11.F. Workshop: Health examination surveys to support decision making and for monitoring risk factors
Authors:   Organised by: EUPHA-PHMR, Finnish Institute for Health and Welfare, Collaborating Centre for Noncommunicable Disease Prevention, Health Promotion and Monitoring,   Chair persons: Hanna Tolonen (EUPHA-PHMR), Heidi Lyshol (Norway)
Published: October 2023

Abstract

Non-communicable diseases (NCDs) contribute for 74% of all deaths globally. They are also major cause of morbidity and disability. Many of the NCDs could be prevented with timely lifestyle changes and treatment of biological risk factors. Several NCDs, such as diabetes, cardiovascular diseases, chronic respiratory diseases and several cancers share same risk factors namely smoking, harmful alcohol use, unhealthy diet and lack of physical activity which impact on biological risk factors such as obesity, elevated blood pressure, elevated blood cholesterol and raised blood sugar levels. Up-to-date, representative, and high-quality health information is needed to support evidence-informed policy making and innovative research. Monitoring of lifestyles and biological risk factors affecting the NCDs is needed, to identify current the situation among different population groups and to plan and target required actions for prevention and treatment. Information on lifestyles is usually collected through survey questions about smoking habits, alcohol use, diet and physical activity. For biological risk factors, self-reported information tends to be biased. For example, elevated blood pressure, blood cholesterol and blood sugar levels are asymptomatic for a long time and people often don’t know about their condition. For obesity, stigma and societal pressure may lead to misreporting. For health care registers, information on biological risk factor is not systematically recorded and whenever data is available, it represents only patients. Therefore, for biological risk factors, the only reliable source for information about population level situation are health examination surveys (HES). At the European level, European Health Examination Survey (EHES) has provided a standardized protocols for measurement of key biological risk factors. These recommendations are in line with the WHO Stepwise approach for NCD risk factor surveillance. In the past ten years, less than half of the EU Member States have conducted at least one national HES. This workshop will include four presentations providing a general overview of why we need to be monitoring NCD risk factors and how broadly this is done in Europe. Three case examples showcase how the monitoring is conducted in different countries. Finland has done NCD risk factor monitoring regularly since 1960's and has the longest time series in Europe, Germany has conducted several comprehensive multi-year cross-sectional surveys since early 2000's and is piloting more flexible methods, and Portugal had their first health examination survey in 2015-2016 and is now planning the next one. How these countries have organized their monitoring and how the data obtained have been used to support actions targeting to improve population health will be discussed.

Key messages
• Health examination surveys are needed to obtain reliable and representative information about NCD risk factors at the population level.
• Standardized protocols for measurements of biological risk factors are needed to ensure cross-country and over time comparison of the outcomes.