bluuebunny/crossref_metadata_2025_split huggingface dataset:
The politics of bad policy: Why don’t governments pick win-wins?
Authors: Falkenbach M , Greer S L 
Published: November 2019

Abstract

Background
Why, fundamentally, are the politics and public opinion of ageing and health so badly mis-aligned with facts about the costs of ageing societies? The literature has for decades characteristically divided between an old politics of expansion and the post-1990s new politics of recalibration and austerity. The problem for understanding the politcs of health and ageint is that a mix is also plausible: recalibration with an element of expansion in long term care. This mix then leads to a further thought: When do governments expand mature welfare states to deal with risks not covered in traditional male-wage-earner welfare programs?

Methods
A narrative review was conducted on the thin literature available attempting to answer the question as to why governments are not picking win-wins (e.g. keep people healthy so they can actually retire at their formal retirement ages, or ensure informal care is valued).

Results
There were a handful of hypotheses identified in the review, including: the “old politics” of welfare expansion where “credit claiming” is used for highly popular initiatives, the “new politics of the welfare state” also known as the “blame avoidance thesis” where politicians will attempt to avoid blame by making cuts less transparent, “blame buffering” and the “median voter theory” as well as “negative policy feedback”.

Conclusions
Mature welfare states are not expanding. In fact, the theories on the politics of ageing are focused on how welfare states are retrenching or reforming, as they call it. Blame avoidance and blame buffering are the most common explanations for decisions, often counterproductive ones, about how to recalibrate welfare states in the face of ageing.
Adverse outcomes of sick leave due to mental disorders: prospective studies of discordant twin pairs
Authors: Mather L , Narusyte J , Ropponen A , Bergström G , Blom V , Helgadóttir B , Svedberg P 
Published: November 2019

Abstract

Background
Sick leave due to mental disorders is common. We investigated if sick leave due to mental disorders increased the risk of reoccurring sick leave, disability pension, unemployment, in- and specialized outpatient care, and mortality, using a co-twin design, taking genetics and shared environment (familial factors) into account.

Methods
The register-based open cohort studies contained twin pairs 18-64 years old discordant for sick leave due to a mental disorder. First, 2202 pairs were followed up to 8 years from the end of the sick leave spell for reoccurring sick leave, disability pension and unemployment. Second, 4979 twin pairs were followed up to 9 years from the beginning of the sick leave spell for death, inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for familial factors, was used to calculate Hazard Ratios (HR) with 95% Confidence Intervals (CI).

Results
Those with sick leave due to mental disorders had 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick leave the first two years and the first year, they had 12.24 (CI: 8.11-18.46) times the risk for disability pension. The risk of unemployment was 1.99 (CI: 1.72-2.31). The HR for inpatient care was 1.90 (CI: 1.66-2.17) among men but lower among women. For men the risk of outpatient care was higher the first 2 years (HR: 2.08, CI: 1.87-2.31), and for women the HR was 1.57 (CI: 1.47-1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI: 1.70-4.99), but not among women.

Conclusions
By adjusting for familial factors we could investigate if the same factors that predispose to sick leave due to mental disorders also predispose to morbidity, mortality and unemployment and hence explain the associations. But, sick leave due to mental disorders was associated with a higher risk of work related and health outcomes, independent of familial factors. The risks varied over time and differed among women and men.
Skills building seminar: Capacity-building for implementing integrated care
Authors:   Organised by: Scottish Government, EUPHA (CHR),   Chair persons: Iveta Nagyova - EUPHA (CHR), Andrea Pavlickova - UK
Published: November 2019

Abstract

Rationale
The significance of integrated care as a means for improving health outcomes and effectiveness and sustainability of health and care systems is widely acknowledged. Integrated care is a central element in many on-going or planned healthcare system reforms, however, the main challenge remains of how to build relevant capacity and know-how for the successful implementation of integrated care. Capacity-building is both the foundation and aspiration of SCIROCCO Exchange EU Health Programme funded project. The project aims to facilitate access to tailored, evidence-based support and improvement planning by recognising different staring points, or levels of maturity of healthcare systems in Europe.

Objectives
This round table aims to explore different levels of local maturity and capacity to implement integrated care in three European regions; Basque Country, Flanders and Poland. The workshop will be a practical opportunity to dispute what actions and activities should be prioritised in these regions in order to improve their capacities for the adoption and scaling-up of integrated care. The workshop also aims to raise awareness about different levels and mechanisms of capacity-building support for integrated care that exists at European level. In particular, the workshop will feature SCIROCCO Exchange Knowledge Management Hub as one of the capacity-building tools and its application in the real-life settings.

