Abstract
Good health governance requires appropriate health intelligence, and consequently, health information needs to be reshaped in order to foster health policy innovation. Several key aspects should pervade the new approaches to the management of health information: advocacy, monitoring broad health determinants, accountability, and transparency. Strong advocacy is needed if we wish to convince non-health sectors of the relevance of health in their policies. Successful advocacy is based on new and innovative ways of framing health information which contributes to moving health higher up the media, public, and policy agendas. The goal is to put across the effects that all societal sectors have on health and well-being. Advocacy in the terms mentioned is also required to transform public health from an underfunded pyramidal bureaucracy into a strengthened public health with higher-profile leadership. This represents a shift of approach from an individual-centred prevention linked to health services to a public health that makes healthy choices easier and is capable of promoting multifaceted policies from diverse sectors emerging through network governance.
We also propose the monitoring of the social determinants which have an established relationship with health. Health outcomes are usually the long-term effects of exposures that act during the whole life course. Consequently, in order to measure the effects of policies which take decades to manifest, we need to assess the evolution of health determinants addressed by these policies. In fact, responsibility for health is now so diffused at various levels and different sectors that it is very important to point out through appropriate information who is accountable for relevant health issues such as inequalities.
Health-related information should be produced and framed in a way that is suited to the relevant level of governance in order to target accountability and transparency. The aim is to identify what part of government (local, national, regional, or global) is accountable for any health-related issue. Recent innovations such as health impact assessment are the starting point for the development of policy-linked indicators: “avoidable burden of disease by policies” or “health expectancy gained through policy.” These indicators may be estimated at every governance level and are understandable to policy makers and to the public. Transparency and intelligibility of health information is a keystone for population engagement that brings about demands for political actions in health, and consequently should guide innovation in health monitoring.
Although, as far as possible, new policies must be evidence based, the absence of evidence is a stimulus to innovation. Future advances in the monitoring of health and well-being must combine research and implementation. The challenges are evaluation of complex social programs; proper surveillance of new policies with health effects; provision of good data on the economic and social effects of health investment; assurance of a high societal visibility of health issues; and engagement of all stakeholders in the call for accountability and transparency.
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References
Marinker M, editor. Targets in Europe. Polity, Progress and Promise. London: BMJ Books; 2002.
Kickbusch I. Perspectives in health governance in the 21st century. In: Marinker M, editor. Targets in Europe. Polity, Progress and Promise. London: BMJ Books; 2002. p. 206–29.
Marinker M. Health policy and the constructive conversationalist. In: Marinker M, editor. Constructive Conversations About Health. Policy and Values. Oxon: Radcliffe Publishining Ltd; 2006. p. 1–16.
Carlsson P, Garpenby P. Democracy. In: arinker M, editor. Constructive Conversations About Health. Policy and Values. Oxon: Radcliffe Publishing Ltd; 2006. p. 63–74.
World Health Organisation. Healthy Cities Around the World: An Overview of the Healthy Cities Movement in the Six WHO Regions. Published on the Occasion of the 2003 International Healthy Cities Conference, Belfast, Northern Ireland, United Kingdom, 19–22 October 2003. Copenhagen, Denmark: WHO Regional Office; 2003.
Ottawa Charter for Health Promotion. In: Health Promotion. Vol. 1. Geneva: World Health Organization; 1986. p. iii–v.
Rose G. The Strategy of Preventive Medicine. Oxford, England: Oxford University Press Inc; 1992.
WHO. Second International Conference on Health Promotion. Adelaide Recommendations on Healthy Public Policy [Online], 1988 [cited 15th Mar 2008]. Available from: www.who.int/healthpromotion/conferences/previous/adelaide/en/index.html
Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000.
Kawachi I, Kennedy BP, Wilkinson RG, editors. The Society and Population Helath Reader. Vol. 1: Income Inequality and Health. New York: The New Press; 1999.
Marmot MM, Wilkinson RG, editors. Social Determinants of Health. New York: Oxford University Press; 1999.
Kawachi I, Berkman LF, Neighbourhoods and Health. New York: Oxford University Press; 2003.
Mackenbach J, Bakker M. Reducing Inequalities in Health: A European Perspective. London: Routledge; 2002.
Leon D, Walt G. Poverty Inequality and Health: An International Perspective. New York: Oxford University Press; 2001.
Kawachi I, Kennedy BP. The Health of the Nations: Why Inequality is Harmful to Your Health. New York: The New Press; 2002.
Ståhl T, Wismar T, Ollila E, Lahtinen E,Leppo K. Health in All Policies, Prospects and Potentials. Helsinki: Ministry of Social Affairs and Health; 2006.
