[Comment] Achieving a healthy lifestyle - you shouldn't be alone
LARA GARRIDO-HERRERO
06.06.2006 @ 10:01 CET
EUOBSERVER / COMMENT - Traditionally, we were told that if we ate well, exercised, drunk less alcohol and didn't smoke we would achieve a healthy and balanced life. But the evidence shows that if you want to be healthy throughout your life, this is what you must do: be rich, pick your parents well, get educated, live in supportive, safe communities, live in quality housing and do not lose your job.
The EU should increase financial support for healthy food, including an increased availability of fruit and vegetables (Photo: Fabrizio Federici)
In Europe, the majority of deaths are due to chronic diseases (i.e. cardiovascular disease, cancer, chronic respiratory diseases, diabetes, nutritional deficiencies). According to the World Health Organization, the causes of chronic diseases are largely preventable and well known.
The most important risk factors are the socioeconomic determinants: the social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food and transport. Adding to that, the absence of preventive actions and of equitable access to health care are much more conducive to chronic diseases than the question of individual responsibility.
Is there much choice?
Diet plays an extremely important role in health yet many Europeans do not have the opportunity to eat well. The World Health Organization says that the lack of a safe healthy diet (called "food inequity") may be responsible for over 1 million deaths yearly 14% of all deaths) in its European region.
The European Common Agricultural Policy (CAP) should be reformed so that safe, healthy food as a human right is the objective. The EU should increase financial support to healthy consumption and production, including an increased availability of fruits and vegetables.
Changes in housing policies would also save lives. The homeless risk freezing as they sleep on the streets of European cities while poor old people die in their own homes because they cannot afford adequate heating. One housing initiative might involve renovating accommodation to reduce heating costs.
Traditional approaches to health promotion, such as simply providing health information, fail to make a major impact on reducing health inequalities. This is because providing health information tends to benefit the wealthy more than the poor.
It is also because health messages about exercise, for example, will not be effective if parks and sports grounds are not accessible and if bicycle lanes do not exist.
Individuals have little choice for a healthy lifestyle if the environment in which the individual lives does not offer the choice. There has to be an emphasis on empowering individuals to make lifestyle choices and changes in their lives. Welfare policies need to provide not only safety nets but springboards to offset earlier disadvantage.
Part of the environment we live in, specially children, is shaped by the voice of powerful corporations, present in TV, internet, mobile phones, cinema and outdoor advertisement. Today, most of the food marketed to children is categorized as 'unhealthy': high in salt, sugar or fat and low in essential nutrients.
Large sums of money are spent on marketing these products to children, using a range of creative approaches including links with cartoon characters. Worst of all, schools are becoming marketing channels for food advertising: it is obvious that the commercial pressure has gone too far. It is not fair to ask individuals alone to stand against the pressure of commercial interests, public authorities must protect citizens and ensure that there is fair play.
Other policies can help
Health promotion should be used to reduce health inequalities. Measures proposed include developing national health inequality targets, working at the local level, reducing barriers in access to health services, and integrating health determinants into other policy areas.
All of these are vital and the emphasis given to working with other policy areas is particularly important. In this regard, the incoming Finnish Presidency has included as one of their priorities "health in other policies."
Working alone, the health sector can do little to reduce inequalities in illness, injury and life expectancy. Working with fiscal, education, agriculture, housing, social and external policies, a great deal could - and should - be done to ensure that everyone benefits from the aspirations of the "European social model."
However, this social model might be changing. Lately, the Lisbon Strategy has focused so much on getting the European Union's economy to be the most competitive that it might have forgotten about the environmental and social components.
The major challenge for the health community is therefore to ensure that the Lisbon Strategy and its drive towards less regulation, reducing red tape for business and competitiveness does not come at the expense of public health concerns.
The author is secretary general of the European Public Health Alliance