Added value
Sharing learning more widely will help to build sustainable integrated care systems and tackle the risks of people working in isolation or re-inventing the wheel.

Format of the workshop
The workshop will consist of two keynote presentations, providing necessary background into the existing European policies, programmes and initiatives to support the adoption and scaling-up of integrated care. The introductory presentations will then follow by three snapshot presentations of 5 minutes featuring the main findings on the maturity and capacity of three European regions to implement integrated care. In the second part of the meeting, the participants will have the opportunity to discuss interactively with the representatives of the regions the use of SCIROCCO Exchange Knowledge Management Hub in the real-life settings, its added value and implications of the outcomes for future actions and improvement planning. The ultimate objective is to stimulate the discussion and knowledge on how to address the existing difficulties in implementing integrated care.

Key messages
Integrated care is considered as fundamental element driving transformation of healthcare systems. The challenge remains how to address different levels of capacities to implement integrated care. SCIROCCO Exchange can facilitate the access to capacity-building support that is needed for transition and/or improvement of existing systems for the adoption and scaling-up of integrated care.
SCIROCCO Exchange - Capacity-building support for integrated care
Authors: Pavlickova A 
Published: November 2019

Abstract

Issue/Problem
Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler of capacity-building support. However, effective knowledge transfer and capacity-building support requires dedicated support and infrastructure to ensure that the flow of appropriate information and knowledge between adopting and transferring entities is tailored to the local context and maturity of the particular healthcare system seeking the support. This is a precondition to help health and care authorities to build their capacity for the successful transition towards integrated care.

Results
A key aspect of the SCIROCCO self-assessment tool is that of context and transferability. In particular, the Tool considers the context in which an integrated care solution has been developed and context into which that solution will be transferred. The Tools also helps to understand the maturity of local conditions enabling the adoption and scaling-up of integrated care and inform about the strength and weaknesses of particular region and organisation in integrated care. This in turn informs about the priorities improvement and focus of the capacity-building support.

Lessons
The experience of regions in using the SCIROCCO tool to facilitate knowledge transfer and capacity-building support demonstrates the clear benefits of the tool in stimulating multi-stakeholder involvement and learning on future directions of integrated care and transformation of health and care delivery systems in Europe.
The Swedish national public health policy and its achievements after ten years
Authors: Lindqvist N 
Published: November 2019

Abstract
Public health issues and their equality aspects have been on the political agenda in Sweden since the early 1980s. Already in the 1990s, the Government presented the first public health policy bill. This highlighted the conditions for a sustainable development from a public health perspective. Increased equality was set to be the overriding objective in prioritizing public health work and that priority should be given to efforts that would improve the situation of the most disadvantaged.
The foundation of today’s public health policy was laid in 2003 when the parliament decided on a new bill in which an overall goal for national public health policy was established: ‘Creating social conditions for good health on equal terms for the entire population’. The bill also established a cross-sectoral target structure for the overall public health work with eleven target areas. It also pointed out that public health policy is cross-sectoral and must be a part in all policy areas. In June 2008, the parliament adopted the bill A Renewed Public Health Policy. Changes made were (among other things) a rewording of the target areas, but many of the starting points were kept.
The Swedish Commission for Equity in Health was set up in 2015 and given two main tasks, to produce a proposal that can help to reduce the health inequalities in society and to work for raised awareness of health inequalities in society and among stakeholders. The work of the commission was finished in 2017 and presents an analysis of how the public health policy works in practice, with regard to the intentions of policy framework. A number of problems or areas of development appear which the Commission considers need to be addressed.
The presentation will first give a short overview of the Swedish public health policy from 2008 and will then present the commission’s conclusions and proposals for development areas.
The public health system in France and the structural developments during the last ten years
Authors: Arwidson P 
Published: November 2019

