Health inequalities in Poland: current situation and Case Studies conducted
Pomorskie
Warmiński-Mazurskie Zachodniopomorskie Podlaskie
Kujawsko-Pomorskie
Wielkopolskie Lubuskie Mazowieckie
Łódzkie
Lubelskie
Dolnośląskie Świętokrzyskie Opolskie
Śląskie
Podkarpackie Małopolskie
Brussels 29-30th March 2012r. Diagnose Important factors responsible for health inequality in Poland: Specific consequences of political transformation process Low level of public expenditures for medical system (4,87% of GNP per year) Life expectancy shortened by gender, low income, low educational level, geographical region High level of infant mortality Limited effectiveness of treatment for rural area inhabitants Limited access to innovations ( innovative medicaments are 15% of pharmaceutical trade in Poland). Personal resources
Liczba lat 70 72 74 76 78 80 82 84
74.7 77.2 79.4 Przeciętneżyciatrwaniekobiet wgwojewództwa zamieszkania latachw i2010 2000 1991, 74.0 77.2 79.7 74.5 77.5 79.8 74.5 77.4 80.1 74.4 77.5 80.1 74.7 77.6 80.2 75.1 78.6 80.4 74.7 78.2 80.4 74.9
77.5 1991 80.5
75.1 78.0 80.6 2000
74.8 78.1 80.8 2010 76.0
78.6 80.9 75.6 78.5 81.0 75.5 78.6 81.0 GUS) (dane 76.0 78.8 81.4
76.4 79.0 81.8 76.5 79.1 81.9
Ministry of Health – National Level National Health Programme 2007-2015: Strategic Objective: 8. Reducing geographical and social inequalities in health status of the population. Expected health effect in 2015: Increased life expectancy in voivodeships with the lowest average life expectancy by 2 years for men and by 1 year for women Health Inequalities Monitoring Indicators Life expectancy Healthy life expectancy (HLY) Dysfunctions and disabilities [due to accidents and chronic musculoskeletal diseases] Incidence and morbidity of chosen diseases Fig. 4.9. Ratio of standardized death rate (SDR) in adults (25 years and older) with primary education and in those with above secondary education by gender and main groups of the causes of death in Poland, 2002 5,0 4,7 Males Females 4,0 3,5 3,2 2,8 3,0 2,5 2,4 2,4 2,3 2,2 2,1 2,3 2,2 1,9
2,0 1,8 secondary. secondary. 1,0
SDR primary/ SDR aboveSDR primary/ 0,0 Total Cancer CVD Respiratory Digestive Ill-defined External Fig. 4.14. Age-standardized percentage of people aged 15 years and older who have been limited in activities because of a health problem for at least 6 months by education in Poland and EU27, 2007 (authors 35 calculation availing data from Eurostat ) 31,6 Males Females 30,1 30 28,7 26,9
25
21,2 21,221,1 19,7 20 17,6 16,1 PL 14,8 Percentage 15 13,7 EU
10
5
0 Primary Secondary Tertiary (first Primary Secondary Tertiary (first (upper) stage) (upper) stage) Early Diagnosing of Breast Cancer Screening Programm Percentage of people involved
Goal-60%
1 January 2011 1 January 2012
Dane LOW NFZ w Zielonej Górze Early Diagnosing of Cervical Cancer Screening Programm Percentage of people involved
Goal-40%
1 January 2011 1 January 2012
Dane LOW NFZ w Zielonej Górze • New Project tackling health inequality open for public consultation since Jan 2012 (160 visits). A Project supported by Norwegian Structural Fund
LUBUSKIE VOIVODSHIP Population Screening Programms Early Diagnosing of Breast Cancer Prevention and Early Diagnosing Cervical Cancer Project „Dental prophylaxis of children and youth from area of Gorzów Wielkopolski” Dental sealant and fluoride varnish: - pupils of „0” classes from primary schools and from kinder gardens - pupils of gymnasium schools
Fluoride varnish: - pupils of basic schools - pupils of secondary schools (over gymnasium) 19459 children Pupils of public and nonpublic educational institutions from Gorzowa Wlkp.
Programm of Prevention and Treatment of Faulty Posture „Straightway to Health”
Screening tests (functional diagnosing) – 7781 children DELOS Professional objective examines (posture control) – 3500 children Medical consultations and diagnosing (specialists in orthopaedics, rehabilitation, radiology,pediatric neurology) Unifying workshops for teachers, school nurses, trainers of posture correction
Individual therapy of children with education of parents – 10 000 visits
Purchase of medical diagnostic equipment Creating healthy playground LUBELSKIE VOIVODSHIP Tuberculosis incidence rate per 100 000 population in Lubelskie as a social indicator
Poland – 21.6 (2009) vs Lubelskie – 30.2 (2010)
Lublin county – 4.8
City of Lublin – 37.0
Krasnystaw county -41.4
Tomaszów county-62.4 Campaign of Lubelskie Governor „Woman for Woman”
Purchase of cytomammobus for rural areas of region Cytommamobus visited 102 localities,performing 26 396 tests (July 2009 - September 2011); Increase the number of Pap tests performed from 24% in 2009 to 27% in 2011.The highest Increase of women attending in the Pap smears tests from 9% in 2009 to 24% in 2011 in rural Biłgoraj county; Increased number of performed mammographies from 36% in 2009 to 43% in 2011