Kickbusch I. Tackling the political determinants of global health. BMJ. 2005;331:246–7.
Sakellarides C. Stewardship. In: Marinker M. Constructive Conversations About Health. Policy and Values. Oxford: Radcliffe Publishing, 2006. p. 76–90.
Boerma JT, Stansfield SK. Health statistics now: are we making the right investments? Lancet 2007;369:779–86.
Murray CJL. Towards good practice for health statistics: lessons from the Millennium Development Goal health indicators. Lancet 2007;369:862–73.
Walker N, Bryce J, Black RE. Interpreting health statistics for policymaking: the story behind the headlines. Lancet 2007;369:956–63.
AbouZahr C, Adjei S, Kanchanachitra C. From data to policy: good practices and cautionary tales. Lancet 2007;369:1039–46.
Health at a Glance 2007 – OECD Indicators. [Online] OECD; 13 Nov 2007 [cited 10th Jan 2008]. Available from: miranda.sourceoecd.org/vl = 2288030/cl = 13/nw = 1/rpsv/health2007/index.htm
Kramers PGN. The ECHI project. health indicators for the European Community. Eur J Public Health 2003;13(Suppl. 3):101–6.
Eurostat. Structural indicators. [Online] Eurostat; 2007 [cited 10th Jan 2008]. Available from: epp.eurostat.ec.europa.eu/portal/page?_pageid = 1133,47800773,1133_47802588&_dad = portal&_schema = PORTAL
Lundgren B. 2004. Indicators for Monitoring the New Swedish Public Health Policy. Stockholm, Sweden: Unit Public Health Policy Anal., Natl. Inst. Public Health.
National Centre for Health Statistics. Healthy People 2010. Leading Health Indicators at a Glance. [Online] National Centre for Health Statistics: 2007 [cited 10th Jan 2008]. Available from: www.cdc.gov/nchs/about/otheract/hpdata2010/2010indicators.htm
European Commission Public health. Health strategy. [Online] European Commission; 2007? [cited 14th Mar 2008]. Available from: ec.europa.eu/health/ph_overview/strategy/ health_strategy_en.htm
Loue S. Community health advocacy. J Epidemiol Community Health. 2006;60:458–63.
Boarini R, Johansson A, Mira d’Ercole M. Alternative Measures of Well-Being. OECD Statistical Brief No. 11. Paris: Statistical Directorate of the OECD; 2006 May.
Diener E. Happiness Accounts for Policy Use. Keynote Speech in International Conference: Is Happiness Measurable and What do Those Measures Mean for Policy? Rome, 2–3 April 2007. University of Rome “Tor Vergata” Italy. OECD; 2007
Canoy M. Well-Being and Policy Making. Presentation in International Conference: Is Happiness Measurable and What do Those Measures Mean for Policy? Rome, 2–3 April 2007. University of Rome “Tor Vergata” Italy. OECD; 2007
Veenhoven R. Measures of Gross National Happiness. Presentation in International Conference: Is Happiness Measurable and What Do Those Measures Mean for Policy? Rome, 2–3 April 2007. University of Rome “Tor Vergata” Italy. OECD; 2007
WHO Commission on the Social Determinants of Health. A Conceptual Framework for Action on the Social Determinants of Health. [Online] CSDH; April 2007 Draft. [cited 15th Jan 2008]. Available from: www.who.int/social_determinants/resources/csdh_ framework_action_05_07.pdf.
Nolte E, McKee M. Measuring the health of nations: updating an earlier analysis. Health Aff 2008; 27:58–71.
Raffle AE, Alden B, Quinn M, Babb PJ, Brett MT. Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical abnormality and modelling of cases and deaths prevented. BMJ. 2003;316:901–5.
Danzon M. The values of values. In: Marinker M, editor. Constructive Conversations About Health. Policy and Values. Oxon: Radcliffe Publishining Ltd; 2006. p. 17–29.
Society at a glance 2005 – OECD Social Indicators. [Online] OECD; 2006? [cited 14th Mar 2008]. Available from: www.oecd.org/document/24/0,3343,en_2825_497118_ 2671576_1_1_1_1,00.html
Bauer G, Davies JK, Pelikan J on behalf of the EUPHID theory working group and the EUPHID community. The EUPHID health development model for the classification of public health indicators. Health Promot Int. 2006;21:153–9.
Agren G. Sweden’s new public health policy. National public health objectives for Sweden. Report 2003:58. Stockholm, Sweden; Swedish National Institute of Public Health; 2003.
UNDP: United Nations Development Programme. Technical note 1: Calculating the Human Development Indices. United Nations Development Report 2006 [Online] UNDP; 2006 [cited 5th Sept 2007]. Available from: hdr.undp.org/hdr2006/statistics/documents/ technical_note_1.pdf
Cobb C, Halstead T, Rowe J. The Genuine Progress Indicator: Summary of Data and Methodology. San Francisco: Redefining Progress; 1995.