Abstract
In 2009, the hospitals, health and territories act has entrusted the responsibility for care and public health to the regional health agencies. This decentralisation aims to adapt strategies to local situations. These regional agencies have a very strong autonomy.
In 2013, it was stated in the national health strategy that it was necessary to develop a scientifically based prevention. Two tracks are to be followed: either by importing and adapting validated or promising programs by identifying effective programs in the international literature; or from existing French initiatives (tobacco, alcohol, psychoactive substances, physical activity).
The high prevalence of smoking motivated the establishment of a National tobacco reduction program in 2014, which was then relayed by a national tobacco control program.
In 2016, the Health System Improvement Act created a major national public health agency combining surveillance, prevention, health promotion and emergency response. The motivation was to achieve greater synergy and collaboration between the different functions in public health. A report from the Inspectorate General of Social Affairs has recommended that this agency should establish a national portal with evidence-based prevention and health promotion programmes.
Established in 2018, the Priority Prevention Plan is a major interdepartmental project to improve the health of the population, and is part of the National Health Strategy. This interdepartmental approach reflects the Government’s desire that all ministries should be able to contribute to prevention and health promotion.
The increased investment in prevention and health promotion is starting to bear fruit with 1.6 million fewer smokers between 2016 and 2018. Immunisation coverage has also been improved. NutriScore, a nutritional information on the front of food containers, very easy to understand, has been put in place with partnership with 100 companies.
Skills building seminar: Skillscamp: from soft skills to health for all
Authors:   Organised by: EUPHAnxt, EuronetMRPH, Young Forum Gastein Chair persons: Alexei Croitoru - Austria, Gisela Leiras - Portugal
Published: November 2019

Abstract

Soft skill-intensive occupations will account for two-thirds of all jobs by 2030. [1] Soft skills, also known as “people skills” or “interpersonal skills” are personal attributes that enhance an individual’s interactions, career prospects and job performance. Those skills are of crucial importance for problem solving, teamwork, leadership development, mentoring, etc. They are also actively applied and broadly fostered in both public and private sectors as well as NGOs, social entrepreneurship, media, etc. These actors play an essential role in achieving Universal Health Coverage (UHC) along with health inclusion and equity due to their contribution to public economy, involvement toward specific population and advocacy power.
Key public health (PH) interventions require health professionals with strong soft skills. For example, a vaccination programme can be strengthened by health professionals who are able to address patients’ concerns about vaccination and explain its benefits. Having PH teams with a wide variety of perspectives, multidisciplinary backgrounds and skills, adds significantly to the improvement of provided services and medical results.
The demand of soft skills requires contextually appropriate PH interventions, depending on the population’s needs, socioeconomic and societal structures. Hence, in order to solve the persisting problems and achieve actionable results, the intervention shall be tailored to fit the concrete target group. In order to reach Goal 3 of the Sustainable Development Goals (SDGs) and particularly “health for all”, soft skills are essential to empathise and interact with social groups with specific needs.
The workshop will address the challenges faced by medical professionals in the interaction process with three specific social groups. To optimise PH interventions in the most inclusive and equitable manner, adequate soft skills are required. Therefore, the focus will be on highlighting the skills which are essential to successfully perform PH interventions.
Within the scope of the session, the necessary soft skills will be defined and analysed. Also, their application in the context of PH will be demonstrated and exemplified. The attendants will be invited to discuss real-life examples and have the possibility to exchange their own experience and expertise with each other.
[1] Deloitte Access Economics “Soft skills for business success”, DeakinCo, May 2017

Key messages
Soft skills are increasingly needed in achieving successful public health interventions. PH professionals need more awareness of the powers of soft skills.
Soft skills for esearch on gender and sexual minorities
Authors: van der Star A 
Published: November 2019

Abstract
LGBTQI+ individuals and the healthcare system. Arjan will present a variety of issues that LGBTQI+ individuals may face when trying to access healthcare or during interactions with healthcare professionals. The group will discuss how and which soft skills would tie into these issues and will brainstorm about ideas for strategies tackling LGBTQI+ discrimination in healthcare systems across Europe. (20’)
Workshop: To regulate or not to regulate: that is still the question
Authors:   Organised by: EUPHA Chair persons: Natasha Azzopardi Muscat - EUPHA, Dineke Zeegers Paget - EUPHA
Published: November 2019

