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

More recently, however, the school setting does not appear
to have been utilized as well as might be expected. With
the devolution of greater responsibility to the municipalities,
including decisions on health education in schools, considerable
disparities have evolved at the local level and school
health education has become disjointed and unorganized.
Apparently only a very small proportion of schools now
meet the national standards for health education.
Teenage pregnancies and abortions are among the lowest
in the world, but smoking figures among teenagers are
comparatively high. Despite the fact that obesity in children
is increasing, physical education is no longer compulsory in
schools.
2.6.3. Healthy Cities
A number of Finnish cities joined the WHO Healthy Cities
programme from an early stage, and the Finnish National
Healthy Cities Network was founded in 1996 with the aim
of assisting in the implementation of the national Health for
All policy. STAKES acts as the coordinator and gives secretarial
support to the Network. STAKES offers developmental
support and is instrumental in disseminating information
to municipalities throughout the country, thus broadening
the impact of the Network. Priority areas for 2005–2008
include:
• reducing inequalities in health;
• formulating municipal welfare reports;
• recommendations concerning the health promotion
aspect of human impact assessment;
• healthy urban planning;
• healthy ageing; and
• physical activity.
2.7. Policies for specific population groups – older
people
The 1985 Health for All policy considered population ageing
the most important demographic factor affecting health
policy, and tackling chronic illness and disability in the elderly
one of the main challenges to public health. Some 80% of
beds in PHC centres were then being used for the care of
older people, in less than optimal circumstances. Although
the importance of community care was mentioned, and
about 90% of communes already employed home helps to
support older people, the main proposals in the Health for
All policy related to health care.
Finland developed its first National Ageing Policy in 1996.
Its main recommendations referred to: maintaining the
health and working ability of older people; maintaining a
good standard of living and housing; developing a needsled
service supply system; improving care; and creating an
enabling society whereby older people have similar rights to
participate and live their lives as others.
The main aim of the policy was to enhance the autonomy
of older people and help them manage their lives independently.
It was expected to be achieved through better
coordination of the public and private sectors, NGOs and
households themselves. It appears, however, that during
difficult economic times the community care system has
not been developed as quickly as intended and services for
older people are vulnerable to cuts at the municipal level.
The Government is expected to present a report on national
ageing policy to Parliament every four years. Although
it is not clear how far morbidity and frailty can be compressed
in the later years of life, on the whole the health
of older people has improved. They have fewer symptoms,
chronic conditions and circulatory diseases than 20 years
ago (30).
Pensioners have been organizing themselves since the 1950s
and now have strong NGOs, although, as in most countries,
the joiners are the better educated while a large group of
non-joiners remains out of the participation picture (11).
Chapter 4
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Case studies: policy development in countries for tackling noncommunicable diseases