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Addressing cardiovascular disease at EU level: tangible plans for the future

Addressing cardiovascular disease at EU level: tangible plans for the future. Hübel M. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).

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Addressing cardiovascular disease at EU level: tangible plans for the future

  1. 1. Cardiovascular diseases:  A European Commission  Perspective Michael Hübel European Commission, DG Health  and Consumers
  2. 2. CVD – largest single cause of death in EU Ischaemic heart diseases and cerebrovascular diseases as percentages of total death rates 2006 50,0% 45,0% 40,0% 35,0% 30,0% 25,0% 20,0% 15,0% 10,0% 5,0% 0,0% bg cz dk de ee ie el es fr it cy lv lt lu hu mt nl at pl pt ro si sk fi se uk Ischaemic heart diseases (I20-I25) Cerebrovascular diseases (I60-I69)
  3. 3. More than 2 fold difference in death rates between EU Regions Source: atlas of mortality in the European Union. Eurostat 2009
  4. 4. Higher risk of CVD for poor and less well educated
  5. 5. 20-50% decline in CVD mortality since 1980 S D R , dis eas es of c irc ulatory s ys tem , all ages per 100000 700 600 500 400 EU EU m em bers before May 2004 EU m em bers s ince 2004 or 2007 300 200 100 Source WHO HFA Database 2009 – standardised death rates all ages 0 1970 1980 1990 2000
  6. 6. Common determinants of CVD and other non  communicable diseases Social and economic situation Unhealthy Physical Tobacco Alcohol diet inactivity use CVD Cancer Type 2 COPD Mental Musculoskeletal Oral diabetes health disorders health Environmental qualitynon-communicable disease Figure: Causal factors of major
  7. 7. % of deaths caused by key risk factors 20 18 16 14 12 10 8 6 4 2 0 e n l e e g o ks i ty ro ity ti o os r us ve cc su e is es tiv lu uc ba st lr l d es ho ob ac l e an po gl na to pr ol co in , od ch tio it ht r od ai al al f ru g o pa gh ic o ei n bl bl w ys ba cu rw hi gh lo Ph gh ur oc ve hi hi O Source: Global health risks: mortality and disease attributable to selected health risks. WHO 2009, table 1 – high income countries
  8. 8. EU Action on CVD and other chronic  diseases.  Overall approach – the EU Health Strategy, EU2020  Determinants – socio­economic, environmental, behavioural Partnership with MS and Stakeholders Values – equity, health is wealth, Health in All Policies EU initiatives – health inequalities, environment and   health, tobacco, nutrition, physical activity, alcohol,   mental health Specific CVD activities, MS, Stakeholders, Indicators,   Research   Emerging chronic disease alliance
  9. 9. Socio­economic determinants – “Solidarity in Health” COM(2009)567 Strengthen collaboration with Member States,  Regions and other Stakeholders “A fair distribution of health as part of overall  social and economic development” Improve measurement and knowledge Health inequality policy audit Action for vulnerable groups – Roma, migrants Use of structural, cohesion,  rural development  Use PROGRESS,  Health Programme and other  funds Initiative on global health
  10. 10. Broader health determinants
  11. 11. Tobacco Legislation  Advertising, Warning messages and pictures Products Smoke free environments Link to international work (FCTC) Prevention work: Youth campaigns 2002­2004: ‘Feel free to say no’ 2005­2008: ‘HELP’ ­ 72 Mio €/4 years 2009­2010: HELP 2.0 – 32 Mio €/2 years Network tobacco control initiatives Exchange Best Practice and develop European  projects
  12. 12. Developing New partnerships:   Nutrition and Physical Activity Alarming rates of obesity in particular in young people – diet/activity key health determinants EU role in food law (labelling, health claims) ­ agriculture, education, transport, taxation… Consumer information, advertising and marketing Develop new partnerships  2004: Roundtable on Obesity 2005: Platform on Diet, Physical Activity and Health A new strategy 2005: Green Paper (consultation) 2006: White Paper on Nutrition and Physical Activity 2007: High Level Group – 2008:Salt initiative 2009: Fat and  sugar reformulation
  13. 13. Alcohol 2006: Communication on alcohol­related harm Young people and children Road traffic and drink driving Adults and the workplace Information and awareness raising Evidence base Work across policies and with Member States  2007: Alcohol and Health Forum 100+ commitments for action Annual Open Forum meetings
