EG on SIHLWA

8th meeting

7-9 October 2009

Riga, Latvia

Title / SIHLWA-8 Meeting report DRAFT
Submitted by / SIHLWA Coordinating Chair and ITA
Summary / Note / This document recalls the main discussion points and decisions made during the SIHLWA-8 plenary meeting and the four subgroup meetings. The subgroup meeting reports can be found in the end of this document as follows:
- Report of subgroup on adolescent health and socially-rewarding lifestyles [ADO] – page 10
- Report of subgroup on alcohol [ALC] – page 18
- Report of subgroup on indigenous mental health, addictions and parenting [IMHAP] – page 25
- Report of the 15th Annual meeting of the Baltic Sea Network on Occupational Safety and Health/ subgroup on occupational safety and health [BSN/OSH] – page 27
List of Annexes / The following annexes are compiled to a separate document which (as well as the annexes themselves) can be found on the SIHLWA-8 meeting page
http://www.ndphs.org/?mtgs,sihlwa_8__riga
Annex 1 – Scope and purpose of 8th SIHLWA meeting
Annex 2 – Agenda of the meeting
Annex 3 – Programmes of the meeting (overall programme and the subgroup programmes)
Annex 4 – List of participants
Annex 5 – Evaluation summary of the meeting
Annex 6 – List of meeting documents

SIHLWA-8 MEETING REPORT

7 October, 2009

1. Opening of the meeting and welcome

The coordinating chair of SIHLWA Expert Group, Mikko Vienonen opened the meeting and noted with satisfaction the wide participation and how good it felt to have all the four SIHLWA subgroups present and having the Baltic Sea Network on Occupational Safety and Health keeping its 15th annual meeting at the same time.

Ms Inga Šmate, Head of Health Policy Planning Department; Ministry of Health welcomed the participants on behalf of the minister of health of Latvia. Latvia has been implementing major health care reforms in the previous decades. Promoting healthy lifestyles and reducing people’s risk behaviour is an essential focus area. Health status and healthy life expectancy depend greatly on the values prevalent in society, and people have still not become accustomed to thinking about and caring for their health while leading their daily lives. Prompt policy action is therefore needed to improve people’s quality of life, prolong their healthy life-span and contribute to higher productivity. We believe in the success of a close cooperation between countries in setting out priorities and activities for reducing public health problems in Baltic Sea Region.

Professor Maja Eglite welcomed the participants on behalf of the Stradins University, the alma mater for over 2000 students, among them many foreigners from different parts of the world. Riga Stradins University gained its status in year 2002, however its historical roots extend to Riga Medical Institute founded in year 1950 on the basis of Latvia State University Faculty of Medicine and in year 1990 renamed as Medical Academy of Latvia. The Latvia’s most eminent practitioners of medicine working in various spheres are educated at this university.

Introduction tour of all participants was held. Together with the participants of the 15th Annual meeting of the Baltic Sea Network on Occupational Safety and Health the meeting gathered 63 participants (of which ADO - 8, ALC - 9, IMHAP - 8, BSN/OSH - 33, others - 5; see the Participant list, Annex 4).

The chair conveyed regrets from NDPHS secretariat which, due to an intensive work period (The Committee of Senior Representatives 16th meeting due in Riga as well next week), couldn't send a representative to the meeting this time. This means that SIHLWA coordinating chair needs at times to take a double role when conveying various messages from NDPHS side and trying to reflect to them from SIHLWA's point of view as well.

2. Proceedings of the meeting

The agenda of the meeting was adopted (ANNEX 2).

SIHLWA ITA Hanna Koppelomäki and OSH member Truls Johannessen were chosen as rapporteurs of the meeting. It was reminded that the sub-groups were to nominate their own meeting chairs and rapporteur(s) for their session.

It was noted that all meeting documents can be found in web at http://www.ndphs.org/?mtgs,sihlwa_8__riga. The additional information material distributed during the meeting would also be available in web, as well as the meeting presentations (List of meeting documents, Annex 6)

The SIHLWA-7 meeting (4-5 May 2009, Östersund) report was presented shortly, and it was agreed that if no further comments or amendments would be made in two weeks time, the report would be approved by silent procedure. (The final report can be found at http://www.ndphs.org/?mtgs,sihlwa_7__ostersund )

3. Key-note presentation: Public Health in Latvia

The key-note presentation was given by Ms. Ilze Straume, Head of the Division of Intersectoral Cooperation, Department of Health Policy Planning, Ministry of Health, who presented some recent statistics e.g. on the causes of death, life expectancy and some health related trends in Latvia[1].

