Presentation - Advancing health literacy and social mobilization for the United Nations 2030 Sustainable Development Goals
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This document discusses advancing health literacy and social mobilization to achieve the United Nations 2030 Sustainable Development Goals. It outlines the 17 Sustainable Development Goals, including Goal 3 which aims to ensure healthy lives and promote well-being for all at all ages. It notes that improving health literacy levels is crucial for attaining the social, economic, and environmental ambitions of the 2030 Agenda. Broadening and strengthening social mobilization through open dialogue, civil society engagement, and effective partnerships is key to securing health, dignity, and equality for all. Mobilizing communities for health promotion links to achieving multiple Sustainable Development Goals.
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Presentation - Advancing health literacy and social mobilization for the United Nations 2030 Sustainable Development Goals
- 1. Advancing health literacy and social mobilization for the United Nations 2030 Sustainable Development Goals Dr Zsuzsanna Jakab WHO Regional Director for Europe
- 2. A world of change agents…
- 3. Transforming our world: the 2030 Agenda for Sustainable Development • 17 Sustainable Development Goals (SDGs) and 169 targets • A post-2015 global framework fully aligned with Health 2020, the European policy framework for health and well-being
- 4. SDG health targets are not new Goal 3: ensure “healthy lives and promote well-being for all at all ages” 3.1 Reduce maternal mortality 3.2 End deaths of newborns and children 3.7 Access to sexual and reproductive services 3.3 End epidemics of infectious diseases 3.4. Reduce mortality from NCDs and promote mental health 3.5 Substance abuse, and harmful use of alcohol 3.6 Reduce deaths and injuries from road traffic accidents 3.a Framework Convention on Tobacco Control 3.9 Reduce deaths and illnesses from environmental contamination 3.8 Achieve universal health coverage 3.b Research and vaccines and medicines 3.c Health financing and health workforce 3.d Management of national and global health risks Health throughout the life-course Communicable diseases, noncommunicable diseases and risk factors Environmental diseases Health systems Goal 3: 13 targets by Health 2020 thematic area Across all SDGs, there are more than 20 health targets.
- 5. Health targets are present across all SDGs Provide access to safe drinking-water, target 6.1 Achieve sanitation and hygiene for all, target 6.2 Significantly reduce violence (all forms), target 16.1 End violence against children, target 16.2Strengthen resilience to climate change, target 13.1 Eliminate violence against women, target 5.2 Eliminate female genital mutilation, target 5.3 End all forms of malnutrition, target 2.2 Provide safe and sustainable transport, target 11.2 Reduce harm from disasters, target 11.5 Protect occupational health/labour rights, target 8.8
- 6. Premature mortality The WHO European Region is on track to achieving this health objective. The most important opportunities to do so lie in addressing social determinants, risk factors, and strengthening health systems. Health 2020 target: reduce premature mortality from cardiovascular diseases, cancer, diabetes mellitus and chronic respiratory diseases by 1.5% per year until 2020.
- 7. 0 100 200 300 400 500 600 700 800 Switzerland Israel Sweden Norway Cyprus Luxembourg Iceland Spain France Finland Italy Malta Portugal Netherlands Austria Belgium Ireland UnitedKingdom Albania Germany Denmark Greece Slovenia SanMarino Turkey CzechRepublic Croatia Estonia EuropeanRegionaverage BosniaandHerzegovina Poland Slovakia Georgia Montenegro Romania Armenia Serbia Kazakhstan Lithuania MKD* Azerbaijan Latvia Hungary Bulgaria Tajikistan Uzbekistan RepublicofMoldova Kyrgyzstan Belarus Ukraine Turkmenistan RussianFederation Deathsper100000populationaged 30–69years The latest data from 4 major noncommunicable diseases caused by premature mortality
- 8. 0 200 400 600 800 1000 1200 2000 2005 2010 2015 2020 Deathsper100000population aged30–69years Minimum value European Region average Maximum value Regional trends Indicator: age-standardized mortality per 100 000 population aged 30–69 years, for combined causes of death from: cardiovascular diseases, cancer, diabetes, chronic respiratory diseases
- 9. Important role of the social determinants of health The distance between the highest and lowest regional values related to the social determinants of health – infant mortality, life expectancy, primary school enrollment and rate of unemployment – declined in recent years. However, the absolute differences between countries are still significant. Health 2020 target: reduce health status gaps and social determinants- related differences in European populations.
