Annex 1: Inventory of indicators from surveys and registries

Examples of good practice
Of the many data sources retrieved, some stand out as examples of good monitoring practice,
either because of their innovative approach or their broad scope of indicators. Because these
examples can be a source of inspiration for other countries, we will discuss them in more
detail.
Finland and Baltic Countries: Finbalt Health Monitor
The Finbalt Health Monitor is a collaborative system for monitoring health behaviour and
related factors in Estonia, Finland, Latvia and Lithuania. It is a very comprehensive health
survey, providing information on a broad range of indicators at different levels of the Nutbeam
model. It is also a good example of co-operation between various countries with a different
public health status and a different level of experience in health monitoring.
This monitoring system originated from a survey in Finland, the ‘Health Behaviour among
Finnish Adult Population’ (AVTK), which was set up in 1978 and conducted annually. In 1990,
a similar monitoring system was launched in Estonia, in collaboration with the National Public
Health Institute of Finland (KTL). Lithuania joined the system in 1994, and Latvia in 1998.
Each participating country is responsible for the national data collection and analysis, whereas
the Finnish centre co-ordinates the collaboration between the national research teams and is
responsible for comparative analysis.
Despite the cultural and socio-economic differences between the countries, the system of a biannual
self-assessment mail survey has been relatively easy to transfer from one country to
another. The survey contains core questions that are obligatory, recommended or optional for
each country, and supplementary questions which individual countries can add depending of
local interests. The core questions in the survey have remained unchanged in order to ensure
comparability over time. Aside form socio-economic information (years of schooling and type
of work), height and weight, these questions deal with health status (including mental and oral
health) and several behavioural measures, such as the use of health services (e.g. visits to the
GP), smoking, food habits, alcohol consumption, physical activity and traffic safety. Questions
about the opinion on health and health policy are optional, as are questions on behaviour
change intentions and attempts and exposure to health promotion interventions. The latter are
mainly used in the smoking section.
A feasibility study revealed that the response rates for this survey are relatively high (ranging
from 64% in Lithuania to 77% in Latvia, as a mean for the period 1994-1998). Late responders
do not differ significantly from early responders, and the proportion of missing data is low, with
the exception of some food-related questions. The final data can be used to compare time
trends and patterns of health behaviour in the participating countries. In addition to providing
public information and serving the program planning and evaluation needs of the individual
countries, the system also produces data that can be used for comparative research on health
behaviour across countries (Prattle et al., 1999).
The Netherlands: Permanent Survey of Living Conditions
The Permanent Survey of Living Conditions (Permanent Onderzoek naar de Leefsituatie,
POLS) is a large, continuous survey of different aspects of living conditions in The
Netherlands. Since 1997, it integrates a number of surveys which previously existed
separately, thus enabling data provision on almost all types of indicators on health and wellbeing
identified in the model of Nutbeam, including health, working conditions, living
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