26 February 2015 – Six years ago, almost 20 per cent of the five-year-olds in the city of Seinäjoki (Finland) was overweight or obese. Since then, the municipality’s health department has worked with the childcare, education, nutrition, recreation, and urban planning departments. As a result, the proportion of overweight or obese five-year-olds has been halved.

The urban planning department improved school playgrounds. Recreation implemented more physical activity in schools. Nutrition worked with day care centres to eliminate sugary snacks and with schools to serve healthier lunches. And the health department instituted comprehensive yearly health examinations in schools, including parent education on healthy eating.

"I am very proud of this programme, but it’s not just the programme that’s achieving good results. It’s the families who have worked hard to change their lifestyles", says Oili Ylihärsila, Director of Health Promotion, Seinäjoki Health Centre.

"Parents are now wiser when it comes to good nutrition and exercise because of our efforts."

Integrating health in all policies

Recognizing that most of the factors that influence child and adolescent health lie outside the health sector, Finland is taking a Health in All Policies approach in its Health Care Act by directing cities, like Seinäjoki, to incorporate health into all of their decision-making areas.

"The Government has reformed the Health Care Act to mandate health promotion services and require municipalities to involve all sectors in their plans," explains Marjaana Pelkonen, Ministerial Advisor, Finnish Ministry of Social Affairs and Health.

The National Institute of Health and Welfare is helping municipalities implement national policies, like the Health Care Act (2011). Municipalities can regularly track their progress on national monitoring websites, share best practices and attend trainings on implementing legislation through a Health In All Policies approach.

Additionally, Seinäjoki and other municipalities are providing free health care counselling and health examinations of equal quality to all children and their families because of Government Decree 338 enacted under the Health Care Act in 2011. Without the decree, many municipalities would have lacked the resources to hire additional public health nurses and physicians to support their programmes to improve child health.

Healthy schools

Following the Finnish National Nutrition Council dietary guidelines, the country is also using schools to improve the health of their pupils.

Firstly, schools must provide free, healthy lunches to every student. Finland has also made recommendations to reduce access to sugary, high-fat snacks and drinks in school vending machines and on how foods can be marketed to children. Sweets, chocolate, soft drinks and ice cream are taxed at higher rates throughout the country.

As a result, childhood obesity is starting to stabilize across the country, and Finland’s experience is proof that when all sectors think about their impact on health and health equity, it can deliver big results.

"While it was difficult to connect everyone in the beginning, we achieved what we planned because we worked together", says Ylihärsila.

"Our programme is now a city-wide priority and an example for other municipalities in Finland."

Source: WHO