- 10. The gap has been reduced 0 10 20 30 40 50 60 1990 1995 2000 2005 2010 2015 Infantdeathsper1000livebirths Year Infant mortality Minimum value European Region Maximum value 60 65 70 75 80 85 1990 1995 2000 2005 2010 2015 Years Year Life expectancy Minimum value European Region Maximum value 0 5 10 15 20 25 1995 2000 2005 2010 2015 % Year Primary school enrollment (non-enrollment rate) Minimum value European Region Maximum value
- 11. Managing the social determinants of health can significantly improve the state of health In Estonia, a man over 25 years of age with university degree can live 13 years longer than his less-educated contemporaries. In Italy, different social groups have a 10-year difference in life expectancy. In Slovakia, newborn and adult mortality in disadvantaged regions are almost twice those of developed regions. In the Netherlands, morbidity and mortality could be reduced by 25–50% through better education. In Israel, there is potential for leading on policy and governance for health and well-being by addressing the social determinants of health. This will result in significant health improvements.
- 12. 1st International Conference on Health Promotion • Took place in November 1986 in Ottawa, Canada • Produced the Ottawa Charter for Health Promotion, a benchmark for a new public health movement
- 13. Our world today Social movements E.g. patient groups, citizen activists Social media E.g. patient forums, blogs Big data E.g. data mining, risk stratification People-centered care E.g. personalized services, life-course approach New technologies E.g. health apps, telecare Ageing population E.g. more contact with health services
- 15. 6th Global Forum & 9th Global Conference on Health Promotion • Took place in October 2016 on Prince Edward Island (PEI), Canada • Themed “Health promotion – at the very heart of sustainability” • Led to the creation of the PEI Declaration, a civil society declaration • Took place in November 2016 in Shanghai, China • Themed “Health promotion in the Sustainable Development Goals” • Led to the adoption of the Shanghai Declaration on Health Promotion, and the adoption of the Shanghai Consensus on Healthy Cities by the International Mayors Forum Celebrating the 30th Anniversary of the Ottawa Charter
- 16. Health promotion is essential to achieving the SDGs
- 17. Promoting health literacy, a key determinant of health Source: Budhathoki, S. S., Pokharel, P. K., Good, S., Limbu, S., Bhattachan, M., & Osborne, R. H. (2017). The potential of health literacy to address the health related UN sustainable development goal 3 (SDG3) in Nepal: a rapid review. BMC health services research, 17(1), 237.
- 18. Health literacy for healthy ageing Source: IROHLA consortium. (2015) Policy brief for health organisations. Health literacy for healthy ageing.
- 19. Health literacy links to key SDGs • Improving health literacy levels is crucial for attaining the social, economic and environmental ambitions of the 2030 Agenda for Sustainable Development. • Harnessing health literacy improves health and reduces health inequities.
- 20. Health literacy in Europe Roughly 50% of the European population is thought to have poor or inadequate levels of health literacy, according to the European Health Literacy Survey. Source: Kickbusch, I., Pelikan, J. M., Apfel, F., & Tsouros, A. D. (Eds.). (2013). Health literacy: the solid facts.
