MALMÖ S PUBLIC HEALTH POLICY. Adopted by the City Council on - PDF

MALMÖ S PUBLIC HEALTH POLICY Adopted by the City Council on A public health policy Malmö is growing. The population has increased for the twentyfourth year in a row. Malmö is changing, and it

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MALMÖ S PUBLIC HEALTH POLICY Adopted by the City Council on A public health policy Malmö is growing. The population has increased for the twentyfourth year in a row. Malmö is changing, and it is a rapid change. The Öresunds Bridge, Malmö University, Turning Torso, Malmö Arena, Västra Hamnen, Nya Hamnen and the City Tunnel are seven examples of the rate of change and the determination present in Malmö. These buildings and the new contexts they have created were not present 10 years ago. It is possible to influence the future and Malmö s development from an industrial city to a knowledge city and its ability for ecological adaptation is proof of that. Political decisions affect how Malmö develops, both in how the city grows physically and the living conditions the Malmö citizens have in order to lead a good life. Today, nearly people live in Malmö, and a big part of the population is young. Not everyone is involved in Malmö s journey toward the future. There are Malmö citizens that lack important health requirements, such as education, work, housing, economy and social context. Malmö s public health policy focuses on the structural requirements for health and the challenge to reach the overall, national public health objective: Creating social conditions for good health on equal terms. With the determination that exists in Malmö, with the emergence of seven new Malmö landmarks and the ecological adaptation to name a few examples, there is a capacity for improving living conditions for all Malmö citizens, towards the vision in the Malmö public health policy. The city s work needs to be directed at creating a sustainable city from all aspects. Environmental, economical and social sustainability needs to be integrated to strengthen each other mutually. That means focusing on the social sustainability dimension so that Malmö can keep on growing to become a sustainable city. The policy is a guiding principle for that work. The welfare report shows that levels of health generally have improved. On the other hand, the distribution of good health has not improved, in fact it has become worse. Health requirements can be influenced as they are based on the conditions which people grow up in, live and age in, and in the healthcare systems we use to handle illnesses. 2 Invest in public health Public health acts an expression of a population s health and includes both levels and distribution of health. Public health work is long-term work, which aims at creating requirements for living conditions which promote health and prevents ill-health. The starting point of the City of Malmö s public health work is the comprehensive public health objective creating social conditions for good health on equal terms, and the eleven prioritised objective areas which have been laid down by the Swedish Parliament. 1 Participation and influence in society 2 Economic and social prerequisites 3 Conditions during childhood and adolescence 4 Health in working life 5 Environments and products 6 Health promoting health services 7 Protection against communicable diseases 8 Sexuality and reproductive health 9 Physical activity 10 Eating habits and food 11 Tobacco, alcohol, illicit drugs, doping and gambling Read more on page 7. The City of Malmö s public health work The eleven objective areas include both living conditions and life style issues. Today there are about 40 policy papers (strategies, policies, action plans) in the City of Malmö. Many different operations within the municipality share the responsibility of realising and following up this work. There is no need for any more policy papers, but rather some new objectives, activities and follow-ups that can deal with the challenges Malmö is facing. Since the public health situation in Malmö when it comes to distribution of health is not getting any better, we need to focus on this present policy paper and future public health work. The existing policy papers which have been approved by the City Executive Board and/or City Council, and which affect the eleven national public health areas, should be the objects for continuous follow-up. The welfare report with about 40 indicators describing public health and welfare development is put together annually. This is the basis for analysis resulting in suggestions for development areas. These suggestions are taken into consideration during planning of which the budget process also is an important part. Every year Annual accounts/ Annual fiscal statement Welfare report Analysis of the public health and welfare situation and suggestions for priorities of objectives/areas Budget processing Prioritised areas Budget resolution in the City Executive Board Budget resolution in the City Council Budget and objectives/goals to the committees Every other year Mapping and follow-up of the municipality s different policy documents (strategies, policies, plans) which affect the eleven national public health objective areas. Suggest possible changes. Malmö s public health policy workflow 3 Vision Malmö s public health policy Our vision is that all Malmö citizens should have the social conditions for good health on equal terms. Being in good health is at the core of people s lives. If there are more Malmö citizens who feel good and are healthy, and if welfare is more equally divided, then we will have better and more long-term growth and a thriving region. Positive development of public health in Malmö is a prerequisite for a sustainable city in the long-run. Purpose The policy states direction, value and attitude towards public health work and should be a guiding principle for steering and realising activities which promote prerequisites