Diener E. A value based index for measuring national quality of life. Soc Indic Res 1995;36:107–27.
Save the Children. The State of the World’s Mothers 2002: Mothers and Children in War and Conflict. A Save the Children Publication. Westport: Save the Children; 2002.
Emes J, Hahn T. Measuring Development: An Index of Human Progress. A Fraser Institute Occasional Paper. (No. 36) Vancouver: The Fraser Institute; 2001.
Estes, R. Table 1: The Index of Social Progress (ISP2000, WISP2000). [Online] University of Pennsylvania [cited 5 Sept 2007]. Available from: www.sp2.upenn.edu/∼restes/WISP2000/ Table%201%20Indicators.pdf
Prescott-Allen R. The Well-Being of Nations: A Country-by-Country Index of Quality of Life and the Environment. IDRC/Island Press; 2001.
Boelhouwer J, Stoop I. Measuring well-being in the Netherlands: the SCP index from 1974 to 1997. Soc Indic Res 1999;48(1):51–75.
EUSI: European System of Social Indicators. Calculation of Composite Index of Individual Living Conditions. European System of Social Indicators [Online] GESIS German Social Sciences Infrastructure Services, ZUMA. Page last updated 2007 July 20 [cited 5 Sept 2007]. Available from: www.gesis.org/EN/social_monitoring/social_indicators/Data/EUSI/ pdf_files/Doku_Index_Constr.pdf
Miringoff M and Miringoff M. The Social Health of the Nation: How America is Really Doing. New York: Oxford University Press; 1999.
Atkinson Foundation. Canadian Index of Well-being: Measuring What Matters. CIW [Online] The Atkinson Charitable Foundation [cited 5 Sept 2007]. Available from: www.atkinsonfoundation.ca/ciw/CIW_Brief_March_2007_MEDIA.pdf
Miringoff ML, Opdycke S. America’s Social Health. Putting Social Issues Back on the Public Agenda. New York: ME Sharpe; 2008.
Desjardins and T. Schuller, editors. Measuring the Effects of Education on Health and Civic Engagement: Proceedings of the Copenhagen Symposium. OECD Directorate of Education, Centre for Educational Research and Innovation. Paris: OECD; 2006
Huisman M, Kunst AE, Bopp M et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet 2005;365:493–500.
Pensola T, Martikainen P. Life-course experiences and mortality by adult social class among young men. Soc Sci Med 2004;58:2149–70.
Steenland K, Henley J, Thun M. All-cause and cause-specific death rates by educational status for two million people in two American Cancer Society cohorts, 1959–1996. Am J Epidemiol 2002;156:11–21.
Kuh D, Ben-Shlomo Y, Lynch J, Hallqvist J, Power C. Life course epidemiology. J Epidemiol Community Health 2003;57:778–83.
Ezzati M, Lopez AD, Rodgers A, Hoorn SV, Murray CJL and the Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347–60.
McDowell I, Spasoff RA, Kristjansson B. On the classification of population health measures. Am J Public Health. 2004;94:388–93.
WHO European Centre for Health Policy. Health Impact Assessment. Main concepts and suggested approach. Gothenburg Consensus paper, Dec 1999. Copenhagen; WHO Regional Office for Europe: 1999.
Mindell J, Ison E, Joffe M. A glossary for health impact assessment. J Epidemiol Community Health 2003;57:647–51.
European Observatory on Health Systems and Policies, Wismar M, Blau J, Ernst K, Figueras J, editors. The Effectiveness of Health Impact Assessment. Scope and Limitations of Supporting Decision-Making in Europe. Copenhagen: Regional Office for Europe, World Health Organization; 2007.
Wismar M, Blau J, Ernst K et al. Implementation and institutionalizing HIA in Europe. In: European Observatory on Health Systems and Policies. The Effectiveness of Health Impact Assessment. Scope and Limitations of Supporting Decision-Making in Europe. Copenhagen: Regional Office for Europe, World Health Organization; 2007. p. 57–78.
Veerman L, Bekker M, Mackenbach J. Health impact assessment and advocacy: a challenging combination. Soz Praventivmed 2006;51:151–2.
European Commission. WHITE PAPER. Together for Health: A Strategic Approach for the EU 2008–2013. Brussels: Commission of the European communities; 2007
Seymour JD, Yaroch AL, Serdula M, Blanck HM, Khan LK. Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review. Prev Med. 2004;39(Suppl. 2):S108–36.
