Gaining health : analysis of policy development in European ...

2.6. Settings
Since the mid-1990s, the settings focus has been strengthened
by involvement in international networks such as
Health Promoting Schools, Healthy Cities and Health Promoting
Hospitals, all of which continue to grow.
2.6.1. Schools
Ireland joined the ENHPS in 1992. From 1993 to 1996
there were 10 schools in the Irish network (5 primary and
5 post-primary). From 1996 to 1999 the network expanded
to include 40 schools (20 primary and 20 post-primary). For
schools in general, health education was an optional subject
until that time, developing in different ways throughout the
country.
It was decided in 1999 that specific support would discontinue
for a designated network of schools and that instead
all schools would be supported. Consequently, when
“social, personal and health education” (SPHE) became a
required part of the curriculum for all primary and postprimary
schools in 2000, it was decided to subsume the
experience of the Health Promoting Schools network with
a substance abuse prevention programme that had been
used in some schools since 1991; a relationships and sexuality
education programme (first developed in 1995); and
a life-skills (health education) programme that had been
operating in many schools in one local region since 1979.
All these were included under the new SPHE umbrella, and
schools are supported to implement SPHE “in a health promoting
school context”. Sub-networks of schools continue
to operate in three regions of the country, using the ENHPS
process, but are not linked to each other or to a national
network.
In 2005, the National Taskforce on Obesity identified
300 000 Irish children as being overweight or obese, a
figure that was increasing by 10 000 each year, and made
recommendations for supporting schools. According to a
survey published by the Irish Heart Foundation in 2007
(38), only one third of schools had developed healthy eating
policies. Energy-dense and nutrient-poor foods are widely
available in tuck shops and vending machines. Schools, many
of which rely on commercial sponsorship for sports and
computer equipment, reported overwhelmingly that they
would be in favour of a code of practice in relation to the
provision and content of vending machines (92%), and a of
national code of practice in relation to industrial sponsorship
(87%).
On a more general level in the education sector, goals in
relation to school retention and addressing literacy difficulties
are acknowledged as enhancing personal skills, affecting
health in the long-term.
2.6.2. The workplace
An all-island (Ireland and Northern Ireland) network for
workplace health promotion was established and all the
then regional health boards had workplace coordinators.
The Health Promotion Unit participates in the corresponding
European network of national agencies and institutes
with responsibility for health in the workplace. The policy
document Healthy bodies – healthy work (39), published in
1999, outlined the need for a proactive approach in the
workplace. The implementation of cardiovascular strategies
is one of the priorities for the workplace setting. Some
650 companies with 350 000 employees participate in the
“Happy heart at work” initiative.
2.7. Policies for specific population groups – older
people
There are a number of policies directed at specific population
groups relevant to combating NCD, including a policy
for men’s health – there is a gap of 15 years between the
average life expectancy of a rich woman and a poor man. In
the framework of this study, we refer only to policy related
to older people.
Chapter 4
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Case studies: policy development in countries for tackling noncommunicable diseases