  14. 14. Mental health October 2005: Green paper consultation – open  and structured December 2007: New departure 2008 European Pact and high level conference Suicide and depression Young people and education Workplace The elderly Stigma and discrimination 2009­11 Thematic conferences on priority   themes
  15. 15. CVD specific activities Member States, Council Stakeholders – European Heart Health Charter Health Programme Funding Indicators Research
  16. 16. Council Conclusions on heart health – June 2004 encourage networking and the exchange of  information between stakeholders    strengthen the comparability of data European food and nutrition policy, to include,  physical activity take a multisectoral approach to preventing cardiovascular disease and assessing the health  impact of other public policies of the European  Union; co­operate with the relevant international and  inter­governmental organisations, in particular  the World Health Organisation
  17. 17. Commitments on Heart Health Luxembourg declaration (2005):  Necessity for comprehensive strategies Heart Health Charter Cooperation cardiologists – heart networks key success factor
  18. 18. EU Heart Health Charter Principles Policies EU Heart National National Health Heart National Heartional Na Charter Health Heart Health Heart Strategies Health Strategies Health Strategies Stakeholders Strategies Monitoring
  19. 19. Facilitate and support national   strategies – Bottom­up approach Heart Health Charter development  process – consensus building process  among stakeholders Mobilisation in Member States key Primary carers/health professionals as  actors in prevention and health promotion  Build partnerships: determinants,  diseases, screening, treatment? 
  20. 20. Health systems Emerging cooperation between Member States The example of cancer screening Patient Mobility Directive Structured cooperation between Member States
  21. 21. Indicators and statistics Responding to the need of comparable indicators for cardiovascular diseases monitoring EUROCISS 1 ­ Cardiovascular Indicators surveillance set  in Europe (Phases 1, 2) Cardiology Audit and Registration Data Standards   (CARDS) project    Responding to the need of comparable incidence data for coronary events European Cardiovascular Disease Statistics ­ European  Heart Network Responding to the need of cardiovascular mortality comparable data Eurostat Atlas of Mortality: cardiovascular diseases
  22. 22. Indicators ­ cont EUROCISS 2 ­ Cardiovascular Indicators surveillance set  in Europe (Phase 2) Project ­ 2008 to define indicators for monitoring CVD  to recommend standardized methods for collecting  indicators in EU countries  to prepare manuals of operations describing in detail  procedures and methods for easy implementation of  population­based registers and CVD surveys.  The achievement of EUROCISS 2 aims will facilitate cross­country comparisons and Will assist efforts to improve the prevention and control of  CVD.
  23. 23. Research projects FP6/FP7 Integrated Project focusing on the genomics of atherothrombosis Network of Excellence in vascular biology Integrated Project on signalling molecules involved in disease mechanisms Towards the stabilisation of atheromatous plaque Genetics of Thrombotic Stroke Cell Transplantation for Myocardial Repair Adult Stem Cell Research
  24. 24. Projects from the Health Programmes Children, obesity and associated avoidable chronic diseases  (European Heart Network)  European Mapping of Obesity Best practice (Learning Lab   Denmark) Development & Implementation of a European Guideline and  training standards for Diabetes Prevention (Technische Universität Dresden, Medizinische Fakultät Carl Gustav) Promotion of vegetable and fruit consumption of school children  (Karolinska Institute) Building Policy Capacities for Health Promotion through Physical Activity among Sedentary Older People (Univ. Erlangen) Move Europe ­ a Campaign for the Improvement of Lifestyle­ related Workplace Health Promotion in Europe (European  Network for Workplace Health Promotion) Shape Up – towards a European network for obesity prevention  in children (PaU Education, Barcelona)
  25. 25. A chronic­diseases alliance Ad­hoc alliance of medical & health  promotion organisations Aiming at producing a policy document: Underlining the NCD challenge addressing common health determinants (tobacco,  nutrition, physical activity, alcohol); Developing a set of joint life­style   recommendations; targeting EU policy makers; to be shared with the Belgian Presidency for their  planned conference on chronic diseases (October  2010); to be ready by spring 2010