• Policy-dependent determinants of several important health problems and related actors in policy-making

      Lucht F van der; Jansen J; VTV (NsPh, 2002-05-23)
      The exploratory study reported on here investigated the possibilities offered by intersectoral (health) policy. The study consisted of two parts. First, a broad description was given of determinants of five health problems (cancer, Chronic non specific lung disease (CNSLD), heart disease, injury due to accidents and psychiatric disorders), and of related actors in policy-making identified. Second, the determinants of one of the diseases were assessed in more depth to give insight into opportunities for prioritzing based on potential health benefits. In the first part, the analyses show that there are many departments within several ministeries that could contribute to an intersectoral (health) policy. Some ministeries have a special connection to one particular determinant of health: e.g. Agriculture, Nature Management and Fisheries has opportunities in the field of nutrition, while there are also ministries that can be of importance for a broad range of determinants: e.g. Education, Culture and Science can play an important role in health education. The Ministry of Finance is also involved in many determinants as a consequence of its (tax)instruments for price policy. The same could be said for ministries involved in control and supervision (Justice and Internal Affairs). In the second part of the study, priority-setting for intersectoral policy based on potential health benefits is described by analysing, in particular, the determinants of CNSLD. Because the desired data and evidence is often lacking, it has proven very difficult to set priorities for intersectoral policy using potential health benefits of interventions on the important risk factors. Still, smoking and allergens in the indoor environment can be put forward as the determinants of CNSLD with the most potential health gain. In conclusion, there are many opportunities for intersectoral policy, making prioritizing desirable. Next to potential health benefits priorities can be set on measures that are not yet in use and on measures that coincide with the targets of other ministries