- 21. What we need: evidence and more data • The health status of a country’s population often correlates with the health literacy levels of the population. • There is much variation regarding the level of health literacy across Europe. • Internationally comparable data is needed to measure the impact of efforts to improve health literacy. Steering Group of the European Health Information Initiative (EHII), Copenhagen, March 2017
- 22. EHII participants: 33 and growing Austria Belgium Czechia Finland Georgia Greece Italy Kazakhstan Kyrgyzstan Latvia Lithuania Malta Netherlands European Commission WellcomeTrust European Public Health Association Poland Portugal Republic of Moldova Romania Russian Federation Slovenia Sweden Switzerland The former Yugoslav Republic of Macedonia Turkey United Kingdom
- 23. Broadening and strengthening social mobilization • Open and inclusive dialogue • Civil society engagement • Intersectoral action • Effective partnerships for health and well-being Harnessing the power of social mobilization for health promotion means forming alliances and enabling participation across all sectors to secure the goal of health, dignity and equality for all.
- 24. Social mobilization campaigns are: partnerships with the people (and stakeholders) for people’s good health and well-being. They are highlighted in SDG 3 and many others.
- 25. From social mobilization to community engagement: WHO’s work in emergencies • Social mobilization is a preliminary step to raise community awareness of hazards. • In emergency response, a further step is needed: community engagement. • Community engagement is working with and through the community to establish trust and bring about behavioral change.
- 26. • Somali community, Sweden • Ultraorthodox Jewish community, United Kingdom • Roma communities, Bulgaria Engaging communities
- 27. → Listening to beneficiaries and frontline health providers → Understanding barriers and enablers to vaccination → Addressing challenges Behavioural and community insights People-centred, bottom-up approach Exploring individual, social, institutional factors Adopted for: • infectious hazard management programmes • antimicrobial resistance programmes • emergencies • global low- income settings
- 28. Promoting the health and well- being of women and girls fuels gender equality. Health promotion goes hand in hand with safe, sustainable working conditions. Social activism is crucial for addressing inequalities and marginalization. Mobilizing people for climate action generates momentum for change. Social mobilization is a driving force for the United Nations 2030 Sustainable Development Agenda Social mobilization links to key SDGs
- 29. Key strategiesAREASDOMAIN POPULATIONS AND INDIVIDUALS Identifying needs Empowering populations Tackling determinants Protecting rights and fostering shared responsibility Enabling informed choice Engaging patients Enhancing health literacy Supporting the development of community health Supporting patient self-management Supporting patients’ shared decision-making Strengthening patient peer-to-peer support Supporting patients’ families and carers Taking action: strategies for empowering populations and engaging patients
- 30. Health literacy and social mobilization for healthy cities and communities • Leadership from cities is needed to reduce inequalities. • Cities are at the frontline of sustainable development. • Healthy cities are safe, inclusive, resilient and sustainable. • Health literacy is a key attribute of a healthy city. • Good city governance is promoted through strong community engagement and empowerment.
- 31. The challenges and the way forward • Health literacy and social mobilization are political matters and need a whole-of-society and whole-of-government approach. • Community engagement is a further step that can bring about true behavioural change and health gains. • Champions and leaders across society, sectors and professions are needed.
- 32. Thank you!
Notes de l'éditeur
- Dear colleagues, Ladies and gentlemen, Let me begin by expressing my sincere gratitude for the invitation and the opportunity. I am very pleased to be with all of you here today and honored to address the issue of harnessing health literacy and social mobilization for the implementation of the SDGs.
- Let me start by saying that the whole UN Agenda 2030, was the result of a three years social mobilization process. The process to design the 2030 Agenda for Sustainable Development was informed by a public consultation at a scope unprecedented in UN history. It was the result of a three–year–long transparent, participatory process inclusive of all stakeholders and people’s voices. The voices of 9.7 million people were listened to. This is the lasting legacy of Agenda 2030, the inclusive nature of the process, people’s engagement and with this the beginning of a fundamental shift in the way “we do business” in development. And we are here today to understand how we can continue on this legacy.
