Christina DIETSCHER Austrian Ministry of Labour, Social Affairs, Health and Consumer Protection, Department X/6, health promotion and disease prevention, AUT
Christina Dietscher is acting head of the department for health promotion and disease prevention at the Austrian Ministry for Health and chair of the Austrian Health Literacy Platform. She is responsible for developing, implementing and monitoring strategies and projects a.o. in the field of health literacy. Before joining public administration in 2015, she worked in health promotion research at the WHO Collaborating Centre for Health Promotion in Hospitals and Healthcare at the Ludwig Boltzmann Institute (LBI) for the Sociology of Health and Medicine and the LBI for Health Promotion Research for more than 20 years. Her professional experiences include the evaluation, coordination, and strategic consulting of projects and networks in health promotion, especially in relation to schools, hospitals, youth work, mental health, and organizational health literacy. Christina is author of numerous publications and a frequent speaker at international and national conferences. She holds a doctorate in sociology.
Abstract summary: Health and sustainable development are inextricably intertwined. On the one hand, health depends on societal development, especially on peace, social security and economic growth. On the other hand, health itself is a major determinant for societal innovation and development. Thus, health is both a driver for, and an outcome of, sustainable societies. For this reason, the interdependence of health and sustainable societal development is high on the political agenda – both internationally and in Austria:
Quite recently, health has been assigned a key role in the fulfilment of the United Nation’s Sustainable Development Goals in the 2030 era of sustainable development, which cover all areas of life, all phases of life and all sectors. Within the health sector, WHO has emphasized the vital contribution of health to sustainable development in the Shanghai Declaration that was launched during the 9th Global Conference on Health Promotion in November 2016. Also, the European Commission relates to health as a driver of economic growth in its position paper on investing in health from 2013.
In Austria, we have set up a systematic process that addresses the interdependence of health and societal development in form of national health targets. The process started in 2011 and was commissioned by the Council of Ministers, the National Assembly and the Federal Health Commission. During a one-year participatory and intersectoral process with more than 40 key political and societal stakeholders (“the plenary”), 10 health targets were defined and finally adopted by the Council of Ministers and the Federal Health Commission. They are now part of the current government program and represent an important framework for the ongoing healthcare reform process. The targets aim to continuously improve the number of healthy life years of the Austrian population, paying special attention to health equity, and their scope goes far beyond the classical health sector: the targets address the social determinants of health in all major life settings throughout the whole life course, including living, learning and working environments, city and regional planning, public safety, and ecology.
Therefore, implementing the targets cannot be achieved by the health sector alone. Rather, a health-in-all-policies approach is needed to address health determinants in all sectors. Accordingly, we have set up specific intersectoral working groups for each health target, whose task it is to define sub-targets, indicators and concrete actions to realize the targets. Monitoring is in place to assess the progress we make. And Austria also works at broadly introducing health impact assessment as a tool to foster intersectoral responsibility for health.
So far, our efforts have strengthened awareness of health equity, health in all policies, health promotion and health determinants both within the health sector and beyond. This is also supported by new intersectoral financing mechanisms. First, we have introduced so-called “Vorsorgemittel” (prevention funds) that are dedicated to funding nation-wide public health interventions that are jointly selected by representatives of the national government, the Austrian federal provinces, and social insurance. The current priority of the prevention funds is on early childhood interventions to strengthen health and health equity (“Frühe Hilfen”). Second, there are now health promotion funds in all nine Austrian federal countries. The projects and programs they fund have to be in line with the national health promotion strategy which is oriented at the health targets.
Key learnings from the Austrian experiences with the Health Targets show that it is crucial
- to build and sustain capacities (leadership, partnership, organizational and workforce development, resource allocation) for facilitating intersectoral cooperation;
- to showcase examples of how other sectors can benefit from activities and investments in health – very often, better health will help them to better meet their own targets;
- to pursue a participatory approach, enabling representatives of all sectors to bring in their own perspectives and interests;
- and to create ownership of the process across sectors.
Last but not least, it is important to think long-term, to be creative and to avoid over-regulation in order to keep the process active and productive over prolonged periods of time.
