SDGs and public health policies: implementing the S2D grid in the city of Lausanne, Switzerland.

Sustainable development goals (SDGs) and public health are often considered as separate policy fields, whereas there is a considerable potential in better coordinating their objectives and measures. Using an analytical grid (S2D grid) linking SDGs and public health objectives and comprising 6 thematic issues and 56 categories, the research team conducted an assessment of health promotion programs in the city of Lausanne, Switzerland. Their objective was to determine whether SDGs and public health concerns can translate into complementary policy objectives, and what was the level of achievement of Lausanne in terms of implementation, intersectoral collaboration and avoidance of redundancy, regarding the vast array of measures potentially dealing with SDGs and health promotion. Results show that measures implemented by Lausanne deal with 80% of categories included in the S2D grid, with a high level of intersectorality and a low level of redundancy. These results also emphasize the fact that linkages between SDGs and health promotion go well beyond the SDG 3 dedicated to 'good health and well-being', and that the S2D grid could be used as a tool in favor of organizational change, promoting the collaboration between stakeholders often reluctant to engage in public health policies.

[Sud Entre Sambre et Meuse intersectoral platform: a local health promotion application in Belgium]. / Plate-forme intersectorielle du Sud entre Sambre et Meuse : une application locale de la promotion de la santé en Belgique.

The various constituents of the “Sud Entre Sambre et Meuse intersectoral platform” have now been clearly defined. The health promotion legislation and the establishment of decentralized support are the cornerstones of this programme. The choice of a global conceptual model, integrating the health promotion approach into its territorial and intersectoral dimensions, as well as a detailed knowledge of the territory of action constitute the framework of this programme.This structure has allowed the development of health promotion strategies: modification of professionals’ and politicians’ behaviour, emergence of new services for the population, increasing implication of politicians, professionals, inhabitants, and implementation of actions designed to improve the environment (mobility, housing).In line with the definition of health promotion, this local dynamic is a permanently evolving process according to fluctuations of partnerships, modifications of the local context and the effects of the actions undertaken. However, its objective always remains improvement of the quality of life of all citizens and the development of their capacity to be actors in this improvement..

[Will health promotion remain a utopia in a fragmented political system? The case of the Wallonia-Brussels Federation]. / La promotion de la santé restera-t-elle une utopie dans un système politique morcelé? Le cas de la Communauté française de Belgique.

In the French Community of Belgium (the Wallonia-Brussels Federation), the changing political landscape and the various laws relating to the roles of the federal state, communities and regions introduced since 1980 have had a significant impact on health policy. Since then, there have been significant developments in health education services and activities. In 1997, a government decree was issued to promote the concept of health promotion, to reform the existing system and to define policy priorities as part of a new five-year plan (1998-2003). Significant progress was made during this period as a result of the development of a global approach extending beyond the mere analysis of risk factors. The second five-year plan (2004-2008), aimed at combining preventive medicine and health promotion, resulted in the involvement of a wider range of actors and greater cross-sector collaboration. However, the sheer number of decision-making levels has been a major obstacle to popular participation and consultation. If the question of social and cultural accessibility is not seriously addressed, the focus on preventive medicine programs may prove to be detrimental to the development of an effective health promotion framework. The disconnect between the political vision and the reality of practice has had an adverse impact on health promotion. Health promotion professionals have repeatedly called for a third five-year plan involving all ministers and aimed at developing a cross-sector approach, at addressing the determinants of health, at promoting the active participation of local communities and at reducing social health inequalities. The concerns of health promotion practitioners were further exacerbated by the introduction of an external assessment process initiated by the Ministry of Health in 2010. The current concerns over the future of the Belgian state, the economic crisis and the impact of spending cuts have increased the sense of uncertainty. The upcoming elections provide further incentive for health promotion professionals to continue in their efforts to promote effective policy responses based on the skills and experience of associations and on practice quality.

Fear of falling and associated activity restriction in older people. results of a cross-sectional study conducted in a Belgian town.

OBJECTIVES: This article aims at describing, in a Belgian town, the frequency of the fear of falling and of subsequent activity restriction among non-institutionalised people aged 65 years and over, and at identifying persons affected by these two issues. METHODS: Cross-sectional survey conducted in Fontaine l'Evêque (Belgium) in 2006, using a self-administered questionnaire. RESULTS: The participants could fill in the questionnaire on their own or with the help of a third party if needed. The latter were not taken into account in this article. Analyses covered 419 questionnaires. Fear of falling and activity restriction were reported by, respectively, 59.1% and 33.2% of participants. They were more frequent among fallers but also affected non-fallers. In logistic regression analyses: gender, the fact of living alone and the number of falls were significantly associated with fear of falling; gender, age and the number of falls were significantly associated with activity restriction. CONCLUSIONS: Our study, despite various limitations, shows the importance of fear of falling and of subsequent activity restriction among older people, among fallers as well as among non-fallers. It also provides information, though limited, concerning persons affected by these two issues in Belgium, and in other contexts as well. Given the ageing of our populations, it is important to take these problems into account when caring for older people.

Role of physicians in preventing accidents in the home involving children under 15 years in the French-speaking community of Belgium.

OBJECTIVES: To measure GPs' and paediatricians' expectations, attitudes, priorities and demands in the area of promoting safety and preventing accidents in the home involving children under 15 years of age. METHODS: A phone survey of a random sample of GPs and paediatricians in the French-speaking community of Belgium (Wallonia and Brussels) conducted in the course of September and October 2000. RESULTS: Close to two-thirds of the physicians surveyed stated that they had been contacted at least once in the 2 weeks preceding the survey to handle an injury. Of the physicians, 80% mention accident prevention after a childhood injury, but only 46% mention it during a routine consultation (whatever the reason of the latter may be). The main obstacles to mentioning prevention during routine consultation put forward by the interviewees are: 1) reasons for consultations that do not permit such an approach (79%); 2) the fact that injuries are not priorities for them (66%); 3) the lack of interesting materials to provide the subject with documentation (63%); 4) the unsuitability of the place where the contact occurs for such discussion, given the time required (56%); 5) insufficient information on the subject (41%); and 6) the patient's lack of interest (39%). An overwhelming majority (98%) nevertheless feel that they have a role to play in preventing children's accidents in the home, with 72.5% seeing this as informative (recommendation on safety rules). More than two-thirds of the respondents feel that they have enough requisite information to play such a role. Those who declare that they have not enough information (34%) proposed some priority subjects about which they would like to find information or additional information to be more effective in preventing accidents. The information needs mentioned most frequently were a systematic review of the risks, of the effective prevention strategies and epidemiological data. CONCLUSIONS: The present study clearly reveals the interest of physicians for accident prevention and puts forward the current obstacles to offering prevention advice during routine consultation. The obstacles mentioned are fairly comparable to those mentioned in other studies, namely, because the reason for the visit does not give such an opening, the lack of appropriate materials and information, the lack of time, the patient's lack of interest, the fact that the issue is not a priority, etc. The problem of lack of priority for certain practitioners underlines the importance of making accident mortality and morbidity statistics available to doctors in order to improve their perception of the magnitude of the problem. The lack of interesting education materials and useful information seems to be a major reason for their failure to carry out such prevention work successfully. These factors should thus be taken into account when developing any policy and/or programme aimed at 'using' GPs and paediatricians in the prevention strategies that are adopted.