Abstract

Public health has always had a close relation with regulation. In the middle ages, the spread of infectious diseases was regulated by imposing a quarantine on travellers, this measure is still the first step to containment of an infectious disease. In the last century, public health regulation was also aimed at smoking, for instance implementing laws to ban smoking in public places (e.g restaurants). These regulations are very often combined with public health information campaigns on how to quit, the negative effects of smoking and passive smoking. In recent years, public health still calls for regulations now aiming at food, such as the fat tax, soda tax and sugar tax.
Regulating for public health is a complex and sensitive issue. Sometimes it is used to solve public health’s failings at promoting a healthy lifestyle. For instance, the information campaigns to overcome obesity and invite people to eat healthily and exercise were not as successful as planned and the obesity epidemic remains an increasing problem. So, law kicked in and taxation policies to change dietary behaviours were introduced. Taxation policies, however, are controversial and widely discussed. The term ‘Nanny-State’ where the government is regarded as overprotective or as interfering unduly with personal choice, comes to mind and this has a negative impact on public health.
The question remains: should we regulate for healthier behaviour or not. In this workshop, we are going to try answer this question. After two general presentations, we have 3 country examples of the relation between law/regulations and public health, followed by a discussion with the audience.

Key messages
Regulation can be one of the tools to promote public health. Careful consideration should be given before regulating for public health.
An emerging trend to tax sugar sweetened beverages and other junk foods: overregulation or an effective way to modify dietary behaviours?
Authors: Romaniuk P 
Published: November 2019

Abstract
Dietary behaviours have an important impact on rising prevalence of noncommunicable diseases responsible for 71% of deaths globally/year. Dietary behaviours also have a growing impact on quality of life, disabilities, as well as economic stability of health systems. In order to overcome the growing impact, many countries are looking for instruments to modify dietary habits of individuals. In the study presented here, we looked at solutions implemented in different countries in terms of junk food taxation, with regard to the political processes related to their implementation, adopted models of taxation, as well as their impact on social and economic reality. Throughout the world, several countries have adopted dietary taxes, such as sugar, fat, salt and soda taxes, while the other are planning or considering doing so. So far there is only one example of withdrawal from the tax that has been implemented. There are different models of taxation, including flat rates, percentages of the basic price and progressive rates on the amount of the component being subject to taxation. These solutions continue to be controversial and subject to intensive discussions in many countries. Nonetheless, the existing evidence shows that the impact on dietary habits seems to be positive.
Example 1: Danish regulations to phase out smoking
Authors: Pisinger C 
Published: November 2019

Abstract
In recent years, progress in Danish tobacco control has come to a halt and there has been an increase in smoking prevalence. A capacity assessment report on the implementation of effective tobacco control measures concluded that there is no overall strategy or plan to protect children, adolescents and adults from the harms of tobacco, despite the national vision of no children and adolescents smoking by 2030. Another finding was that the tobacco industry is influential in Danish policy-making and not properly regulated. Key recommendations were: 1) Develop an overall, comprehensive strategy and implement a well-designed plan. 2) Increase tobacco taxes. 3) Adopt plain packaging and a point-of-sale display ban. 4) Ensure protection from exposure to second-hand smoke and 5) Protect public health policy from the influence of the tobacco industry. The Danish Government, however, is very reluctant and there is no sign of implementation of the recommendations, despite strong public support. On the other hand, there is progress at local level as many municipalities and private workplaces have implemented smokefree working hours (no smoking at all during working hours, even if you work at home), schools have implemented smokefree school hours (no smoking from 8 to 16, even if pupils go home for lunch or break) and large supermarket chains have implemented point-of-sale display bans.
Example 2: The Italian law on compulsory vaccinations
Authors: Signorelli C 
Published: November 2019

Abstract
In March 2017, the so-called “Lorenzin law” (named after former health minister Beatrice Lorenzin who was responsible for the bill) was introduced to implement compulsory vaccination for children six years old and younger to be allowed into the school system. Without proof of the required immunizations, including those for measles, mumps, rubella, chickenpox and polio, children were not eligible to attend kindergarten. But the Five Star Movement and the League, which formed a ruling coalition in 2018 to form the current government, pledged to scrap the vaccination obligation during the run-up to elections in March, courting the so-called “anti-vax” vote. The newly appointed minister of health, Giulia Grillo, adopted a temporary measure relaxing these vaccination requirements until the end of March 2019. The temporary measure allowed children to stay in school as long as their parents attested that the children had been vaccinated. A doctor’s note was not needed.
The temporary measure was adopted pending a complete revision of the law on compulsory vaccinations. As no new law was adopted in March 2019, the previous law returned to force, leading for instance to around 300 children in Bologna, Italy, not being admitted to kindergarten as they did not have the required immunizations. Amid confusion over the rules as the new school year begins, the governing Five Star Movement (M5S) presented parliament with an amendment that effectively halts its own reform and reinstates the previous vaccination requirements.