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

programme along the lines of the second WHO European
Alcohol Action Plan. The Committee made ten proposals for
a programme covering 2001–2003, stressing the role of more
general determinants of health such as housing, income and
employment in affecting alcohol-related problems.
The present programme covers the period 2004–2007
(39). The main aims are to:
• reduce the harmful impact of drinking on the welfare of
children and families;
• reduce risk-level drinking and its effects; and
• reduce overall alcohol consumption.
In keeping with the Finnish tradition of evaluating actions,
a comprehensive package of interventions has been found
to be effective, and these are to be implemented mainly
through existing structures for cooperation. Funds are to be
provided through the state budget for municipalities, from
public appropriations for health promotion and from the
Slot Machine Association for NGOs, in addition to these
partners’ own resources. Participation in the programme
is voluntary and in its initial year over 100 partners had
already signed up, including about 60 NGOs, the churches,
trade unions and about 20 municipalities. Guidelines for
intensifying work on substance abuse are provided for
municipalities.
Particular emphasis was placed on monitoring progress, and
the results of an interim survey were included in the Government’s
report to Parliament in 2006. The interim report
indicates that EU legislation and the expanded markets have
undermined the traditional alcohol policy and reduced the
effectiveness of price policy. For example, the restrictions
on imports of alcoholic beverages were abolished in 2004,
as agreed in the Treaty of Accession to the EU, by reducing
taxes levied on alcohol by 33% on average, with the result
that alcohol consumption rose by 10.3 litres of pure alcohol
per inhabitant (40). The objectives of the government strategy
are therefore far from being reached and new ways of
influencing alcohol consumption must be found (41).
2.5.3. Nutrition
Various factors have contributed to keeping food and nutrition
issues on the agenda in Finland. Although Finland has
produced and imported sufficient food for an adequate diet
since the Second World War, healthy eating habits were
not quickly adopted nor was the production of food surpluses
avoided. The land given to those who were relocated
after the War was more suitable for raising dairy cattle,
and until 1987 the Centre (Agrarian) Party shared political
power, creating a strong agricultural lobby.
“It is interesting that excellent data identifying the link
between health status and food and nutrition were available
in Finland, based on thirty years’ tradition of research
into coronary diseases, long before comprehensive action
was taken” (11). However, by the early 1980s, the public
had become highly aware of the impact on health of poor
diet, largely through the North Karelia Project. This made it
easier to set up a National Committee on Diet and Health
in 1981, which issued dietary recommendations.
Progress was not always easy, as indicated by events in
1988 “when dairy producers, reacting to decreasing butter
consumption, began to fight back. Full-page advertisements
were taken out to refute the claims of the nutritionists. A
lively public debate followed in all the mass media. Butter
consumption continued to decline, however” (11).
A plan for health education for 1984–1988 included: improved
public information; dietary guidelines for workplaces
and institutions; the adaptation of producer food prices to
favour low-fat milk; food regulations concerning sodium
content and labelling; training of relevant staff; and further
study of eating habits. All these were achieved, which
perhaps led the food industry to increasingly seek (through
surveys and symposia) the views of nutrition experts. Less
was done to evaluate the effectiveness of health educational
Chapter 4
55
Case studies: policy development in countries for tackling noncommunicable diseases