Public Health in the Netherlands Marieke van der

Public Health in the Netherlands Marieke van der Waal, Executive Director Netherlands Public Health Federation

Public Health in The Netherlands • • Country facts Public Health Facts Public Health System Netherlands Public Health Federation

The Netherlands (facts) • • • 41. 526 km 2 (1, 2 times smaller than Slovak) 300 km long and 200 km wide 16. 2 million inhabitants (Slovak: 5, 4 million) 8. 0 million ♂ and 8. 2 million ♀ 483 municipalities

Population density

Death and its main cause • 141. 936 people died (2003) • 62% died on Cardiovascular Diseases - Cancer • Life expectancy at birth: ♀ 80. 7 years and ♂ 76. 0 years (2002) Absolute numbers: Cardiovascular diseases (46. 942) Cancer (39. 867) Infectious diseases (1. 892) Problems at pregnancy/birth (8) • Perinatal Mortality (≥ 24 weeks) 8. 8 per 1000 births

Avoidable causes of Death (1) Smoking: 15%

Avoidable causes of Death (2) Overweight and Obesity: 6%

Avoidable causes of Death (3) High Blood Pressure: 6%

Avoidable causes of Death (4) Not enough exercise: 6%

Avoidable causes of Death (5) Saturated fatty acids: 5%

Avoidable causes of Death (6) Eating not enough vegetables and fruits: 5%

Other problems that effects your chances on an early death • • • Social inequalities: education and income Deprived area’s in large cities Environmental factors Type of work Ethnicity

Unfortunately Once in a lifetime you have to die

Our wishes • • We like to get as old as possible We don’t like to get a disease We like to die in our sleep We don’t want to die because of war, anthrax, smallpox's, BSE, chickenpox’s • We don’t want to die because of water/air/soil pollution

How to full fill our wishes • Individual: live healthy and make the healthy choice • Local level: safe roads, vaccinations, health education • (Regional level: safe drinking water, safe roads, safe dikes) • National level: acts (tobacco smoking, collective prevention etc), screening programs

National Public Health System (1) Ø Minister of Health and his ministry Ø Health Care and Protection Inspectorate Ø Advisory councils (research, policymaking, infectious diseases, food safety) Ø National NGO’s (Health Promotion and Education, Food, Consumer Safety) Ø Associations of Community Services, Professional Workers, Municipalities Ø School of Public Health Ø Research institutes / universities

National Level: Ministry of Health

Ministry of Health • Acts on tobacco control, collective prevention, food safety etc. • National Screening Programmes • National Vaccination Programmes • Public Health Policy Document • Based on Public Health Forecast of RIVM (Friday) • Intersectional policy making

Public Health System Local level or the Municipality (1) Involved are: Ø 483 Majors and alderman of health Ø 40 Community services and there professionals Ø Home care organisations Ø (Local Health Care Professionals like GP’s, dentists, physiotherapists etc)

National Vaccination campaign Meningitis C: local implementation

Local Public Health System (2) Ø Implementation of Law on Collective Prevention (major revision in 2003) • • • Local public health policy document Epidemiology Preventive Health Care for 0 -18 year old children Vaccination (influenza, meningitis, DTKP) Health promotion and education Stimulation of cooperation between public health workers and curative professionals Screening of breast cancer, cervix cancer, PKU & CHT (baby’s) Mental health Diminish social inequalities Infrastructure and environment

Financing Public Health System • Tax (raised on national and local level) • General Exeptional Medical Expenses Act (AWBZ)

Public Health in the Netherlands • Shared responsibility of national and local government • Many different organisations involved • Lack of coordination within knowledge transfer • Quality and Quantity of Public Health Workers is not guaranteed

Netherlands Public Health Federation • Founded in 2000 • 34 members: → 14 associations of public health workers → 20 public health institutes • Six board members • Two employees • Annual budget 2004 approx € 150. 000, -

President of the NPHF

Goals NPHF • Lobbying and influencing politics • More money and attention for Public Health issues • Sharing information and knowledge • Improving Public Health System

Activities • Public Health policy program • Press releases on policy documents of National Government • Advising Ministry of Health • Organising conferences, lectures and workshops • EUPHA project (SAVEZ) • Public Health Magazine • Fundraising • Website

NPHF desk at 2 -day conference

Money from fundraising • Empowerment of public health system (World Health Day, Week of the Public Health, Two-day National Conference on Public Health) • Manpower Planning • Incorporating Public Health Activities in Curative Settings • Improving Knowledge Transfer

Thank you for your attention!