Global Health Diplomacy:Promoting Multisectoral actions inHealth Literacy

United Nations ECOSOC Annual Ministerial Review

Beijing, China29-30 April 2009

Scott C. Ratzan, MD, MPAVice President, Global Health

Government Affairs & Policy

Johnson & Johnson

                                                             

“The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health.”

World Health OrganizationPreamble to the

Constitution

Our Goal: Health for the public good

Developing Health Literacy

“Informed opinion and active cooperation on the part of the public are of the utmost importance in the improvement of health of the people.”

World Health OrganizationPreamble to the Constitution

The Opportunity to Advance Health: Health Literacy for the public good

Apply our evidence-based approach to Health Literacy

• Over 14 years of research in the peer reviewed Journal of Health Communication had measurable outcomes with communication affecting:

– Knowledge– Attitudes– Awareness– Practices– Perceptions– Intentions– Behavior change, and– Social Change

健康认知能力理论架构Health Literacy Framework

健康认知能力 - Health Literacy

Health Literacy is “the degree to

which individuals have the

capacity to obtain, process, and

understand basic health

information and services needed

to make appropriate health

decisions.”

Ratzan and Parker, NLM/NIH Current

Bibliographies of Medicine, 2000USDHHS, Healthy People 2010

Institute of Medicine, 2006

健康认知能力是“个人获取，处理，并了解基本的健康信息和服务以作出适当的关于自身健康决定的能力及其发展程度。”

Ratzan ( 作者本人 ) 和帕克，美国国立医学图

书馆完整目录医学， 2000 年美国卫生与社会服务部 (USDHHS) ，健康人

民 2010 年美国医学研究院， 2006

Measure Health Literacy A broad set of factor that empower and facilitate health

““what gets measured gets done”

• Incorporate health literacy with measurable items

• Link to global, regional and national efforts to measure health quality, disparities, and cost

健康认知能力平衡计分卡Health Literacy – A potential scorecard

1. What do we do to stay healthy? – Key areas and numbers:

immunizations, blood levels (glucose, cholesterol), weight, blood pressure, etc.

2. If we are sick, how can we get better?– Can you do quality self care;

screening?

– Do you rely on the system for health decisions

3. If we are living with illness, how do we get effective medical care? – Knowledge, information and

practice

1. 什么我们如何保持健康？ 关键领域和数字：免疫接

种，血液水平（血糖，胆固醇） ，体重，血压等

2. 如果我们生病了，我们怎样才能做得更好？ 你可以做质量自我照顾 ;

筛选吗？ 你依赖于系统的健康决定

吗？3. 如果我们的生活与疾病，我们

如何获得有效的医疗护理？ 知识，信息和实践

儿童健康认知能力Consideration of Pediatric health literacy

• “Most children and their caregivers [could] benefit from a set of health literacy skills adequate to meet common preventive needs (e.g nutrition, development, home safety, vision and lead screening, immunizations.) AND

• common acute health needs” (e.g. Fever, dehydration, upper respiratory tract infections, sexually transmitted infections)

Source: Benard Dreyer, American Academy of Pediatrics, 2009

• “ 大多数儿童及其看护人 [ 可以 ] 受益于一套健康的识字技能足以应付共同预防需要（如营养，发展，家居安全，远见和领导检查，预防接种。 ）

• 常见的急性健康需求（如发烧，脱水，上呼吸道感染，性传播感染）

来源：贝纳尔德雷尔，美国儿科学会， 2009 年

亚太和中国版本健康知识平衡计分卡 Not an Easy Task for Asia Pacific

亚太和中国版本健康知识平衡计分卡 An

Illustrative Health Literacy Scorecard: Asia Pacific

1. What do we do to stay healthy? – Key areas and numbers: body

mass index in range, minerals/salt, immunizations, weight, blood pressure, etc.

– Do I or my family/friends smoke cigarettes?

2. If we are sick, how can we get better?– Can I recognize and understand

signs/symptoms?– When do I seek a health service

worker advise?

