Where to go from here policy discussion and recommen-dations

By the year 2000, life expectancy at birth in the [European] Region should be at least 75 years and there should be asustained and continuing and continuing improvement in the health of all people aged 65 and over.
Health for All by the Year 2000, World Health Organisation

The European Institute of Women`s Health believes that, working together, the European Union and Member States can enhance older women`s quality of life and health, helping them maintain a greater degree of independence, vigour and productivity well into their later years. In fact, there are already several initiatives under way that could be used as building blocks for developing a coordinated European effort on mid-life and older women`s health.

  • The Treaty on European Union (Article 129 on Public Health) provides the necessary mandate for establishing programmes intended to improve the health status of European women after middle age (Council of the European Communities,1992).
  • The Europe Against Cancer programme has done much to improve awareness of cancers and promote best practices regarding prevention, screening and treatment.
  • The European Commission’s Heath Promotion, Information, Education and the important Training Programme has the potential to improve the situation of vulnerable or disadvantaged groups, to which, unfortunately, many women belong (European Commission, 1994).

As a next step, the European Institute of Women’s Health hopes that the Commission’s annual reports on health status in the European Union will recognise women as a distinct population group with specific needs.

This report is addressed not only to policy makers but equally to women, particularly from the age of 40 onwards. Women in mid-life have an opportunity to take charge of their health, change their lifestyle, seek early diagnosis and treatment for disorders to which women are more susceptible and advocate greater attention to women’s health issues.

The report was inspired by the World Health Organization’s (WHO) Targets for the Health of Women and Healthy Aging, which call for “sustained and continuing improvement” in the health of women and all people over 65 and set specific targets to achieve that end (see Appendix 2).

Making a difference

Coronary heart disease, cancer, osteoporosis and depression represent four of the most serious conditions faced by European women n their middle and later years. Long-term public health programmes are essential to prevent or reduce the disease and disability that burden Member States’ health and social services and destroy the quality of women’s lives. To be effective, these programmes must include prevention, education of patients and health careprofessionals, early detection, early treatment, and research.

It is up to those most aware of the criteria quality of life and economic issues associated with women and ageing particularly women’s groups, political leaders, organisations for the ageing, patients, health professionals and health economists – to lobby for attention to women`s health.

International groups such as the United Nations and WHO have expressed support for action on women’s health. The Beijing Declaration and Platform for Action, developed by the UN Fourth World Conference on Women, sets specific goals for Health Security. The Platform also sets out strategic objectives and detailed action recommendations promoting women’s health, WHO has outlined targets in Health for All, including Europe-based strategies for healthy ageing and women’s health (WHO, 1991).

The European Union is working along similar lines. The European Commission’s Framework Programme on Public Health has articulated broad health aims (European Commission, 1993). Non-governmental organisations such as Eurolink Age provide information on health and socio-economic issues affecting ageing to governments and the public.

Some Member States have been forward looking by addressing the health needs of women. The Irish government, for example, has published Developing a Policy for Women’s Health, a far-reaching document on women’s health (Department of Health, Ireland, 1995). The following policy objectives, drafted as a strategy for Ireland’s health services, can serve as a model for the European Union and other Member States:

  • To ensure that women’s health needs are identified and planned for in a comprehensive way.
  • To promote the health and welfare of women.
  • To ensure that women receive the health and welfare services they need at the right time and in a way that respects their dignity and individuality. They must have ease of access to and continuity of care.
  • To promote greater consultation with women about their health and welfare needs. This should be done at national, regional and local levels.
  • To promote within the health services greater participation by women both in the more senior service positions and at the representative level.

The success of pilot community programmes to improve general health or eradicate diseases suggests that viable responses to the challenge are available. Programmes for the prevention of heart disease, such as North Karelian Finland and the Kilkenny Health Project in Ireland, have managed to change not just individual behaviour but the behaviour and outlook of the whole community. These programmes involve women and encourage them to be responsible for their own health. They also educate women in their roles as carers for children and elderly parents and as those responsible for nutrition and lifestyle standards in the home.

Attention must also be turned to encouraging local and regional self-help and peer-group projects that ally the efforts of non-governmental organisations, medical professionals, private industry and politicians. In particular, there is an urgent need to address the needs of women in poverty or social or physical isolation, women with poor education and women of ethnic minorities.

All groups can seek to involve women in developing health policies more proactively. The political weight of the ageing population, for women especially, will grow as awareness of the special health needs of mid-life and older women spreads.

Professional health care organisations can work with practitioners to improve their understanding of women’s health needs and promote greater equity in medical treatment for women.

Academic medicine can expand its focus on women’s health research and train a new generation of health care practitioners to understand and treat the needs of the aging.

The media can contribute to bringing health and lifestyle messages to women and their doctors, while reinforcing the importance of research in women’s health issues.

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