for good health on equal terms. Value The policy s value rests on the UN declaration of human rights and the national public health objective creating social conditions for good health on equal terms for the whole population irrespective of sex, transgender identity or expression, ethnicity, religion or other beliefs, disability, sexual orientation or age. In these values the concept of empowerment is also present. The foundation is to promote the individual person s interests, responsibilities and opportunities to deal with their own health. Limitation The policy includes the margin for manoeuvre which the City of Malmö has to achieve better public health for Malmö citizens. In several respects it is actors other than the City of Malmö who can influence public health development, and decisions are made beyond the municipal level. For instance, it is a matter of national labour market policy actions, social security systems, healthcare etc. The public health policy can also be a guiding principle for collaboration with other actors. 4 Six principles for public health work in the City of Malmö To realise the vision of Malmö s public health policy there is a need for action on several levels. 1 Systematic public health work Public health work is part of social planning and should, as far as possible, be part of regular work. The systematic work includes the welfare report, analysis and suggestions for prioritised areas/objectives in the budget preparation work, as well as continuous follow-up of all the municipality s policy papers regarding the eleven national public health areas. If the development of a public health area goes wrong it should be stopped. 4 Quality and innovation The City of Malmö is a learning organisation. The organisation needs continuous updates of new knowledge regarding methods of promotion and prevention. In the City of Malmö we should, as far as possible, use cost efficient and evidence based methods, but we should also find new innovative ways to influence health development. Collaboration and cross-border leadership can generate creative and innovative solutions to the challenges of public health. 2 3 Better analysis why does it look the way it does? We do not necessarily need more knowledge about the health situation, but rather knowledge about why the situation is as it is and what consequences it will have, both when it comes to health and economy. It is about measuring and understanding the problem with equality in health and assessing the effects of different actions. The analysis generates suggestions for priorities and actions. Prioritise Public health work is everybody s responsibility and everybody s task. When all political areas and sectors in the City of Malmö consistently work to create prerequisites for good health on equal terms it will have a positive effect. This involves a focus on the social dimension of sustainable development. 5 6 Collaboration and cross-border leadership In order to produce change, we take for granted that there will be action over all social sectors and political areas. This is a challenge for the whole of Malmö, but it will also take collaboration and cross-border leadership between the public administrations, and also between the City of Malmö and other actors both social actors as well as associations and businesses. Skills development In order to know what benefits there are with good prevention and health promotion work and prioritised public health work there is a need for continuous development of skills. It is about strengthening the competences within and between administrations, sectors and among politicians, and to which extent decisions and different actions affect public health. 5 Organisation Everybody s responsibility and commitment All administrations and almost every sector of the City of Malmö influence Malmö citizen s living conditions and prerequisites for health, directly or indirectly, on an individual and/or structural level. All employees who meet citizens every day can contribute to change. It is in these meetings with preschool children, pupils, parents, those who claim supplementary benefits, unemployed, disabled, elderly, neighbours, road-users, park visitors, association members and colleagues to name just a few that we can make a difference. It is in these meetings where commitment, trust, respect, expectation, demands and interest can contribute to the process of change. That is why the starting point of public health work is the existing organisation and the attitude that the municipality is a learning organisation where public health issues are a part of regular work and development work. The responsibility of implementing the policy is shared by all sectors within the City of Malmö. However, there are some head actors who are in charge of assuring the policy objectives. The Public Health Council Since January 2009 there has been a public health council which acts as the political leadership of public health work. The council is the city executive board s preparatory body whose job it is to lead the work by following the development, setting objectives, prioritising areas and following the outcome of the efforts. The City Office The City Office is responsible for preparing matters for the Public Health Council like for instance putting together the annual welfare report. It is also the City Office s task to coordinate, evaluate and support the development of the public health policy. Commission When it comes to efforts regarding inequality in health and decreasing the gap between those with good health conditions and those who do not have them, an extensive change process with new perspectives and working methods is required. For that reason a commission has been appointed. The commission s task is to analyse the consequences and costs of inequality in Malmö, across borders, and to suggest strategies to explicitly decrease health inequalities. The commission works over a limited period and the result of this work can mean that the public health policy and other guiding documents can be revised. Other important actors No single actor can tackle the challenges of public health alone. The City of Malmö is dependent on its surroundings. All associations, non-profit organisations and social entrepreneurs which are present in Malmö are all very important actors for both health promotion work and prevention efforts. The business world also plays a crucial role, as well as healthcare, regional and national actors. 