Greater policy orientation for promoting health and welfare

"Finnish health policy-making is supported by an extensive knowledge base and high level of expertise in epidemiology. We also know a lot about the sorts of measures and policies that would produce better health and health equality," explains Ministry for Social Affairs and Health ministerial advisor Eeva Ollila.

In Finland the aim of integrating perspectives on health and welfare into social policy is generally recognised. But realising this requires more sensitivity towards policy trends and existing the political and economic context than is now the case.

"We need to better understand what politicians and other policy makers think and what kinds of approaches are feasible for a given moment," Ollila explains. "We should also be better equipped to anticipate future developments and influence them at the right time." Eeva Ollila believes that this requires the health sector to be better acquainted with planning in other sectors.

A boost in this direction may come with the 8 th Global Conference on Health Promotion (8GCHP), which will take place in Helsinki on 10-14 June under the auspices of the World Health Organization and the MSAH. The 1 st  global conference was held in 1986, in Ottawa, the global conference issued the Ottawa Charter for Health Promotion, which soon became a cornerstone in policy work on health promotion.

The main theme of the 8GCHP is Health in All Policies (HiAP), a topic that at EU level was advanced during the Finnish EU Presidency in 2006. In 2010 in Adelaide, Australia, a WHO international conference on HiAP issued the Adelaide Statement. The statement was titled ‘moving towards a shared governance for health and welfare.'

One of the key aims of Health in All Policies, both in Finland and internationally is to ensure that there is adequate consideration of the potential health and health equity implications of policies across all areas of society.

 "The government programme given by the government when it takes office is one obvious starting point in the search for policy development in which health, welfare and equity perspectives should be included in the forthcoming preparations. It is also important to follow international developments, as most of our legislation is done within the EU."

The current government programme states that welfare and health promotion, and reducing inequality will be will be taken into account in all societal decision-making, and incorporated into

the activities of all administrative sectors and ministries. This is currently being considered in preparing the strategic work of the Advisory Board for Public Health.

In trans-sectoral advocacy work it is essential to know how and when to deal with issues in different situations. "The standpoints of welfare, health and equity should optimally be raised at the earliest possible stage. Often we also need to select the most pressing issues that we should and can influence. There is so much to be done that we have to set priorities."

It is also important to recognise that health and health efforts for improved equity also promote the achievement of other societal goals.  "During this government term we've considered such things as how we can best support the aims of the government programme of prolonging working life or preventing social exclusion among young people by our efforts to promote health and prevent and cure health problems."

Eeva Ollila hopes that the global conference will spur developments in HiAP both in Finland and internationally, and provide a measure of successes achieved and yet to happen.

The HiAP approach has increasingly been seen as a key approach to improving health and health equity and to pinpointing the social determinants of health. But there remain significant challenges over applying HiAP in practice.

With this in mind, the main emphasis of the 8GCHP in Helsinki will focus on the "how to" approach in order to make health and welfare palpable features of policy-making.

 "I think that the Conference will strengthen our work. The conference will provide us with a perfect opportunity to exchange experiences in incorporating health and health equity into societal policies.  We have reason to be proud of what we have achieved, even though there is an enormous amount of work still to be done."

"On the international level, it may for instance strengthen the WHO's cooperation with other UN agencies. The WHO might get more support for its activities on giving guidance for the health authorities in member states by producing up-to-date analyses of the potential health impacts of various global agendas, such as trade and investment agreements."

Within EU policy, Ollila thinks it is important that well-being, health and equity perspectives are integrated into the positions prepared by the various sectoral ministries at national level, even if they may not be easily integrated in the EU policies in practice.

"For instance, agriculture, together with the nutrition and alcohol policies that go with it, is still very disconnected from health issues. The same goes for industrial and trade policy."

Paula Mannonen and Mark Waller