Larissa Loufman, MPH, RD, LD, CLC, CCRC, is a Social/Clinical Research Specialist with the Department of Family Medicine who attended the European Public Health Conference in November 2019 and recapped her experience below.
Marseille (pronounced MAR-say) is the oldest city in France. It is also a port city. Historically, for port cities to survive and thrive, they need to be open to all. It was no mistake that the 12th European Public Health Conference, hosted by the European Public Conference Foundation, European Public Health Association (EUPHA), and Société Française de Santé Publique (sfsp), took place in this vibrant city. It was even more fitting the conference took place in Marseille since the main theme was “building bridges for solidarity and public health.” According to the EUPHA, the theme incorporates two major elements: “leaving no one behind and translating knowledge.” The conference was divided into tracks, such as “healthy living, food, and nutrition,” “solidarity in health,” or “maternal, child, and adolescent health.” I attended presentations from multiple tracks to get a better sense of the wide variety of topics covered. Throughout the conference, several key takeaways emerged which I believe are important and relevant to the health system changes many are hoping to achieve here in the U.S.
Analysis. Advocacy. Action.
In a time of anti-science rhetoric and fear, some have turned their backs on or flat out ignored scientific research findings (i.e., the anti-vaccination movement). Some have also chosen to isolate certain populations because they are a perceived burden on society. Health misinformation is a major global issue causing confusion and backtracking of progress in the field and towards the achievement of the 2030 Sustainable Development Goals (SDGs) outlined by the United Nations General Assembly.
The EUPHA stated three commitment areas:
- Take responsibility for supporting migration policies
- Be determined to the value of solidarity through the “health for all” policies approach
- Call for action to combat inequities in health
The concept around the catchy slogan “Analysis. Advocacy. Action.” represents a call for health professionals to:
- Produce strong, scientifically-based evidence utilizing rigorous data collection and analysis methods
- Use the research literature to inform policies that include the most vulnerable populations
- Collaborate jointly with professionals across sectors to implement policy on the ground level, participate in capacity building to develop best health practices, and strengthen health systems to address the needs of all people
Several expert speakers from major international and national organizations reiterated EUPHA’s three commitment areas and emphasized that now, more than ever, we need to band together to conduct quality research, create strategic plans to combat misinformation, advocate for inclusiveness and health in policy making decisions, and put innovative public health practices into action. Our own UNC Department of Family Medicine strategic plans and faculty focus areas echo similar approaches to health transformation through groundbreaking research, influencing multilevel health policies, and enhancing patient-based care that addresses our underserved and diverse populations.
Changing Populations & Equity: Leaving No One Behind
Health is a basic human right. I am sure many of my fellow colleagues agree. This sentiment is nothing new, but what does it really mean? We know there are major gaps in our health delivery system that will require us to be more inclusive in our efforts to transform and ensure comprehensive health care for all. Some thought-provoking questions asked by presenters included: Are we acknowledging (in policy) the special needs of women in the workforce who commonly handle childcare and household chores on top of work responsibilities? Are we prepared to address the unique needs of the growing aging population? Are we investigating overcoming poverty from a multidimensional (and not just financial) perspective?
Unprecedented socioeconomic, racial, and health disparities exist globally and are threats to health status. As populations are changing, health professionals need to guarantee that vulnerable groups are not overlooked in policy and practice. In this digital age, health data platforms can serve as opportunities to empower patients to take control of their health and allow researchers to collect key data to display inequalities that inform policy and practice improvements. At the same time, privacy is a noteworthy concern. “Big data can be used against people to discriminate and can also be a powerful tool for advocacy,” according to Dr. Neha Pathak of the UCL Institute of Health Informatics, United Kingdom.
In one of the plenary sessions, attendees were asked three True/False questions:
- Fertility rates among migrants are higher than among host populations- True or false?
- Migrants are damaging economies- True or false?
- Migrants are a burden on health services- True or false?
According to the panel of speakers and, as evidenced by data presented in The UCL-Lancet Commission on Migration and Health, the answers to these questions are all “false.”
Addressing the health of underrepresented groups also supports the health of a country’s general population. For example, the incarcerated population is a very mobile group who often suffer a higher burden of poor mental and physical health and are never truly isolated from society since these people come and go from the system. Migrants and refugees may risk their lives to escape dire living conditions, abuse, political conflict, and economic turmoil. This is another population who may impact and/or be impacted by the health of the native population, especially when it comes to the spread of communicable diseases. The Marseille Statement, supported by nations across Europe, declares that “no one seeking asylum or without appropriate documentation should die or be put in danger by limited or no access to healthcare.” From a human rights and equity perspective, conference speakers made a compelling argument to support why we should to address the health needs of special and general populations alike. Halting these inequities at the local level with buy-in and input from the community will support generating ideas to raise awareness and fully address the health of underserved populations here in North Carolina.
Bridging Sectors: Community & Interdisciplinary Approaches
New and innovative approaches to tackling public health challenges are required to influence change and make progress towards healthcare transformation. Attendees were encouraged to seek interdisciplinary, internal and external (i.e. law enforcement, government officials, businesses, pharmaceutical companies, civil engineers, etc.) partnerships that will place health priorities at the forefront of multi-sector agendas. Presenters also acknowledged the importance of addressing Social Determinants of Health as critical for health improvement through a focus on community-based, collaborative strategies to meet patients’ medical and social needs. Another potential tactic proposed was the integration of “skill mixing innovations,” or the expansion of scope of practice where multidisciplinary health professionals could broaden their skill set to streamline health system operations and reduce barriers to access.
European health leaders admitted that they have put a lot of work into higher level efforts (global and national health policies, for example) and recognized the need for more action on the local and regional levels where policies are not always implemented and access to Universal Health Coverage is being denied to eligible applicants. One such effort
being tested is the integration and assessment of SDGs on the city and zip code levels within the city of Cascais, Portugal led by Ricardo Baptista Leite, an MD, member of parliament, and former deputy mayor. In the face of climate change, many presenters also stressed that joint, environmentally-friendly, and sustainable solutions are required to ensure future health, equity, and overall well-being. As leaders near retirement, many expressed the importance of training and empowering the next generation of health specialists. As younger professionals move into leadership positions, this will grant them the opportunity to build the necessary capacity and skills to effectively influence the healthcare delivery. Moreover, allowing inter-generational colleagues to have a voice in decision making may bring a fresh perspective to overcoming health system challenges. Fortunately, our department has the vital task of training the next generation of health practitioners and recruiting faculty and staff from diverse backgrounds, who have developed the wide variety of skills necessary to tackle current and future health needs.
This annual EPH Conference is attended by over 2,000 researchers, policy makers, practitioners, and educators from 78+ countries with an interest in public health worldwide. Planned three years in advance, the next conference will take place in Rome (2020) and Dublin (2021). For more information, please visit: https://eupha.org/
The latest copy of the European Journal of Public Health can be found here: https://academic.oup.com/eurpub/issue/29/5