87 The third is to reduce the interregional health inequalities by developing an

effective system of health promotion interventions which encourage a healthy lifestyle and social and emotional wellbeing in the region. Specific efforts to increase the early detection of non-communicable chronic diseases are also involved here.

The fourth aim addresses intra-regional inequalities by supporting vulnerable groups like young mothers and children, dropouts, unemployed, elderly, people with special needs and ethnic minorities. For each group, specific interventions are identified to encourage a healthy lifestyle and increase their capacities for gaining independence and upward social mobility.

The final aim focuses on a healthy physical environment. It aims to encourage environment friendly behaviour of the population, and to support environment friendly policies at the local level.

Although the strategic document is specifically designed for the Pomurje region, the strategic plan also provides a valuable input for the national strategy in the field of health inequalities.

National Programmes:

Through the National School Nutrition Programme

children in Slovenia are offered healthy meals as part of their school curricula. The programme is running in three different schemes:

1. All kindergartens in Slovenia offer breakfasts, midmorning snacks, lunches and afternoon snacks. Meals are prepared or cooked in vast majority in their own kitchens.

2. Most primary schools offer breakfasts, midmorning snacks, lunches and afternoon snacks. All primary schools offer at least two meals (midmorning snacks and lunches) every school day. Most of them have their own kitchens financed by the Ministry of Education and Sport.

3. In 2008, the Slovene government adopted the decision to finance on healthy cooked meal in all secondary schools. These meals are offered by all schools to all secondary school students on a daily basis by different selected providers.

Scheme one and two of the National School Nutrition Programme are running since 1950 in Slovenia. All three schemes are obliged to follow the national guidelines for healthy nutrition (2005). Originally it was launched aiming to ensure that all children ate enough quantities of healthy food, but nowadays it is being used to teach them about healthy eating habits as well.

The programme is subsidized for children from lower socio-economic groups (approximately 35% of all children receive subsidized meals). The subsidies for school meals for pupils/students in 2006-2007 were: €0.55 daily per pupil, and €0.85 daily per secondary school student.

More information about this programme or other running programmes in Slovenia can be provided by:

Mojca Gabrijelčič Blenkuš Health Promotion Centre,

Head National Institute of Public Health [email protected]

88

Spain

(Extra information was provided by the Spanish Food Safety and Nutrition Agency)

National Strategy:

The Spanish Strategy for nutrition, physical activity and the

prevention of obesity (NAOS strategy) was launched in 2005 and addresses obesity through different working groups. More information about this strategy can be found in the EuroHealthNet and WHO report.

National Support:

The Spanish Food Safety & Nutrition Agency (Agencia

Española de Seguridad Alimentaria y Nutrición – AESAN launched several actions directed to children. However, these are not specifically targeted to lower socio- economic groups but they are tried to be reached by implementing the interventions in public schools or semi-public schools. The agency has also published a guide about healthy eating directed to immigrants.

National Programmes

: Several activities have been undertaken as a result of

the NAOS strategy. An overview of programmes can be found in the EuroHealthNet and WHO report. However, none of these national campaigns are aiming to target lower socio-economic communities.

The main project of the agency is the PERSEO intervention, which reaches almost 70 schools and more than 12.000 children. The intervention runs during 2008-09 and teaches pupils about health eating and it promotes physical activity during and after school hours. The targeted schools are located in low socio-economic

districts. More information can be found on the website:

http://www.naos.aesan.msc.es

For more information please contact:

Juan Manuel Ballesteros

Technical adviser - NAOS Strategy Spanish Food Safety & Nutrition Agency +34 91 3380062

[email protected]

Sweden

(Extra information was provided by the Swedish National Institute of Public Health – EuroHealthNet member)

National Strategy:

Sweden has no national action plan or a national strategy

regarding the prevention of obesity. The Swedish government wants to implement specific actions regarding diet and physical activity rather than a full action plan. However, there is a Nordic Plan of Action on better health and quality of life through diet and physical activity [98] approved July 2006.

However, in 2003, the Swedish Parliament ratified the first Public Health Bill, which introduced a public health strategy using health determinants as its starting-point to put focus on factors in both structure of society and people’s living conditions and lifestyles that are either good or bad for health. The overarching aim of the policy is to create societal conditions that ensure good health, with equal terms for the entire population. The policy consists of eleven objective domains including a number of established policy areas such as economic policy, social welfare, the labour market, agriculture, transport and the environment. Two of the objective domains; 9 – Physical activity; and 10 – Eating habits and food; directly concern the relevant area.

In 2008, the bill “A renewed public health policy” [99] was published. The bill is

based on a holistic view of people and contains a greater element of individual responsibility than before. The public health policy covers many different areas, with special focus on for example supporting for parenting; and eating habits and physical activity. The Government’s public health bill focuses particularly on children, young people and the elderly. The Bill emphasises that medical care must promote health, that social networks are important as a protective factor that government agencies must be able to cooperate with civil society and that local and regional work is important. It does not specifically target lower socio- economic communities.

89

National Support:

The Swedish National Institute of Public Health has been

commissioned by the government, to coordinate the monitoring of the eleven objective domains on the national level and is responsible for the collective monitoring of the overarching public health aim.

Specific government assignments includes that the National Institute of Public Health has been instructed, in cooperation with the National Food Administration, to implement and evaluate measures for good eating habits and increased physical activity, with a focus on the problem of overweight. The Government also intends to make it possible for the National Board of Health and Welfare to register information about children’s height and weight and develop initiatives to promote good eating habits and physical activity.

The Government is also giving priority to programmes with physical activity on prescription. Current studies indicate that physical activity on prescription leads to a higher level of physical activity and improved self-perceived health. The Government has also set up a dialogue forum where representatives from industry, experts, voluntary organisations, government agencies and media jointly discuss how good eating habits and physical activity can be promoted.

National Programmes:

In Sweden there is a focus on intersectional

collaboration between the municipalities, national agencies and boards, nongovernmental organizations, etc., as well as between the national, local and regional levels.

For more information, please contact

Nina Akeson, MPH

Public Health Planning Officer, Healthy Eating Swedish National Institute of Public Health +46 63 19 97 33

[email protected] | http://www.fhi.se/en

Switzerland

(Extra information was provided by Health Promotion Switzerland – EuroHealthNet member)

National Strategy:

The Federal Council’s Concept for a national sports policy of

2000 [100] sets the basis for the political contribution to creating a culture of

physical activity whereby sport is part of social, economic, ecological and sustainable development.

Based on the results of the third and fourth Swiss nutrition reports, a working group established by the Nutrition Council defined the goals and tasks of the Swiss nutrition policy for the period 2001-2005. The key goals were to promote healthy body weight through a well-adjusted energy and nutrient balance and to increase the consumption of fruit and vegetables. To achieve these goals, strategies were developed and programmes launched in cooperation with partner organizations [53].

Long-term measures involve influencing political and social conditions in such a way as to ensure a sustainable trend towards the maintenance of a healthy body weight. The Fifth Nutrition Report [101] was published in 2005 and will be the

basis for setting goals and tasks for a future nutrition policy in Switzerland. In 2001, the Action plan on nutrition and health[102] was approved by the Federal

Council in order to: reduce the prevalence of nutrition-related diseases; ensure a supply of safe food of good quality; contribute to the sustainable and environmentally-friendly production and distribution of food; and put consumer interests in the centre of nutrition policy [53].

A parliamentary proposal was made in 2007 on the taxation of energy-dense foods containing excessive amounts of fat and sugar. Although it was rejected by the Government, it was kept as a future option in case other solutions fail. As

90

In document Focusing on obesity through a health equity lens (Page 89-92)