Interview with Health Commissioner Kyprianou

In an interview with ENWHP Markos Kyprianou, Commissioner for Health and Consumer Protection, talks about the significance of the setting "workplace", the key priorities of the Commission, and the contributions which the Network ENWHP has made to increase investments in health at work in Europe.

Commissioner Kyprianou: For several years now DG Sanco has actively supported the promotion of health at work in Europe. What contribution can health promotion and prevention make at work in order to improve Public Health in the Community?

Kyprianou: The Commission recognises the workplace to be an important tool in the improvement of health across the EU. It allows access to a wide cross-section of society in health promotion measures, including those who might otherwise fall between the gaps in public health policies. As people tend to spend a large proportion of their day in work, clearly the workplace health policy and conditions are going to have an impact on their wellbeing. Moreover, employers are becoming increasingly aware of the benefits of promoting good health amongst their employees, realising that a healthy workforce is, of course, more likely to be a productive one.

In one of your recent speeches you called for stronger efforts to be made in the field of mental health promotion and the prevention of mental disorders. Mental Illness is very often related directly to work, and it may trigger off other health problems such as MSD. How will the Commission go about combating this epidemic more effectively?

Kyprianou: Mental health is one of the key priorities within our overall public health objectives, given the impact it has on quality of life, social cohesion and economic development. Around 20-25% of Europeans experience some form of mental health problem at least once in their lives, and the costs of this on the European economy through illness, fall in productivity and loss of employment are around 3-4% of the annual GDP. In order to reduce these figures, we must focus as much on the promotion of mental health as on the treatment of mental illness. For its part, the Commission will publish a Communication on Mental Health later this year, which will be followed up with a consultation process involving all stakeholders. The EU is also funding a number of projects in order to better understand the causes of mental illness and ways in which it can be reduced or prevented.

"It is in the daily work environment that some of the most effective action can be taken to promote and protect mental wellbeing amongst EU citizens"

I firmly believe, however, that mental health is not something that can be addressed by policy-makers alone. In fact, it is at "ground level" that the biggest impact can be made in promoting mental health. Work places, as somewhere where the individual generally spends a large amount of time, have a great influence on levels of mental health, as well as attitudes towards dealing with related problems. It is in the daily work environment that some of the most effective action can be taken to promote and protect mental wellbeing amongst EU citizens. Our objective is to raise awareness amongst employers about the possibilities of strategically managing mental health issues and making work places more conductive to good mental health. Companies and employers will in turn reap the rewards of a more profitable, innovative and stable work-force.

New member states lack the tradition of health promotion and prevention which has developed gradually in the EU-15 over many years. Low investments in health limit the capacity of these states to address major health problems, including those which occur at workplaces. You yourself come from a country which has recently joined the Union: How can the Community respond to the severe health challenges which arise from past and future enlargement?

Kyprianou: The new Member States clearly have some catching up to do with other EU Members when it comes to national health services and health promotion. It is not my role to advise national governments on how much they should invest in health care. However, I do find it concerning that some of the central and eastern EU countries spend a significantly smaller proportion of their GDP on public health, particularly as the level of certain diseases and health risks has been shown to be higher in some of these countries than in the EU-15. Bearing in mind that poor public health can act as a brake on overall social and economic development, I would advocate more EU and national resources being allocated to public health in the central and eastern European countries. Meanwhile, the Commission will play its part in raising public health levels by communicating health risks to citizens, encouraging healthier lifestyles and co-ordinating information exchange on best practices. We must remember that the EU is adapting not only to internal enlargement, but also to the constant new challenges posed by globalisation. If the economy of the enlarged EU is to be one of the most competitive in the world, it must be fuelled by a motivated, educated and, above all, healthy workforce.

The health gap is not only widening between East and West in Europe, but also within the Member States themselves. Privileged social groups increasingly seem to have a better standard of health than those less privileged. Employed citizens, for instance, enjoy better health than the unemployed, which proves emphatically that work has beneficial effects on health. Can health at work help to bridge the social gap in Europe?

"It's a "chicken and egg" type situation. Good workplace practices help to lift public health standards, which in turn boosts the overall competitiveness of a society."

Kyprianou: Unfortunately it is true that we still see discrepancies in EU citizens' levels of health depending on social class, employment, education levels and income. It has been shown, for example, that EU citizens in regular employment enjoy better health than citizens who are frequently without a secure job. Moreover, it has been found that, in general, the better the quality of the employment, the better the workers' health. Therefore, we can see health promotion in the workplace as one of the keys to bridging the gap in health standards across society. It's a "chicken and egg" type situation. Good workplace practices help to lift public health standards, which in turn boosts the overall competitiveness of a society. A more competitive society will lead to further employment. And, as more quality employment means improved health, every newly-created job is an active contribution to the improvement of public health in the EU. For this reason the Commission is determined to increase awareness of the benefits of good working conditions, while also using other tools such as well-targeted public health campaigns to narrow the differences in health standards amongst EU citizens.

A major obstacle in responding to health threats more effectively is the lack of comparability in work-related health information. The European Union is working on a European health monitoring system in which the definition and application of key indicators are very central. What role does the world of work play in this context?

Kyprianou: One of the objectives in the Public Health Programme is to develop comparable information on health in all Member States, so that we can properly evaluate the health situation across the EU and identify areas where more work may need to be done. To achieve this, we have developed a set of common indicators which will be used to gather data on all factors shaping citizens' health, including living and working conditions. In the past we did not put enough emphasis on collecting information on health and the workplace, which doesn't make sense, seeing as this is where many EU citizens spend the major part of their day. Through the application of the new indicators in work-related health monitoring, we will be able to get a clear idea of the real impact work has on citizens' health, while also linking the information gathered to other variables such as social status, income, education levels and leisure activities.

There is sound evidence that health promotion at the workplace makes European companies socially and economically more competitive. But the evidence is still ignored by many companies: While carefully maintaining their machines, many of them still hesitate to invest in the maintenance of their ultimate production factor: the human being. From your point of view: What needs to be done in order to convince companies in Europe to run prevention programmes and to promote health at work more consistently?

Kyprianou: I feel that more and more employers are beginning to understand the value that investing in workers' health and wellbeing adds to a company in terms of productivity and competitiveness. We are constantly seeing improvements in this field. However, there are still some companies who believe that they can save money by cutting costs related to workers' health. Long-term, however, this proves to be false economy, and they are likely to pay a high price through increased absenteeism, lower productivity, and poor worker morale. Recent figures collected by the ENWHP have confirmed the merits of investing in health, showing that healthier workplaces can result in better worker performance, improved customer service, higher attendance levels and more innovation. The Commission will continue to use such data, along with other evidence gathered, to reinforce the message that the most competitive companies, and economies, run on a healthy workforce.

Interview: Dr. Thomas Theuringer
Picture: EU Commission