is the basis for a solid economy and a happy population. Public health is subjective and long-term and it is important not to focus on short-term economic costs in the planning of public health initiatives.
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4 Public health policy should be based on assets rather than disease |
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At the moment, health policy is based on disease. The attention of policymakers is more directed towards acute illness and direct interventions. These interventions are based more on care than on prevention. In future, public health actions should not be based on deficiencies (= illness), but on assets (= good health).
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5 Research remains a solid basis for the development of public health practice and policy |
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As in the past, good research is the basis of successful public health interventions. Especially epidemiological research helps to identify risk factors for disease as well the impact of health promotion measures. In the future, some fields of research will remain important or become more important.
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6 Research should focus on the needs of policy and practice |
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There exists a significant gap between research on the one side and policy and practice on the other. A better interaction between policy/practice and research should be organised. This not only means that researchers should be open to policy/practice important aspects of research, but also that practitioners and researchers should learn to translate their research findings into recommendations for the solution of practical or policy problems.
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7 Researchers should learn how to interact with politicians and practitioners |
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Research should adapt the way that it presents its results. Results should be interesting for policymakers and practitioners and researchers should interact continuously with policymakers and practitioners.
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8 Innovative ways to promote health should be encouraged |
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One important aspect of developing public health is to be innovative. What has been effective in the past may not be taken too seriously by a new generation. New ways of either sending the same message or sending a new message need to be continuously developed.
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9 The future public health practice: think globally, act locally |
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Public health practice should be based on flexibility and pragmatism. Policies are set up at a national or international level, the implementation is at the local level and should be adaptable to different situations.
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10 EUPHA can do a lot |
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The EUPHA has two major assets that would be beneficial in the development of the new public health:
- it is an European non-governmental association of public health experts; and
- it consists of researchers, policymakers and practitioners.
Therefore, EUPHA can be a great boundary spanner, not only between policy, research, and practice, but also between the different disciplines. It can easily use its network to collect information from different countries on policy, practice, or research.
If our European Public Health community agrees on these principles and statements we can start to make concerted efforts to overcome the health challenges of the present and the future.
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Acknowledgments |
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The project could not been implemented without the precious work of Dineeke Zeegers, to her goes my personal and EUPHA acknowledgements.
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