- The 2030 agenda gives tremendous support to our work as it is adopted by Presidents / PMs at the highest level, and it gives a central role to health as an outcome, determinant and enabler of sustainable development. The 2030 agenda and H2020 are fully aligned and they both represent an opportunity to ensure policy coherence. Since its endorsement in 2012, the European health policy framework Health 2020 has formed the basis of policies to achieve better, more equitable, sustainable health in the WHO European Region. Our policy environment was fully updated in Europe and coherence achieved. Health 2020 recognizes that improved health and well-being depend largely on political commitment. Health 2020 calls for action on the full range of determinants of health (political, economic, social, environmental, commercial, cultural and behavioural), which interact in complex ways throughout life and across generations. It advocates high-level leadership for health and well-being, strong intersectoral mechanisms, and focuses on approaches involving the whole of government and society and the consideration of health in all policies.
- There is one health goal with 13 targets and they reflect most of the health priorities of the European Region. Some of the targets follow from the ‘unfinished MDG agenda’; others are important health priorities and objectives of Health 2020, and are addressed in many of WHO/Europe’s committal documents. These include for example: noncommunicable diseases, mental health, risk factors, nutrition, road traffic accidents, and environmental pollution, health services, health financing and the health workforce and research.
- There are 25 other health related targets in other goals for example, violence against women is covered under SDG 5, target 5.2; violence against children under SDG 16 target 16.2; malnutrition, including obesity, is under Goal 2 target 2.2, Safe drinking water and sanitation under targets 6.1 and 6.2; Disaster mitigation SDG target 11.5 and Climate change resilience SDG target 13.1
- H2020 has headline targets to achieve and a monitoring framework system with agreed indicators with MSs Three important targets are to increase life expectancy and reduce premature mortality in the Region (by 1.5% annually) and to reduce inequities in health. There is good progress in all three which shows that our strategies work.
- In the European Region, the leading countries with lowest levels of premature mortality are Switzerland, Israel and Sweden.
- Progress in the Region is due to improvements in the countries with the highest values.
- Health 2020 is about addressing inequities / inequalities in health between and within countries. There is progress in Europe: the distance between highest and lowest values declined in recent years but the absolute differences are still significant. This lead us to think of the root causes, like social determinants of health and the important role they play in shaping our health. Equally, education is a low hanging fruit.
- As you can see, the gap has been reduced in important indicators, like infant mortality, life expectancy, primary school enrolment. In order to move further, we have to work together on social determinants, education, health literary, people empowerment. This is the aim with our policy dialogue and policy platform with education and social sectors – as well as the relevant partners (Paris conf. – December 2016).
- Education, employment, income and financial circumstances, housing, sanitation and water etc. are the fundamental determinants of health and the existing health inequalities in Europe. That is why the housing, resources for families and direct access to community services, as well as the number of completed schooling and political decisions affecting the income is directly converted into opportunities for health throughout the life. In Israel, there is a strong potential for leading on policy and governance for health and well-being towards managing the social determinants of health that can significantly improve the state of health.
- Sustainable development is not new to us. It is embedded already in the Constitution of the World Health Organization in the Alma Ata Declaration. Further, already in 1986, at the International Conference, the Ottawa Charter for action to achieve Health for All, that “The conference was a response to growing expectations for a new public health movement around the world. It recognized the need to enable people to increase control over and to improve their health and well-being by ensuring healthier, sustainable environments where people live, work, study and play. Social justice and equity were highlighted as core foundations for health, and there was an agreement that health promotion is not simply the responsibility of the health sector. Subsequent WHO global health promotion conferences have reiterated these elements key for health promotion.”
- Thirty years after the Ottawa Conference on Health Promotion, the societal challenges we face today have changed greatly. These are some current societal issues the European Region is facing.
- In 2013, one of the solid fact publications focused on health literacy, as a determinant and as a resource to improve health and well-being.