She concluded that interaction between health and life conditions is reciprocal — poor life conditions often have a negative impact on health and, conversely, poor health may worsen life conditions. Social and economic problems, inequality, poverty and social exclusion are preconditions for poor health. These factors are often related to higher rates of smoking, alcohol and drug consumption, depression, suicides, antisocial behavior and violence, numerous health problems and heavily decreased life expectancy in all age groups.

The economic crisis has influenced choice of strategies and now one has to focus on several new sectors for improvement. A New Public Health Strategy 2011-2017 is under preparation, and among its main goals are to achieve improvement of the health status of the population of Latvia, to decrease the gender gap and social inequality between men and women and to improve lifestyle habits of the population

4. Short information report of the subgroups

The chairs of the four subgroups each gave a short presentation on the situation in their field of work.

4.1. BSN-OSH - Wiking Husberg[2]:

There are three main action lines for the Occupational Safety and Health (OSH) subgroup:

- Baltic Sea Network on Occupational Safety and Health, now holding its 15th annual meeting.

- Developing the National OSH System and Improving Health and Preventing Accidents in the High-risk Sectors in North-West Russia project (FIOH as main project implementer)

- ILO North-West Russia OSH project: Developing and implementing Occupational Safety and health system in North-West region of Russian Federation to provide Decent and Safe work – 3rd phase (2010-2011). Both these projects are targeted in N-W Russia - nevertheless, there are needs in the other countries of the area to intensify the work, and one should be prepared to work towards new funding opportunities e.g. from the EU.

Mr. Husberg reminded of the “Health at Work” Strategy, adopted at the NDPHS Annual Conference in 2007, and which is based on WHO, ILO and EU OSH strategies - this has been a good example of how to use SIHLWA/NDPHS as a political platform to further promote important goals. From BSN point of view SIHLWA and NDPHS can be seen as a political tool for advocacy and information sharing.

Except for strengthening collaboration with NDPHS, other action priorities for the ongoing BSN work plan include situation analysis of OSH in the BSN countries: each country continues developing and updating their profile, updating BSN webpages at http://www.balticseaosh.net/ and publishing the Barents Newsletter.

4.2. Subgroup on Alcohol:

Lars Møller of WHO-Euro, who was to chair this Alcohol subgroup meeting, gave a presentation[3] on the recent trends of alcohol consumption in European countries and plans and actions of WHO in this regard.

Alcohol is among the leading risk factors as causes of disease burden all over the world. About 25% of the difference in life expectancy between the EU10 and the EU15 for men aged 20-64 years in 2002 can be attributed to alcohol. WHO is just preparing country profiles on alcohol consumption harm and policies for 45 European region countries, and the Global alcohol strategy to reduce harmful use of alcohol is under preparation and planned to be adopted at the World Health Assembly, May 2010.

Mr. Møller also reminded of two fresh publications by WHO-Euro, released for the EU Alcohol Conference this September, namely: Handbook for action to reduce alcohol-related harm and Evidence for the effectiveness and cost-effectiveness of interventions to reduce alcohol-related harm. He also mentioned the new European Information System on Alcohol and Health that will go live in April 2010. Data will also be used for a European Alcohol Status Report to be published in April/May 2010.

Pi Högberg, who chaired the last ALC meeting, gave an overview of what's been done since the last meeting in Östersund May 2009:

- The ALC group compiled information and prepared an overview of EIBI implementation in ND countries. On the basis of the overview, a NDPHS fact sheet 1/2009 "Early Identification and Brief Intervention on hazardous and harmful alcohol consumption in the Baltic Sea Region" (available at http://www.ndphs.org/?folder_and_factsheets in English, Russian and Polish) and a poster with the same title were produced for the EU Alcohol conference in Stockholm 21-22 September.

- Participation of the group members in the above mentioned EU Alcohol conference in Stockholm 21-22 September and the Global Alcohol conference 23 September.

- ALC group offered a suggestion for a text to be taken into consideration when preparing the Oslo declaration on Prison Health.

- The discussion on scaling up the social component is also continuing.

