The EUROHEPRO survey reveals great differences between countries in the Baltic Sea Region. The results indicate the potentials for change, says HEPRO expert and researcher.

The Hepro project has, through EUROHEPRO, surveyed health and well-being among 33000 citizens in Norway, Estonia, Latvia, Lithuania, Poland, and Denmark. Citizens in 27 cities and municipalities have been interviewed and filled in questionnaires.

The main aim of the project has been to support development and planning of public health on the local municipal and city level, among members of National Healthy Cities Networks.

Former Head of Research at the Danish Institute of Public Health Dr Niels Kr. Rasmussen has been involved as an expert in the HEPRO project since its beginning in 2005. At the International WHO Healthy Cities conference 2008 in Zagreb he presented the findings for other researchers and public health professionals.

-  The survey reveals very big differences in the aspects of health and well being that were studied in the different countries, cities and municipalities. The observed differences between lowest and highest indicate the potentials for change and improvement in health and well-being. The differences within each country indicate the potentials in a short term, whereas the differences that appear across the borders indicate the potentials in longer terms, says Rasmussen.

The survey asked participants, among other things, about their health. When the responses to a question about the citizen’s own perception or evaluation of their health – their subjective health – was analysed, different patterns appeared in the countries.

The level of good health was highest among the youngest age groups – and higher among men than among women in all countries. And the level decreased with increasing age, probably reflecting the increasing prevalence of diseases. But in Denmark and Norway the decrease in the level of perceived health was much less steep than in Latvia, Lithuania, Poland or Estionia.

The results indicate that the burden of disease on a person’s well being is different between these two groups of countries.

-  There can be several explanations for this difference. On the societal level, it can be differences in supportive health care and social service systems between the countries. It might also be differences in the severity of the diseases. Only further analyses can throw light on the causes for these differences, says Rasmussen.

The results from the survey also challenge health promotion and disease prevention. First of all, it raises the question about how the rather high level of diseases can be prevented and reduced. Secondly, as it evidently is impossible to prevent all diseases, how do the societies manage to reduce the negative impact of diseases on well being and daily functioning and thereby contributing to a healthy aging for the population?

-  In the local community, many different sectors and administrative branches are responsible for policies and planning that have an impact on health and well-being.
Very often collaboration and coordination between the different sectors involved in public health is lacking. The HEPRO project has overcome these barriers and has succeeded in involving representatives from these different sectors in the development of the survey and the use and implementation of the results, says Dr Rasmussen.

The established HEPRO database will offer unique opportunities for analysing, which factors contribute to health differences, and thereby what should be the focus of future preventive and health promotion actions.