- At the 6th Global Forum on Health Promotion, in 2017, themed “Health Promotion - At the Very Heart of Sustainability”, it highlighted the contributions of civil society and health promotion initiatives to sustainable development. The Declaration adopted will have lasting impact on health promotion. The 9th Global Conference on Health Promotion was held in Shanghai, China in November 2016 and celebrated the anniversary of the very First International Conference on Health Promotion in Ottawa 30 years before. The theme of the conference was on the topic of “Health Promotion in the Sustainable Development Goals”, which was timely in order to accelerate the implementation of the SDGs through increased political commitment to involve all actors in a new global partnership to achieve the transformative Agenda.
- The focus in Health Promotion has turned towards the SDGs and how health promotion strategies and approaches can be deployed to achieve the Sustainable Development Goals. The conclusions from the 6th Global Forum and the 9th Global Conference on Health Promotion have all pointed in the direction of mayors, local health promotion leaders and civil society to promote positive social change. They should advocate for a more holistic approach to health and well-being and to the determinants of health at all levels. They all call for action for achieving the SDGs. More specifically, special attention goes to the health literacy challenge and the driving potential of social mobilization and how progress in these issues will accelerate progress on the SDGs targets. Health Promotion is a valuable approach for addressing the health literacy challenge and harnessing the potential of social mobilization for achieving the UN 2030 Sustainable Development Goals.
- Health literacy is not only seen as a means of implementation but it should be approached as a determinant of health, closely related to other social determinants of health such as general literacy, education, income and culture. Poor health literacy leads to poorer health outcomes and health inequalities. Health literacy can be used to overcome these barriers to better health and well-being and to strengthen health systems.
- The recent European Health Literacy Survey, within the IROHLA project, found that roughly half of all adults in the eight participating European countries have inadequate or problematic health literacy skills, resulting in poor health literacy. Particularly older, lower educated persons with lower socio-economic status face health literacy problems. Older persons often cope with more chronic health problems and struggle with managing their own health and with adhering to medical treatments. Therefore, more focus on health literacy was proposed for the ageing population, such as through Empowering Social support E-health and m-health Accessible health services (health literate environment)
- “While there is no specific target on health literacy within the SDGs, efforts to raise health literacy will be crucial in whether the social, economic and environmental ambitions of the 2030 Agenda for Sustainable Development are fully realized. The health literacy challenge: Harness the use of social media and technology for health promotion Include youth perspective in future agendas and action means Overcoming the European health literacy gap Health literacy services targeting the elderly population need to be better supported great potential for eHealth and mobile health initiatives
- We have a lot of work to do in our Region. The recent European Health Literacy Survey stated that roughly half of all adults in the eight participating European countries have inadequate or problematic health literacy skills, resulting in poor health literacy. Particularly older, lower educated persons with lower socio-economic status face health literacy problems. Weak health literacy competencies have been shown to result in riskier behavior and poorer health, to be detrimental across the life course and to result in more hospitalization. Limited health literacy levels follow a social gradient and can further reinforce already existing inequalities within Members States and between Members States. This weighs heavily on human and financial resources in the health system and present a significant obstacle to sustainable development. Health literacy is an important key dimension of Health2020 which states that health promotion programs that are build on the concepts of engagement and empowerment, including improved health literacy, can prove to be real beneficial to the European population. An emphasis was also put on the need to focus on youth and school-based interventions to improve health literacy.
- According to the first European study on Health Literacy (EU-HLS), there is much variation regarding the level of health literacy across Europe. In order to know whether the efforts to improve health literacy of the population are successful, there is a strong need for evidence and more data, ideally in an internationally comparative form. Repeating the European HLS across all countries in the Region, would be an important step further. Austria requested input from EHII on the formation of an action network on the Health Literacy, and requests the Steering Group’s assistance in formation of a network and development of a comparative survey of health literacy for the European Region.
- EHII number of participants has tripled in the past year. Strategic coordination WHO European Region coordinates health information work through the European Health Information Initiative (EHII). EHII is WHO Europe’s strategic framework committed to improving the information that underpins health policies in the European Region.
