Ávarp flutt á málstofunni „Betra líf með heilbrigðum lífsstíl“
sem haldin var af Norrænu nýsköpunarmiðstöðinni og Norrænu ráðherranefndinni á
Hótel Hilton Nordica í Reykjavík þann 18. mars 2009
A better life through healthier choices
Dear Distinguished Guests
I would like to welcome you all to Iceland.
I hope you had a pleasant trip and are feeling well and ready for a good day’s seminar.
It is an honour for me to stand here in front of you and open this seminar on choice. Yes choice, a healthier choice towards a better life. The focus of this seminar is on the dichotomous relationship between the determinants of health and the consequences of ill health. How can we get people to want, what we want them to want, in order to make our societies healthier? How do we shape to the best of our abilities the public’s choice and make those choices as healthy as possible? Let me come back to choice later.
Health is a complicated state to define and at the same time a state of ever dynamic and changing nature. Public health is most often defined as both the science and the art in preventing disease, promoting health and prolonging life. Public health is largely based on how we as individuals and communities behave, function and act. But as well on how societies take care of their citizens what support they provide and what sort of policies govern. The focus of this seminar is on diet and physical activity and how, through public policies and civil actions we positively affect people’s well-being. The World Health Organization (WHO) has underlined the seriousness of the problem of an unhealthy diet, physical inactivity, and overweight at the global and European level. Projections made by WHO point to a major increase in the next years in mortality due to chronic non-communicable diseases. An unhealthy diet, physical inactivity, and overweight are among the most important underlying determinants behind this trend. WHO therefore recommends the development of governmental strategies and policies on the promotion of a healthy diet and physical activity and the prevention of overweight and obesity.
The ambitions of the Nordic council of ministers in these matters were stated in a council action plan in 2006 named: “Health, food and physical activity”. The ambitions concerned improvement of diet, increased physical activity, reduction of citizens burdened with overweight and a low tolerance for social inequality in health related to diet and physical activity. Promoting a healthy diet and physical activity and preventing overweight are our collective responsibility. If we are to make progress in reducing the number of overweight individuals and at the same time increasing their well-being it is obvious that a large number of sectors and stakeholders must be involved at all levels of society. We, the Nordic countries favour such a horizontal, multi-sectoral approach. It is an ideology growing out of the tree of our Nordic equalitarianism.
The Nordic council of ministers agreed on following three common areas in effort to reach earlier stated ambitions:
1) To enable children and youth to make healthier choices and to protect them form environments that encourages unhealthy choices,
2) To make healthier choices easier for all, and
3) To use targeted action to reach groups of vulnerability and risk.
Then the intentions were to monitor our actions and results and share best practices. Have we managed this? Have we managed to focus our national public health polices and their implementation around these three common areas?
I can only speak for Iceland and would like to state that we have been working toward a national public health policy, focusing on causal factors. An action plan was presented late last year focusing on nutrition, exercise, mental health promotion and general health promotive actions.
Are these the areas we should in current times focus on when it comes to public health? I ask myself these questions given the state of anomie and social changes we in Iceland seem to be going through right now. Although I am being told by experts that it is important to keep on promoting health through the usual means I somehow wonder if we shouldn’t turn to more basic methods. Meaning that on the macro scale that we should turn from the strategy of less governmental intervention is best, toward more state regulated basic public health policy intervention.
On that note let me go back to choices, it is rather strange to stand here to talk about choices in these times we now life in the world where our choices are limited by the day due to the economic recession that we are now experiencing. We are moving from times of abundance towards times of more moderation and even shortage. We now are forced to link our material longings more and more to our basic needs rather than our wants like before. Times like these are challenging and at the same time interesting for public health. It is my predictions that we in the western world soon might see less lifestyle related public health problems but at the same time more real life related public health problems, including an increase in mental health problems.
It is in the realm of politicians to take decisions concerning public good. Common - good, in common-unities, communities. We, elected politicians are the servants of the public and the laws, regulations and rules we pass as well as our actions have health determining affects. It is our democratic mandate to serve and direct our societies. Every decision we take and law we pass affects publics well being, and public health. The question in the end is a dichotomous one: “Where lies the balance between shaping public health and letting the public shape their own health”. Or, in other words how much control and how much choice.
I am convinced that if that choice is shaped through soft power, directing people through policies rather than instructing them by hard power we shall see better public health results in our societies. Nevertheless given our situation and the spirit of our time I have to say that a combination of choice and a certain degree of control seems to be wise for the future.
I hope I have provoked your minds for future debate on public health during the day.
I announce this seminar open.
(Talað orð gildir)