3. If we are living with illness, how do we get effective medical care? – Knowledge, information and

practice

1. 什么我们如何保持健康？ 关键领域和号码：身体质量指

数的范围，矿产 / 盐，免疫接种，体重，血压等

我或我的家人 / 朋友抽烟？ 1. 如果我们生病了，我们怎样才

能做得更好？ 我可以承认和理解符号 / 症状？

我什么时候寻求保健服务工作

者提供意见？ 1. 如果我们的生活与疾病，我们

如何得到有效的医疗护理？ 知识，信息和实践

Can we develop an approach for health literacy?

CONCLUSION..

Efforts to impact health literacy requires multisectoral actions

A Health Literate citizen

and world

Medical sector and research institutionsAcademic institutions, physician associations, individual doctors

• Testing and patient diagnosis• Appropriate treatment and care• Disease management

- hospital and pharmaceutical firms• Research

- epidemiology- scientific and clinical - social

International health associations and organizations (UN, WHO, World Economic Forum, etc)

• International standard setting- guidelines, protocols- best practice

• Technical assistance• Funding• International coalition building

Private sectorFunding, individuals

• Corp. employee engagement - education and financial support

• Corp in-kind support• Innovation and creativity

Foundations, NGOs• Financial support• Grass roots intervention

- initiate and sustain community action• Lobbying and advising government• Service delivery

Mass media and mobile technologiesPress outlets (TV, Radio, Newspaper, Magazine)Telecom outlets ( Message boards, SMS etc.)

• Public forum and information- data dissemination- public feedback and discussion

GovernmentHealth Ministry, Public Health Officials, State and local governments

• Legislation and policy• Direct funding

Possible engagement with the

United Nations and health literacy - 2009

WHCA

Monograph(September 2009)

ECOSOC Meeting on Promoting Health Literacy(Beijing, 29-30 April 2009)

+ECOSOC Meeting on NCDs in the Middle-East

(Qatar, 10-11 May 2009)+

ECOSOC High Level Segment on Global Health(Geneva, 6-8 July 2009)

UN General AssemblyHigh Level Discussion on Health

(New York,June 2009)

ECOSOC Outcome Report at General Assembly for action under provisions of a resolution on “Global Health and Foreign Policy” (September 2009)

Advancing health literacy on multiple levels is ideal for health

diplomacy later this year

“Health is, I believe, a fruitful – and a friendly – arena for foreign diplomacy.Health operates as a key driver of economic and social progress. Health contributes to stability and is a foundation of prosperity”

A little impatience will spoil great plans, or Patience is a virtue.

* 小不忍则乱大谋。 《论语》 the Analects of Confucius

解释：凡事要忍耐、包容一点，如果一点小事不能容忍，将坏了大事。 *

Thank You!

APPENDIX/BACKUPS

中国公共医疗卫生的总体目标 The overall goal of Public Health Care in China(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System

Reform”)

• 注重预防、治疗、康复三者的结合

• 到２０１１年，基本公共卫生服务得到普及

• 到２０２０年，人民群众健康水平进一步提高。

• emphasize the combination of prevention, treatment and rehabilitation

• By 2011, the basic public health services shall have been available far and wide

• And by 2020, the health level of the people shall be further enhanced.

建立覆盖城乡居民的基本医疗卫生制度Establishing the basic health care system covering urban and rural residents

(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform”)

• 加强健康促进与教育。医疗卫生机构及机关、学校、社区、企业等要大力开展健康教育，充分利用各种媒体，加强健康、医药卫生知识的传播，倡导健康文明的生活方式，促进公众合理营养，提高群众的健康意识和自我保健能力。

• Efforts should be made to strengthen health promotion and education. Health care institutions, government agencies, schools, communities, enterprises, etc. shall massively carry out health education, take full advantage of various media, strengthen the dissemination of medical and health knowledge, advocate healthy and civilized lifestyle, promote rational nutrition among the public, and enhance the health awareness and self-care ability of the people.

完善体制机制，保障医药卫生体系有效规范运转Establishing practical and shared health care information system

(Excerpt from “Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform”)

• 建立健全医药卫生法律制度。完善卫生法律法规。加快推进基本医疗卫生立法，明确政府、社会和居民在促进健康方面的权利和义务，保障人人享有基本医疗卫生服务

• Establishing and improving health care legal system Efforts should be made to improve the health legislation. Quicken the promotion of the basic health care legislation, specify the rights and obligations of government, society and residents in terms of enhancing health to ensure that everyone is entitled to the basic health care services.