- Social mobilization, defined by McKee, as the process of bringing together all feasible and practical intersectoral allies to raise awareness of and demand for a particular program, to assist in the delivery of resources and services and to strengthen community participation for sustainability and self-reliance. Civil Society as an advocate for change. Achieving the ambitious targets of the 2030 Agenda requires a revitalized and enhanced global partnership that brings together governments, civil society, the private sector, the United Nations system and other actors and that mobilizes all available resources. Enhancing support to developing countries, in particular the least developed countries and the small island developing States, is fundamental to equitable progress for all. SDG17 includes a specific target to “encourage and promote effective public, private, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships.” Social Mobilization, is therefore An important means to advance sustainable development policy Driven by the rise of social media and new technologies Potential to advocate change for health promotion providing incentive to form cross-sectional partnerships to collaborate for health and well-being By mobilizing communities to address the social, economic and environmental determinants of health, higher levels of health literacy can be attained, which in turn, will yield social benefits.
- Ultimately social mobilization is a partnership with the people, the beneficiaries. Social mobilization campaigns are an enormous opportunity to raise people’s and stakeholders awareness on certain health threats: they are indeed a partnership for health. I am giving here few examples in the area of communicable diseases that our Regional Office either leads or contributes to with a European focus: European Immunization Week Flu Awareness Campaign World Antibiotic Awareness Week World Aids Day There are many others including World TB Day and World No Tobacco Day, and of course World Health Day. Through these campaigns we target people, patients, health care workers, policy makers, to describe the problem and what they can do to tackle it. Vaccination, responsible use of antibiotics, testing for HIV or TB or stopping smoking are certainly societal responsibilities. We use a number of channels and tools (including posters, leaflets, videos) to support European countries’ campaigns so to reach their stakeholders, their people. Awareness is a prerequisite to action – to contribute reaching SDG 3 especially 3.3 (End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases), as well as for example 1,4,5,8, and 10 for vaccine preventable diseases; and 1, 2, 6, 8, 12 and 17 for antimicrobial resistance… But awareness is not yet action.
- There is a step further we can and should go; and the best example of it is our work in emergencies. Mobilizing large groups might be an initial step, but in emergencies we need tailored and targeted approaches. We need to engage with the community to understand the perceptions, the concerns, the fears and address them. We also need to partner with those member of the community that are trusted as this is a prerequisite for people to accept guidance and adopt protective behaviors. In this picture a WHO/Europe’s staff is talking to the parents of children during a polio outbreak to understand the barriers to immunization.
- There are other areas where this applies and the most exemplary is vaccine-preventable diseases, where the use of social sciences is most advanced. Access to vaccines is a core element of the third SDG, not least because it is critical for ending preventable deaths of newborns and small children. Vaccination is also essential in reaching other SDGs: ensuring education and cognitive development for children, reducing inequality, promoting sustainable growth and even ending poverty through increasing productivity and avoiding catastrophic costs. Every year immunization averts 2 to 3 million infant deaths globally. Still, an estimated 19.4 million infants worldwide continue to miss out on basic vaccines. The Tailoring Immunization Programmes – the TIP – a tool developed by WHO Regional Office for Europe, draws on social mobilization to address low vaccination uptake, including challenges related to health literacy. We have applied this in Sweden, where community groups in the Somali community now guide and inform parents about the importance of vaccination, drawing on the oral tradition of this community; in the ultraorthodox Jewish community in the United Kingdom, where one of the leading Rabbis is now spearheading efforts to promote vaccination in a community that has seen a number of measles outbreaks in the past; and in Bulgaria, where health mediators of Roma origin were identified as critical to addressing challenges, including those related to health literacy.
