My trip to Kuopio did not begin well. A few weeks earlier the UK government had introduced new restrictions on hand baggage on planes for reasons that they have never adequately explained and which, given their record for getting things wrong (WMD etc.) left many people perplexed. The effect was predictable – complete chaos at British airports with anyone who could switching to flights through other countries (so causing British Airways to loose about £100m). I was changing planes at Helsinki and it was no surprise that I, along with everyone else who had come from London, found that our baggage had missed the transfer.
Anyway, at last we arrived in Kuopio. The reason for my trip was a conference under the Finnish presidency of the European Union. The European Observatory (where I am a research director) had produced a book on the conference theme – “Health in all policies”. Kuopio was a perfect setting for the conference. Aside from being in a beautiful setting in the Finnish lakes, which is enough to inspire anyone to better things, it has a strong track record of actually getting health into all aspects of life. The city authorities had developed a fully integrated public transport system, new housing developments were designed with health and social cohesion very much in mind (with shops and community facilities integral to the design), there were outstanding sports facilities, and the university has a strong focus on health.
My task was to give one of the opening speeches, on the potential for health gain in Europe. The approach I took was to highlight the enormous diversity that exists within Europe – simply look at the cookery section in any bookshop, where you can find advice on how to prepare dishes from every part of Europe, each with their own characteristics. What’s more, there is an enormous regional diversity in many countries. Of course, not everything appeals to everyone, but I decided against referring to the famous comments by President Chirac and Prime Minister Berlusconi on Finnish food – certainly what we enjoyed at the conference was superb!
This dietary diversity has profound implications for health – for example, death rates from heart disease in Spain are about one third what they are in the UK, something that is to a large part due to differences in diet. And of course, things get even worse as you move north, exemplified by the sale of deep fried Mars Bars in Scottish chip shops!
Of course it would be a pity if everyone in Europe adopted the same diet (in passing it is noteworthy how Europe contrasts with the USA, where the extent of regional diversity is very much less) but what would happen if each country to get its death rates down to the level in the country that was doing best. A few back of the envelope calculations show that the effect would be enormous – if everyone could reduce their death rates from ischaemic heart disease to those of the French then we would have a quarter of a million fewer deaths every year, including 40,000 fewer in the UK.
A key issue throughout the meeting was the importance of partnership. It is essential that we find ways of moving beyond the traditional players to include all those who can contribute to better health. Of course we have to recognise that many of these players will have different goals. The food and drink companies are required to increase their return to shareholders, which is fine. The challenge is to find ways in which we can work together so that they do so in a way that enhances health. Our goals will not coincide but they do overlap. What we need to do, as my colleague Josep Figueras noted, is to ensure that the overlap is as large as possible.
On the other hand, there are some that we cannot work with, exemplified by the tobacco industry, who have engaged in a long campaign to undermine scientific evidence. Unfortunately, as we have seen time after time, those researchers who become involved with them are either used or themselves become corrupted.