A Nationally Coordinated Health Promotion Program for the Elderly in a Federal State, Switzerland
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A Nationally Coordinated Health Promotion Program for the Elderly in a Federal State, Switzerland Philippe Chastonay 1 & Dominik Weber 2 & Thomas Mattig 2,3 Received: 16 March 2018 / Accepted: 5 December 2018/ # Springer Nature B.V. 2019
Abstract In a federal state like Switzerland, where health policies are the responsibility of local, regional and federal authorities, implementing a nationally coordinated health promotion program is a political and logistic challenge. The VIA project, presented hereafter, is one of the rare health promotion projects to be coordinated at the national level in Switzerland. Its aim is to promote the health of older people, a population which is heavily affected by chronic diseases. Indeed, in the group aged 65–79 years living at home, 28.8% suffer from one and 25.2% from several chronic diseases; in the over-80 age group, the proportions are 29.6% and 41.3%. The VIA project, a multi-year project, tackles specific issues known to affect the health of the elderly, such as fall prevention, promotion of physical activity and healthy eating as well as social integration through supporting local stakeholders with theoretical knowledge, practical know-how and facilitating networking among various stakeholders. The coordination work was considered useful by most local program-managers: especially considered as useful were network encounters and exchange of experiences among professionals. Keywords Health promotion . Older people . Network . Intervention . Coordination .
Health policies . Federal state
Background The Health of the Elderly in Switzerland In a country like Switzerland with an aging population (Cotter 2005, 2016; Grimaldi 2015; Menthonnex 2015), much of the disease burden affects the population aged over 65, notably caused by non-communicable
* Philippe Chastonay [email protected]
1
Department of Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
2
Health Promotion Switzerland, Bern, Switzerland
3
Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
P. Chastonay et al.
diseases (NCDs). In Switzerland, 49% of people aged 65 and older have suffered from a chronic illness for at least six months (BFS 2017, 2018). Between 14% and 18% of men and 9% of women have diabetes, nearly 50% suffer from back pain, and 15–20% receive treatment for osteoarthritis. Dementia affects less than 2% of people between 65 and 69, 13% of those between 80 and 84, and more than 30% of those over 90 (Enderli et al. 2017; Bachmann et al. 2015). In addition, older people often suffer from multiple chronic diseases simultaneously. In the group aged 65–79 years living at home, 28.8% suffer from one and 25.2% from several chronic diseases; in the over-80 age group, the proportions are 29.6% and 41.3%. The leading cause of death among people aged 65– 74 is cancer (43.9% of deaths in men and 48.2% in women), followed by cardiovascular diseases (25% for men and 19% for women) (Bopp and Minder 2003). This picture is reversed in those aged ov
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