6 The 11 national public health objective areas 1 Participation and influence in society Inclusion and influence in society is one of the most fundamental conditions for public health. A lack of influence and opportunity to affect living conditions has a strong connection to health. 2 Economic and social prerequisites Economic and social security are fundamental for public health. There is a clear connection between good public health and a society characterised by economic and social security, equal living conditions, equality and justice. Economic stress and social insecurity cause ill-health, especially mental ill-health and lead to increased health inequality. 3 Conditions during childhood and adolescence The conditions during childhood and adolescence are of great importance for both mental and physical health for the rest of one s life. Efforts to promote children s long-term health can be made in many areas, such as parental support methods and efforts in preschool and school. There are good opportunities to prevent mental ill-health through early efforts during adolescence. 4 Health in working life A good working life with well functioning working conditions does not only reduce work related ill-health and social differences in ill-health, it contributes to a better general public health, it is also a necessary requirement for sustainable growth. 5 Environments and products The objective area of environments and products is wide and includes widely varying environments and exposure situations. The area has been divided into a number of subareas: healthy outdoors environment, healthy products, healthy indoors environment (including noise) and safe environments and products (from an injury perspective). 6 Health promoting health services Healthcare plays an important role in the development of good public health. Not just through treating disease and injury, but also through the possibility it provides for preventing these and promoting health. 7 Protection against the spread of communicable diseases Efforts to prevent the spread of contagious diseases are part of public health work and therefore important in order to reach the overall public health objective. 8 Sexuality and reproductive health The opportunity to have a safe and secure sexuality is fundamental for the individuals experience of health and well-being, and society has to protect areas such as sex education, family planning and maternity healthcare. Safe and secure sexuality, free from prejudice, discrimination, constraints and violence is healthy. 9 Physical activity Physical activity is a prerequisite for good health development. The objective for the assembled efforts in this area should be that society is shaped in a way that it creates chances for increased physical activity for the population as a whole. 10 Eating habits and food Good eating habits in combination with physical activity can prevent a range of health issues, for instance cardiovascular diseases, type 2 diabetes, strokes, organ diseases, some forms of cancer and mental ill-health. Many of the public health problems today relate to food. 11 Tobacco, alcohol, illicit drugs, doping and gambling The use of addictive substances, as well as addiction to gambling, affects health. The overall national objectives for social efforts within these areas are: decreased use of alcohol and tobacco, a society free from narcotics and doping, and reduced damage from excessive gambling. 7 Glossary Public health Expression of the population s health conditions which takes both levels and distribution of health into consideration. Good public health is not only about health being as good as possible, it should also be as equally divided as possible. Evidence based methods The best scientific knowledge of the efforts effects at that moment. Sustainable development A development which meets today s needs without jeopardising the opportunities for future generations. The three dimensions of social, economic and ecologic development are equally dependent on each other. Sustainable development is when all three dimensions are attached an equally great value. The social dimension puts people s needs and well-being at the forefront and centre. A society s values are democratic. Health, inclusion, equal division of power and safety are central concepts. Development from social sustainability strives for a society where all people, irrespective of sex, age, socioeconomy, ethnicity or cultural belonging have the same opportunity to take part of and be active in society. Equal, equality All people have the same rights, possibilities and obligations in all essential areas of life. Living habits Exercise and food habits, alcohol, sex and tobacco habits etc. Living conditions Society s social, economical and environmental conditions which affect the individual s possibilities to be responsible for his/her own health. Examples are education, economy, connection to the labour market and social networks. Learning organisation Characterised by a constant learning for all, with a high level of responsibility and initiation, and where it is easy to set up, develop and pass on knowledge, as well as an ability to change and apply knowledge and insights. In a learning organisation one always seeks new or better ways of working, methods, routines and strategies. Photo: Colourbox Design: Sven Eighteen Stadskontoret tel
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