08.09.2015 "Strengthening health skills cannot be the task of public health policy alone."
Six questions for Stefan Spycher. Health skills are a key factor in the physical and mental wellbeing of the individual; they reduce pressure on the health system and consequently on society as a whole. But how can health policy help to establish and develop these skills in all people, and what is the state doing specifically to improve equality of opportunity? Stefan Spycher, Head of the Health Policy Directorate and Vice Director of the Federal Office of Public Health (FOPH) provides some answers.
How do you define the concept of health skills?
At the FOPH, we understand health skills as empowering every individual to take decisions within their environment that have a positive effect on their own health and on the health of the people around them, such as their children.
How can health skills be developed and whose task is it to nurture them?
Health skills are learned at school, in the family, through interacting with healthcare professionals and in the workplace. The media can also play a role in promoting health skills. The first important factor in developing them is the initiative of each and every individual and his or her ability to learn. But the state can also play a part in promoting people's skills and their options for adopting health-promoting behaviours through health policy measures such as information campaigns.
Where do the limits of public health policy lie?
Strengthening health skills cannot be the task of public health policy alone. The contribution of education, both at school and later in adult life, is of at least equal importance. In addition, we are observing a growing trend among employers to focus on the health skills of their employees. The main contribution of health policy is probably in areas involving everyday health behaviours and the way the health system is used. We need to keep an eye on the complexity of the system and reduce it where necessary.
Are health skills more an individual matter or something that concerns society as a whole?
Responsibility for personal health, and thus for health skills-driven behaviour, is first and foremost the task of the individual. Society – whether in the form of public- or private-sector stakeholders – should in turn ensure that conditions for the development of health skills are as conducive as possible.
Where do you see opportunities for health policy to promote health skills, and what are the challenges facing the FOPH as it seeks to promote these skills?
I see good opportunities in the fact that the concept of health skills provides a useful starting point for making individuals in problem situations stronger and improving their options for achieving good health. Poor people, for example, are still dying at a younger age than the better-off in Switzerland. And they also have more serious health problems during their shorter lives. Furthermore, if the population as a whole has better health skills, this can keep costs in the health system down because people with health-promoting skills live healthier lives and, if they do fall ill, are in a better position to know what assistance they need to provide rapid relief. As I said before, there are a lot of areas in life and many stakeholders that play a role in developing health skills. This wide range of factors presents a certain challenge in attempts to deal with the subject on a political level.
Which short-, medium- and long-term measures are planned as part of Health 2020 to promote health skills?
The FOPH is already running prevention campaigns on a number of topics such as alcohol, smoking and transmissible diseases that are aimed at the population as a whole. We are also making an effort to prepare healthcare professionals to deal more effectively with the special needs of parts of the migrant population – for example with a telephone interpreting service and an internet-based training course. The new federal legislation on electronic patient files that is currently being debated in Parliament is intended, among other things, to improve the individual's access to his or her own health information, and one of the things that this will do is promote health skills. And, finally, we want to carry out a broad-based survey to gain an overview of the level of health skills in the Swiss population. During 2016, the FOPH will use the results of this survey to decide which further measures will be implemented.