Core Document - International Union for Health Promotion and ...

4 Engaging this group in the development of health promotion programmes has
been key to success. There is evidence of increased condom use, and decreases in
drug use. There is less risky sexual behaviour. Socially, there is evidence of
dialogue restarting between the generations, with the young people feeling they
are valued. Some of the programmes in themselves actually provide a source of
income, and cost savings to other health services can be identified. Perhaps above
all, the health promotion work in this area has helped put this important social
group back on the agenda.
Health Challenges 1: The Lifestyle Killer – Heart Disease
1 Cardiovascular disease (CVD) is the number one killer and the major cause of
disability in Europe. Half the deaths in the industrialised world are the result of
CVD. Contrary to widespread mythology, CVD is not something which attacks
only elderly people. Much of the burden concerns the middle aged, women and
people in lower socio-economic groups. It is a major contributor to inequality
in health.
2 The problems facing decision makers in a Europe which is already
witnessing a reduction (by demographic causes) of its available
working population are first, the early elimination from the workforce of human
talent and much needed resource and second, the cost of treatment when CVD
disables, but does not kill. The costs to health services are enormous.
3 The major causes of CVD are well known and have been well documented:
smoking, poor dietary habits, lack of exercise, high cholesterol. The effects of
these are very heavily influenced by the capacity of people to discriminate and
make positive health choices. Health promotion strategies over the past 20 years
have been shown, without doubt, to make a major difference in tackling those
diseases and illnesses which are most significantly affected by the way people
choose to live.
4 One of the most carefully documented interventions has taken place in North
Karelia, Finland, where cardiovascular mortality has been reduced by 73% since
1972, and all-cause mortality has been reduced by 50% in the working age
population over the same period.
5 As so often happens, lifestyle changes introduced to deal with
cardiovascular disease threats have a positive benefit in other health
areas too. The North Karelia experience recorded reductions in lung cancer
mortality of 71%, and cancer (other causes) mortality by 44%.
6 The example in Finland, while spectacular in its success, is not alone. Other
studies show that programmes aimed at changing lifestyle habits bring very
positive health benefits. In Belgium, a WHO collaborative worksite project for
CVD prevention resulted in a 25% reduction in CVD mortality. Programmes
aimed at lowering serum cholesterol through healthy diets in schools produced an
average reduction in levels of 15%, with huge positive health implications.
Taking the Health Promotion Pulse
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