- In fact, the TIP approach goes far beyond social mobilization and health literacy. It allows Member States to apply a comprehensive approach to understanding and addressing low vaccination uptake. Drawing on the behavioural sciences and social science research methods, it explores barriers and enablers to vaccination; be they related to individual knowledge or attitudes – social or cultural norms – or institutional or access-related factors. It is a people-centred approach, where subjective experience matters and is used to develop the solutions. Other health programmes, including Infectious Hazard Management and Anti-Microbial Resistance, have adopted this approach. It is also being adopted globally for low-income settings. And we are working to further expand the approach for use in other health programmes including infectious hazards and antimicrobial resistance.
- In the policy brief for the 9th Global Conference on health Promotion in Shanghai, 2016, it says that “Social movements emerge from a sense of shared grievance and injustice. They steer the society to take the needed forms. Today civil society has gained momentum in advocating change on a range of topics, from climate change to women’s empowerment, from social justice to transparent governance. There is a tremendous potential to harness the growing power of social mobilization for health promotion. Integrating health promotion into various efforts will push SDGs forward as health is a subject that touches lives of everyone, everywhere. SDGs provide an opportunity to form alliances across areas which have previously worked in parallel and to expand space for all people to participate in meaningful decision-making.”
- We have worked to document these and other key strategies for empowering populations and engaging patients in our work, including for example, the WHO European Framework for Action on Integrated Health Services Delivery, endorsed by Member States at the 66th session of the Regional Committee this past year. The Framework importantly recognizes populations and individuals as a first and key domain for transforming services, and the areas for action calling for efforts to empower populations and engage patients, include for example, key strategies for enabling informed choice, enhancing health literacy, supporting shared decision making, and peer-to-peer support. The Framework’s implementation package includes a volume of resources and tools that have been identified and catalogued to support these strategies, such as using decision aids, developing self-care plans and building coalitions with community development workers. With these strategies and options known, the challenge put to our healthy systems and services delivery is then the task of putting these efforts into practice, working to ensure in our day-to-day interactions that our systems strive to empower the public and engage people, patients and their family members and carers. Key to doing so will be the advancement of our services delivery model of care and the alignment of system enabling conditions, as the Framework highlights.
- With two thirds of the population of the European region now living in towns and cities, and within the context of globalization and migration, local governments, municipal leaders and mayors play an essential role in creating healthy cities and communities. Representing the local government, they are in the unique leadership position of addressing urban health and promoting their citizen’s health and well-being. “Health and well-being depend on action at city level.” “Cities are both key vehicles for the implementation of the 2030 Agenda and agents for achieving a future that is sustainable, inclusive, safe and resilient. We cannot achieve the goals of the 2030 Agenda or Health 2020, and improve the health and well-being of all, without engaging at the city level.” SOURCE: speech by Dr. Zsuzsanna Jakab on 1th March 2017 in the city of Pécs at the WHO European Healthy Cities Network Annual Business and Technical Conference. Local governments and urban leaders have the responsibility to ensure that communities and neighborhoods have access to basic health services and goods, that they are socially inclusive and promoting good physical and psychological well-being. Healthy cities are all about local involvement and social mobilization.
- HOW TO MOVE FORWARD FROM HERE Embed actively health literacy into national programs Social inequality levels need to decrease and levels of traditional literacy need to increase to improve health literacy. Ensure curricula development for schools and Universities; and start with school health promotion Initiatives to increase access to education and avoiding early drop-outs are required. Extend good examples from some European Members States to all. For example, Wales has incorporated health literacy in their strategy to combat social inequalities and Scotland launched a national action plan on health literacy. The role of Internet as a source of health information should be looked at closely and access training in digital skills (especially for the elderly population) should be made available. Harness the use of social media and technology for health promotion Include youth perspective in future agendas and action means Questions: Will a national plan for strengthening health literacy accelerate progress on the SDGs? How do we create consumer environments that support healthy choices? How do we set standards for health literate organizations? How can health literacy contribute to quality education and promote lifelong learning?