EU Internal market and health: a contradiction in terms?

European Public Health Alliance

Health and the internal marketPresentation by Tamsin Rose, General

Secretary, 8 September 2004

A network of 102 non governmental and not-for-profit organisations across Europe working on health and health-related issues. Our mission is to improve the health of European citizens and to increase their participation in EU policy-making

EU Internal market and health: a contradiction in terms?

Structure of the presentation

- Health status in Europe - Risk factors and health trends - Lifestyle factors and disease trends- EU role as a regulator- Some questions to debate

EU Internal market and health: a contradiction in terms?

The good news

Major improvement in health over 150 years. A doubling of life expectancy achieved by

Hygiene: (water, air, food) Legislation, eg on safety seatbelts and

helmets, control of pollutants Prevention: vaccination and screening Information and education Improved healthcare: technology and

treatments

EU Internal market and health: a contradiction in terms?

The bad news

Much of current ill health and early death is preventable

Extensive health inequalities New health threats (HIV, SARS, drug

resistant TB) Demographic changes Rising healthcare costs

EU Internal market and health: a contradiction in terms?

Is modern life killing us?

Majority of deaths are lifestyle related Cardiovascular disease – improve diet,

increase physical exercise, stop smoking, reduce alcohol consumption, reduce stress

Cancer – as above but also tackle environmental pollutants (air, water, soil contamination, chemicals)

Tobacco, alcohol, food, chemicals and consumer products are all goods regulated by the EU internal market

EU Internal market and health: a contradiction in terms?

Consumer products – safe?

Pesticide residue in fruit and vegetables

Pthalates in childrens toys Flame-retardants in household furniture Chemicals in hair dyes, cosmetics and

tattoo inks Anti-bacterial and microbicides in

mattresses

EU Internal market and health: a contradiction in terms?

What causes death and ill health?

EU Internal market and health: a contradiction in terms?

Future expectations of health

a

b

c

Good Compromised Poor

Now

EU Internal market and health: a contradiction in terms?

Obesity – a clear example of manufactured risk

Obesity has increased by 10-40 % in Europe in the last decade, in the UK it has doubled

75 % of salt in our diet comes from processed food Soft drinks are the leading source of added sugars in the

US diet. Increase in diabetes and obesity has coincided with a 61 % leap in consumption by adults and a doubling of consumption by children between the late 70s and mid 90s. Uk evidence kids drink an average of 4.7 litres of soft drink per week, of which only 10% are fruit juice or water.

Most alco-pops contain as many calories as sugary soft drinks, link between binge drinking and obesity

Fat per 100g is a lot cheaper than other sources of energy

EU Internal market and health: a contradiction in terms?

The context of food consumption

800 to 1 ratio : For every 1 pound spent on health education on promoting healthy diets, 800 is spent by the food industry 95 % of which are for products that encourage weight gain (confectionary, snacks, fast food.)

Fruit industry spends only 2% on advertisements of the amount spent by snack industry

Food advertisements were shown more frequently during children's programmes (45-58% of all advertisements) than during adult programming (21%).

The overwhelming majority of the foods advertised during both adult (86%) and children's (95-99%) programmes were high in fat, sugar and/or salt.

EU Internal market and health: a contradiction in terms?

Fireworks – a case study of regulating harmful products

Minimum safety requirements for products Limit availability (points of sale) Limit accessibility (age limits) Limit visibility (bans on advertising) Warnings (on packets) Restrictions on use (timing, space) Public education campaigns Enforcement and policing

Can we use this logic for tobacco, alcohol, unhealthy foods?

EU Internal market and health: a contradiction in terms?

Sharing responsibilities

The individual's challenge to live a healthy life, in the face of a rising gradient of societal pressure to live unhealthily.

While ultimately individuals must meet this challenge themselves, government can play a role both by providing individuals with support as they climb, and by lowering the gradient against which they are climbing.

EU Internal market and health: a contradiction in terms?

Some points to debate:

Health as a human right but also as a duty to society

What are we prepared to pay for quality healthcare systems

Is poor health an acceptable price to pay for consumer choice

How should corporate profits on unhealthy products be balanced with health costs