Læknablaðið - 15.02.1985, Blaðsíða 50

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LÆKNABLADID
from diseases of the circulatory system by at least 15%
and from cancer by at least 15%.
The next three chapters deal with the three major
categories of change that can bring about such
improvements in the health of the European peoples,
such as changes in lifestyle (Chapter 3), in the
environment (Chapter 4) and in the care system
(Chapter 5).
The starting point in changing lifestyles (Chapter 3) is
to recognise that to a considerable extent health is
dependent on the political, social, cultural, economic
and physical environment. The first aim is therefore to
provide opportunities and develop capacities for
adopting healthy lifestyles by formulating general
policies that are consistent with the requirements of
health promotion and protection, so that healthy
lifestyles become the easiest choice. The second aim is to
strengthen and develop caring interpersonal and family
relationships that help protect health. The third aim is
to increase the interest of individuals, groups and
communities in actively promoting their own health
and wellbeing and that of others. More specifically, this
chapter proposes targets aimed at promoting positive
types of behaviour, such as nonsmoking, balanced
eating and physical activity, and reducing health-
damaging behaviour such as alcoholism, drug abuse
and violence.
In Chapter 4, on the environment, specific targets are
set for reducing water, air and food pollution,
hazardous wastes and risks in human settlements and in
the working environment. A significant reduction in
these risks will depend partly on adequate machinery to
monitor, assess and control environmental hazards,
partly on community awareness and involvement and
partly on effective international action.
Chapter 5, on appropriate care, lays stress on
primary health care, to which secondary and tertiary
care provide crucial support. This is the key to greater
equity, to prevention and to health promotion as well as
to the provision of adequate treatment and rehabilita-
tion services to meet the basic health needs of the
population. The targets call for a rational distribution,
based on need, of health care resources, for coopera-
tion between health personnel, individuals, families
and community groups, and for coordination at the
community level of all activities relevant to health. The
need for systematic assessment of the quality of care is
stressed.
The last two chapters set forth the measures needed to
support health development. Chapter 6 deals with
directing research strategies towards giving effective
support to the attainment of health for all targets, and
with the need to coordinate efforts in planning and
carrying out this reorientation of research. Chapter 7
stresses that important prerequisites for national and
regional health development are a strong political
commitment, efficient management, supported by a
good information system, that will turn health policies
into effective health programmes, adequate planning
of manpower requirements and national education and
use of health personnel, the provision of information
and education on matters connected with health for
personnel in sectors that have an impact on health and
the systematic assessment of health technology.
4. Priorities
The document specifies 38 targets, the relative impor-
tance of which will vary from country to country.
Different countries will thus need to choose on the basis
of their local situation what importance to attach to
particular types of action in contributing to an
improvement in their own health as well as to the efforts
of the Region as a whole. There are targets for health
improvement, targets for activities needed to bring
them about and targets designed to promote implemen-
tation of the whole strategy.
In matters concerning the Region as a whole, priority
will be given to major health problems, in the case of
which a sufficient amount of knowledge is available
about ways and means of achieving a change for the
better, and in respect of which the necessary political
drive for action will be forthcoming; typical examples
are a reduction of infant mortality or of accidents
related to work. Other major health problems, about
which too little is known as yet for scientifically based
action to be recommended, will become priority areas
for research. Typical examples can be found in the field
of positive health behaviour. It is a special responsibili-
ty of the Region to promote and coordinate concerted
action on problems which cannot be solved by
individual countries alone. Examples of this are
transfrontier air pollution and efforts to change
important aspects of lifestyles by means of long-term
educational campaigns waged jointly by several coun-
tries with a view to popularizing health-promoting
types of behaviour, such as nonsmoking.
The national priorities set will depend heavily on the
basic political and cultural characteristics of the
country concerned. The following paragraphs, there-
fore, can only give a general idea of the way priorities
can be selected in groups of countries or areas within'
countries, since only an individual country can analyse
its own priorities.
4.1. PRIORITIES IN LAUNCHING ACTIVITIES
AT THE NATIONAL LEVEL
In countries where this has not already been done, the
first priority must be to bring national health policy
closer to health for all principles, and then to develop a
national strategy setting out the major directions of
change and how the change is to be brought about. At
an early stage, it will be essential to determine what
information is available so that steps can be taken fo fill
any important gaps. Special importance is attached to
information on environmental risks and lifestyles,
especially if it helps to determine what groups are
particular at risk. The education, training and retrain-
ing of health personnel will also require early attention.
4.2. PRIORITIES IN HEALTH DEVELOPMENT
A central aim must obviously be to ensure greater social
equity by reducing poverty in its widest sense, by
securing the basic requirements for health — food,
water, sanitation, education and decent housing for
everybody — and by ensuring that everybody has access
to primary health care. Major health improvements
could also be achieved through specific programmes
such as immunization. A major political challenge is to