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Lectures: Lifestyles, Work, and Health in the EU – EPH2022Lifestyle in the EU (International Health) – case 1
Lifestyle
Behaviours that emerge through a complex interrelationship among voluntary,
biological, and environmentally induced factors.
Historical role of lifestyle in health
• Focus on lifestyle is arguably the oldest approach to public health
• Focus was partially eclipsed by 3 A’s in medicine:
antisepsis, anaesthesia, antibiotics
• Focus on lifestyle (re-)emerged after 2nd world war as an indispensable
component of public health work
Lalonde Report
Four macro-determinants listed below are seen in every health model:
- Professional care
- Genetics
- Behaviour (lifestyle)
- Environment
Alma Ata Declaration (1978)
Health that would permit people to lead a socially and economically productive life,
- Health for all
- Primary health care
- Health and fundamental human right
- Equity
- Appropriate technology
- Inter-sectoral development
- Community participation
Environmental factors influence people differently
You push two people of a dock. One can swim, the other cannot swim. The same
occurrence, but a very different experience for ether one.
Differences include:
- Constitution (how you’re made)
- Coping (skills)
- Medical state (health)
- History
- Ambitions (what you strive for)
Lifestyle in health
• Always relates to behaviours, whether voluntarily chosen or not
• Work to change lifestyles has been widely linked with the ideas of participation
and empowerment
• Lifestyle is almost universally conceptualized as subject to forcefield of biological
and environmental factors
,Lifestyle determinants:
o Life expectancy
This is increasing year after year in the EU (except during peak covid-19).
However, these is also a growing gap between East (Poland, Russia, Ukraine)
and West (Spain, Italy, France, Germany, UK). The East is getting older
slower than the West.
The median life expectancy for people coming from economically developed
countries is above 100 years old.
o Overweight (BMI>25) and Obesity (BMI>30)
These rates are increasing very fast.
o Health in all Policies (HiaP)
Focus on health in different sectors and policies.
o Smoking
Most people die because they have a heart attack due to smoking.
And 80-90% of people get lung cancer due to smoking.
We see that the incidence of young smoking women has gone up, possibly
due to more freedom.
However, there is a great difference in cigarette taxing in Europe. Some
countries have a much higher tax than others. It has been shown that taxation
does influence the consumption.
o Physical activity
Walking for 30min a day is enough to get the majority of the health benefit.
There is a clear difference in physical activity between boys and girls.
Boys get substantially more physical activity than girls.
Because boys are encouraged more to do sports, in addition, it could be a
biological thing that girls choose for less physical activity.
o Suicide
There is a great difference in suicide rates in Europe.
No clear pattern can be found as to why rates are higher in one country, and
lower in another.
However, among adult populations economical aspects play a role in suicide
rates. The choice to commit suicide is not only a question of one’s free will, but
there are structural environmental influences that play a role.
For example, in Greece the suicide rates went up during the great recession.
Emile Durkheim
- Society transcends the individual / Suicide is a social fact
- Rates of suicide differed between Catholics and Protestants
- Thus, suicide is a highly personal act and choice that is heavily socially
influenced
,Europe 2020 Strategy
▪ Europe 2020 and Health
▪ 2013: Investing in health
▪ 2007: Together for health
To summarize…
o Differ greatly by EU country and certainly combine to explain some if not much of
the differences in life expectancy
o Cannot be separated from aspects of the physical environment (e.g. availability of
products, even weather)
o Cannot be separated from aspects of the social environment (e.g. cultural
norms/values, history, national policies)
o Approaches to changing lifestyle must take a two-pronged approach:
Possibly focus on a given behaviour, but also account for the influence of the
broader set of factors.
Precede-Proceed Model
Developed by Green, Kreuter, Deed, Partridge (1980).
It has since been refined by Green and Kreuter.
It is an example to a model that focuses on lifestyle but recognizes wider factors.
Precede = before the intervention
Proceed = steps to implement intervention
, Applying the Precede-Proceed Model:
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