Fewtrell L, Kaufmann R, Prüss-Üstün A. Lead: assessing the environmental burden of disease at national and local level. Geneva, World Health Organization, 2003 (WHO Environmental Burden of Disease Series, No. 2)
Cole BL, Fielding JE. Health impact assessment: a tool to help policy makers understand health beyond health care. Annu Rev Public Health. 2007;28:393–412.
Boyd DR, Genuis SJ. The environmental burden of disease in Canada: Respiratory disease, cardiovascular disease, cancer, and congenital affliction. Environ Res. 2008 Feb;106(2): 240–9. Epub 2007 Sep 29. PMID: 17904543 [PubMed – in process]
Mindell J, Joffe M. Predicted health impacts of urban air quality management. J Epidemiol Community Health. 2004;58:103–13.
Valent F, Little D, Bertollini R, Nemer LE, Barbone F, Tamburlini G. Burden of disease attributable to selected environmental factors and injury among children and adolescents in Europe. Lancet. 2004;363:2032–9.
Stafford M, Cummins S, Ellaway A, Sacker A, Wiggins RD, Macintyre S. Pathways to obesity: identifying local, modifiable determinants of physical activity and diet. Soc Sci Med. 2007;65:1882–97.
Frank LD, Saelens BE, Powell KE, Chapman JE.Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity? Soc Sci Med. 2007;65:1898–914.
Gauvin L, Riva M, Barnett T, Richard L, Craig CL, Spivock M, Laforest S, Laberge S, Fournel MC, Gagnon H, Gagné S. Association between neighborhood active living potential and walking. Am J Epidemiol. 2008 Jan 27; [Epub ahead of print] PMID: 18227097 [PubMed – as supplied by publisher]
Kelly CM, Schootman M, Baker EA, Barnidge EK, Lemes A. The association of sidewalk walkability and physical disorder with area-level race and poverty. J Epidemiol Community Health. 2007;61:978–83.
Murray CJL, Lauer JA, Hutubessy RCW et al. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk. Lancet. 2003;361;717–25.
Asaria P, Chisholm D, Mathers C, Ezzati M, Beaglehole R. Chronic disease prevention:health effects and financial costs of strategies to reduce salt and control tobacco use. Lancet. 2007;370:2044–53.
Haby M, Vos T, Carter R et al. A new approach to assessing the health benefit from obesity interventions in children and adolescents. Int J Obesity 2006;30:1463–75.
Segal L, Daziel K. Economic evaluation of obesity interventions in children and adults. Int J Obesity 2007;31:1183–4.
McPherson K, Marsh T, Brown M. Foresight Tackling Obesities: Future Choices – Modelling Future Trends in Obesity and the Impact on Health (2nd ed.). UK: Department of Innovation Universities and Skills, Government Office for Science; 2007.
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:1747–57.
Powles J, Day N. Interpreting the global burden of disease. Lancet. 2002;360:1342–3.
Roosli M, Künzli N, Braun-Fahrländer C, Egger M. Years of life lost attributable to air pollution in Switzerland: dynamic exposure-response model. Int J Epidemiol, 2005;34: 1029–35.
Bere E, Veierod M, Skare O, Klepp KI. Free school fruit – sustained effect three years later. Int J Behav Nutr Phys Act. 2007;4:5–11.
Rodgers A, Ezzati M, Vander Hoorn S et al. Distribution of major health risks: Findings from the global burden of disease study. PLOS Med. 2004;1(1. e27):44–55.
Künzli N, Perez L. The Public Health Benefits from Reducing Air Pollution in the Barcelona Metropolitan Area. Barcelona: Centre recerca en epidemiologia ambiental (CREAL) Publication. 2007.
Suhrcke M, McKee M, Sauto Arce R, Tsolova S, Mortensen J. The Contribution of Health to the Economy in the European Union. Luxembourg: Office for Official Publications of the European Communities; 2005.
Mills PR, Kessler RC, Cooper J, Sullivan S. Impact of a health promotion program on employee health risks and work productivity. Am J Health Promot. 2007;22:45–53.
Miller P, Murphy S. Demonstrating the economic value of investments in health at work: not just a measurement problem. Occup Med (London) 2006;56:3–5.
Madon T, Hofman KJ, Kupfer L, Glass RI. Implementation science. Science 2007;318:728–9
Cohn D. Jumping into political fray: academics and policy making. IRPP Policy Matters 2006;7(3):1–36.
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Hernández-Aguado, I., Parker, L.A. (2009). Intelligence for Health Governance: Innovation in the Monitoring of Health and Well-Being. In: Kickbusch, I. (eds) Policy Innovation for Health. Springer, New York, NY. https://doi.org/10.1007/978-0-387-79876-9_2
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