Academic journal article Inquiry

Exploring the Life Expectancy Increase in Poland in the Context of CVD Mortality Fall: The Risk Assessment Bottom-Up Approach, from Health Outcome to Policies

Academic journal article Inquiry

Exploring the Life Expectancy Increase in Poland in the Context of CVD Mortality Fall: The Risk Assessment Bottom-Up Approach, from Health Outcome to Policies

Article excerpt

Abstract

Life expectancy at birth is considered the best mortality-based summary indicator of the health status of the population and is useful for measuring long-term health changes. The objective of this article was to present the concept of the bottom-up policy risk assessment approach, developed to identify challenges involved in analyzing risk factor reduction policies and in assessing how the related health indicators have changed over time. This article focuses on the reasons of the significant life expectancy prolongation in Poland over the past 2 decades, thus includes policy context. The methodology details a bottom-up risk assessment approach, a chain of relations between the health outcome, risk factors, and health policy, based on Risk Assessment From Policy to Impact Dimension project guidance. A decline in cardiovascular disease mortality was a key factor that followed life expectancy prolongation. Among basic factors, tobacco and alcohol consumption, diet, physical activity, and new treatment technologies were identified. Poor health outcomes of the Polish population at the beginning of 1990s highlighted the need of the implementation of various health promotion programs, legal acts, and more effective public health policies. Evidence-based public health policy needs translating scientific research into policy and practice. The bottom-up case study template can be one of the focal tools in this process. Accountability for the health impact of policies and programs and legitimization of the decisions of policy makers has become one of the key questions nowadays in European countries' decision-making process and in EU public health strategy.

Keywords

life expectancy, health risk assessment, policy, bottom-up approach, health determinants

Introduction

Many epidemiological studies find a range of health outcomes (eg, mortality) to be consistently related to provided policy. (1,2) This is made possible by identifying and affecting risk factors directly connected with some health outcomes. The results in health outcomes might be related to many different policies at the same time.

The conceptual model of the determinants of health inequalities of the World Health Organization (WHO) concludes the influence of the main aspects that affect inequalities in health, the majority of them being outside the health sector. (3) Following this conclusion and considering the factors that affect equity in health and well-being, it is necessary to reinforce the need for considering the concept of "Health in All Policies." In Poland, like in other Central European countries (eg, Czech Republic, Slovakia, Hungary), the life expectancy has significantly improved over the past 20 years. This process has started after political and socioeconomic transformation in the region that started in 1989. This study focuses on how this interaction has caused significant life expectancy prolongation in Poland over the past 2 decades and thus includes health policy context. As an example of effective population health management, it may aid decision makers, public health experts, and health promoters in engaging in scientific and intellectual reflections on how to improve population health and the distribution of health outcomes within a given population in the future.

The objective of this article was to present the concept of the bottom-up policy risk assessment approach, developed to identify challenges involved in analysis of risk factor reduction policies and in assessing how the related health indicators have changed over time.

This study was a part of a European Commission's public health research project Risk Assessment From Policy to Impact Dimension (RAPID). (4) The aim of the project was to develop and provide policy makers with methodological guide for the assessment of the complex impact structure of policies in relation to the health of the population. …

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