4.3. IMHAP (Indigenous Mental Health, Addictions and Parenting)

Chair of the group, Eric Costen said it was very impressive to listen to the achievements of the other subgroups. The IMHAP group is only taking its first steps and the existence itself can be seen as the greatest accomplishment this far. The Nordic Council of Ministers has expressed willingness to co-chair the IMHAP group (Canada being the lead partner). Following the official establishment of IMHAP by the Committee of Senior Representatives in October 2009, IMHAP membership will be formalized. Now it is important to make up an achievable work plan for the next 6 moths and to continue to develop the network of actors in the field of indigenous health and wellbeing.

4.4. ADO

The co-chair of the group, Aldona Jociute gave a presentation[4] on the Better Schools Through Health: The Third European Conference On Health Promoting Schools held in Vilnius, Lithuania 15-17 June, 2009. The general objective is to invest in school health promotion in Europe by common action across sectors and across boarders.

The chair of ADO, Mikko Vienonen combined his presentation on ADO sub-group's latest developments with the overall SIHLWA timely common issues presentation (see agenda item 6. for details).

5. SIHLWA North-West Russia Stakeholder Analysis - Conclusions and comments

Mr Dmitry Titkov, project manager at the National Institute for Health and Welfare (THL, Finland), gave a presentation on the conclusions and comments of the SIHLWA North-West Russia Stakeholder Analysis[5]

The study's purpose has been to provide up-to-date info about key stakeholders/expert organisations/other actors within the project area related to alcohol, adolescent health and socially rewarding lifestyles, (and updated info on workability), to identify most crucial programmes/projects related to these areas to improve networking and exchange of data and know-how and to take up ideas for further co-operation.

The results show that the issues were relevant for the studied regions; health and lifestyle are among the greatest problems in the area. Healthy lifestyles-related questions are fragmented in federal and regional laws. No special laws about health promotion or healthy lifestyles. Youth laws are available at regional level. At federal level a bill has been prepared. Relevant strategies and policies at federal and regional level are available, but for healthy lifestyles in the conceptual format mainly. Certain risk factors or aspects of healthy lifestyles are present in different policies and strategies. Youth strategies and policies are present at federal and regional levels.

The idea is that the Stakeholder analysis template could be used for other regions and themes by SIHLWA experts.

6. SIHLWA administrative and other timely NDPHS issues

The coordinating chair of SIHLWA, Mikko Vienonen gave an introductory presentation[6] on SIHLWA's present state, leadership, action summary for the year 2009 this far, and, most importantly the NDPHS Strategy Working Group's report and recommendations for the Committee of Senior Representatives of NDPHS - Actions proposed as the follow-up of the NDPHS evaluation of 2008.

The SWG report (which is going to be officially presented to the CSR at its 16th meeting, i.e. the following week after SIHLWA-8) proposes that the NDPHS goals and operational targets for thematic areas be closely aligned with the EU Strategy for the Baltic Sea Region.

The report further suggests goals, operational targets and indicators for thematic areas, of which especially five goals under "Thematic area 4: Lifestyle-related non-communicable diseases and good social and work environments" can be seen to link strongly with SIHLWA's scope and activities:

Goal 7: The impact in the ND countries on society and individuals of hazardous and harmful use of alcohol and illicit drugs is reduced

Goal 8: Pricing, access to and advertising of alcoholic beverages is changed to direction, which supports the reduction of hazardous and harmful use of alcohol

Goal 9: Tobacco smoking is minimized and, where possible, prevented in the ND area.

Goal 10: The NDPHS Strategy on Health at Work is implemented in the ND area

Goal 11: Public health and social well-being among indigenous peoples in the ND area is improved

The list of materials and further information links related to the NDPHS Strategy Working Group Report and the EU Strategy for the Baltic Sea Region can be found as a separate event document (ref. SIHLWA 8/6).

The sub-groups were tasked to further elaborate on the following issues (related documents to each item can be found among the meeting materials on http://www.ndphs.org/?mtgs,sihlwa_8__riga ):

1.  SIHLWA 2009 draft Annual Report

2.  For Information and discussion draft report of NDPHS Strategic Working Group Report (follow-up of NDPHS external evaluation report 2008)

3.  Start-up discussion of SIHLWA Action Plan 2010 (- > 2013) based on past experiences and new challenges coming from the NDP-SWG report.