New research led by University of Limerick has revealed that policy decisions are far better at preventing non-communicable diseases than the actions any one individual can take.
Non-communicable diseases are by far the leading cause of disability and death in Europe and the new research shows that these diseases are much better prevented by policies rather than by advocating for individual behavioural change.
The EU-funded Policy Evaluation Network (PEN), which aims to identify public policies most likely to sustain healthy lifestyles, has revealed key research findings in a special issue of the European Journal of Public Health.
The research was led by the Physical Activity for Health (PAfH) Research Centre at UL and warns that the numbers are grave; Chronic diseases caused by physical inactivity and poor nutrition such as cardiovascular diseases, diabetes, cancer and respiratory diseases account for 77 per cent of the burden of disease and almost 86 per cent of premature mortality, and these diseases are still on the rise.
“The main reasons for this are relatively clear - in their daily life many Europeans mix physical inactivity and sedentary behaviours with the excessive consumption of energy from food and drinks with too much saturated fatty acids, trans-fatty acids, sugar and salt, as well as low consumption of vegetables, fruits and whole grains,” explained Professor Catherine Woods of the PAfH Research Centre at UL and deputy coordinator of PEN.
“Public policies include processes activated across multiple sectors to achieve specific outcomes, for example a reduction in population levels of physical inactivity.
“This requires a delicate balance between what is achievable, what is evidence informed and what has political will or ‘buy in’. The outcomes of the research done for Policy Evaluation Network show what successful policy action looks like, and how policy action, if implemented in full, has the potential to influence the health and well-being of an entire population,” Professor Woods said.
The researchers argue that in addition to the role of the risk factors driving non-communicable diseases, our understanding of their impact on the burden of communicable diseases such as COVID-19 is only beginning to emerge.
Professor Wolfgang Ahrens, who is Deputy Director of the Leibniz Institute for Prevention Research and Epidemiology - BIPS in Bremen, Germany, and Project Coordinator of PEN, explained: “The facts about the prevalence of non-communicable diseases have been clear for decades, but we see little to no improvement.
“To change the current situation, it is necessary to move beyond individual behaviour change to broader policy and system approaches. Policy is about changing systems, not people,” Professor Ahrens added.
As part of the Joint Programming Initiative on a Healthy Diet for a Healthy Life, 28 research institutes from seven European countries and New Zealand combined their expertise to form the Policy Evaluation Network. Researchers from UL, UCC and UCD represented Ireland in the PEN project.
The networks’ vision is to provide Europe with the tools to identify, evaluate and benchmark policies designed to address physical inactivity, unhealthy diets and sedentary behaviour directly or indirectly, while accounting for existing health inequities.
Until now, systematic research of this field across Europe was sparse.
The existing body of evidence on the topic has substantially changed with PEN’s special issue just published by the European Journal of Public Health, which has produced articles across a wide range of areas covered by the research project, which several members of UL’s Department of Physical Education and Sports Sciences and PAfH team members have contributed to.
Topics examined include new theoretical models to advance our understanding of the policy process and its evaluation, while the project provides an overview of priority public policies and policy areas most likely to sustainably reduce physical inactivity, unhealthy diets, and sedentary behaviour.
It explores the first steps in a bespoke policy monitoring and surveillance system for Europe, and a refinement of our knowledge of appropriate research designs and methods for the quantification of policy impact. PEN scientists illustrate how best to evaluate the implementation and impact of policy to yield the best results for a healthy life of European citizens.
Importantly, PEN has provided recommendations on equity and diversity to ensure that policy actions are inclusive as opposed to exclusive and the researchers have issued a “call to action for governments and policymakers from national and local levels to use the newly acquired knowledge to develop, implement and evaluate strong, comprehensive policy solutions that are sustainable, equitable and address the current health challenges effectively”.
“It is a call to funding agencies at European, national and local levels to continue to prioritize and fund policy research, to build on the work of PEN which has really only begun to understand the potential policy impact on human behaviours and environments,” explained Professor Woods, who was a guest editor on the special journal supplement.
“It is also a call to policy researchers to move beyond peer-reviewed publications and to translate their findings into relevant and meaningful advice and advocacy documents for policymakers to use to advance policy action to promote health-for-all citizens across Europe,” Professor Woods added.