Turning healthy choices into easy choices
Author: Marjolijn Vos, Healthcare staff member at Gezond Leven
Co-authors: Bruno Buytaert, Senior staff member health equity
& Saidja Steenhuyzen, Senior staff member scientific support
If we want people’s health to improve, we need to monitor the effects and the efforts being made – we need to look at the process itself.
We want healthy environments and healthy incentives to be omnipresent. In Flanders, we switched from health objectives that focus on themes and individual behavior, to health objectives with a transversal setting-based approach that cuts across themes. We want healthy schools, healthy regions and municipalities, healthy workplaces, healthy childcare, and healthy welfare and health care. And we want to measure the efforts made in these settings.
Europe supports this setting-based approach by giving some good examples such as the WHO European Network for Health Promoting Schools (ENHPS), the European Network for Workplace Health Promotion (ENWHP) and the WHO Healthy Cities Network.
To help organizations towards a more sustainable preventive policy, the Flemish Institute for Healthy Living set up three frameworks, based on the European ones: Healthy School, Healthy Workplace and Healthy Municipality. Every three years, the Flemish Institute for Healthy Living executes a health policy survey. The goal of the survey is to find out if healthy living in a healthy environment is embedded in each of these settings, and if everyone is reached with this approach. We can find out whether the setting-policy uses more than just the strategy of education and actually also inserts environmental measures in regulations and agreements as well as in health care and coaching strategies, as proposed in the Ottawa charter for health promotion (Bangkok, WHO, 2005).
We want healthy environments and healthy incentives to be omnipresent.
By measuring people’s health status and behaviors, we know that health promotion is necessary. We know everybody needs to have equal opportunities for health, and that we should reduce social inequalities. But these results do not give us enough insight into how we can do this. Individual measures that only look at symptoms implicate that everyone has a free will and an opportunity to change so we often try to persuade people into making the right choice, for example: “stop smoking!” But it’s their own responsibility. This approach doesn’t consider that there are many people living in unhealthy circumstances, putting all their energy into surviving each day.
To convince everyone of the benefits of an environmental approach, we need to measure more than just the effects, but also the process and causes that are in the environment. The health policy survey measures policies in settings, and therefore monitors and evaluates the health objectives of the Flemish government. In 2016, the Flemish government proposed a new action plan called “The Flemish Belgian lives healthier in 2025.” Examples of questions in the survey include:
- How many Flemish schools still have vending machine for soft drinks?
- How do municipalities try to stimulate inhabitants to move more?
- What initiatives do companies take to help employees stop smoking?
One astounding result: 70% of secondary schools still have soft drinks vending machines which prompted a multi-sector response: in November 2016, the Flemish government with different umbrella organizations for education and partners from the food industry signed a declaration of engagement to support schools in offering healthy snacks and drinks and make schools free of soft drinks by 2020 – 2021. Schools can now use the guidelines and recommendations of the framework ‘Healthy School’ of the Flemish Institute for Healthy Living to make the right choices for their snacks and drinks. This declaration is a perfect example that shows the importance of influencing policy in making the right choices and to advise health workers in these settings.
We make a plea for a European model that supports national governments in measuring health efforts so that comparable results can be made available. If we really want to promote health, minimize health inequalities and protect the environment we need to look past the individual level and look at the bigger picture. The INHERIT project advances this setting-based approach by investigating and analyzing good practices that create health opportunities in the environment for everyone; by looking for ‘triple-win’ solutions that are good for society, health and the environment; by involving different sectors and policies to become a ‘health in all policies’; and by helping to turn healthy choices into easy choices for everyone.
The Flemish Institute for Healthy Living is an independent center of expertise in health promotion and disease prevention, and an official partner of the Flemish government. It delivers strategies, advice, methods and training to health workers and professionals with as main goal: a healthier Flemish population.