DAN - Relatórios científicos e técnicos
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- Pilot study: Reduction of salt (sodium) in bread and its contribution to the decrease of cardiovascular diseases Health Impact Assessment of the introduction of new legislation - Screening reportPublication . Caldas de Almeida, Teresa; Costa, Luciana; Costa, Alexandra; Santos, Joana; Braz, Paula; Coelho, Mariana; Brazão, Roberto; Assunção, Ricardo; Lopes, Isabel; Guerreiro, Ana CristinaIntroduction: The importance of using a Health Impact Assessment (HIA) methodology to evaluate a new policy, program or project resides in the possibility of using the results to increase knowledge about the proposal, inform decision makers and affected population, and minimize potential effects and maximize the positive effects on health and well-being. The methodology of HIA is thus an essential tool in assessing the potential effects of interventions on the health of a population by its contribution to decision making for health and equity protection. In Portugal there is a growing interest in understanding the extent to which health interventions and policies in other sectors have an impact on health and equity. The new Public Health Law (Number49 / XIII) which is being discussed in the special field in Parliament, defines the competences of public health services and proposes to carry out at national level studies to assess the impact on health, from a "whole of government" perspective. Following this Law, a model is being developed to guide the implementation of health impact studies at the national, regional and local levels. In this way, the initiatives that promote technical training in this field are of particular importance, particularly to the National Institute of Health Doctor Ricardo Jorge, IP (INSA, IP) regarding its mission. It is therefore important to develop technical skills, tools and methodologies for impact assessment from a "whole of society" perspective. In this sense, within the scope of the Biennial Collaborative Agreement between the World Health Organization (WHO) and the Ministry of Health of Portugal, INSA, IP is implementing in collaboration with technical experts from WHO a "capacity building HIA training program”. In this context, a Workshop on HIA was held in November 2017 in Lisbon. This Workshop included a Policy Dialogue, with the main objective of training health professionals and other sectors to develop health impact studies and discuss strategies for implementing HIA as a tool to support a "Health in all policies" approach. This strategy is considered essential for governance in health and for equity and well-being, not only for other sectors to recognize their responsibility in Health, but also for Health to recognize the impact of its interventions in other sectors. Following this initiative, three stakeholder groups were organized for the implementation of three pilot studies on HIA, with WHO expert follow-up. Online meetings and seminars based on a "Learning by doing" program, were organized and supported by "Screening" and "Scooping" tools described in the HIA Guidance of the Institute of Public Health in Ireland [1] intending in the end to build from the case studies a guide to the national context. This report concerns to one of the studies carried out in this context, and serves to present the preliminary results of the study “Reduction of salt (sodium) in bread and its contribution to the decrease of cardiovascular diseases Health Impact Assessment of the introduction of new legislation”.
- Pilot study: Reduction of salt (sodium) in bread and its contribution to the decrease of cardiovascular diseases Health Impact Assessment of the introduction of new legislation - Terms of referencePublication . Caldas de Almeida, Teresa; Costa, Luciana; Costa, Alexandra; Santos, Joana; Braz, Paula; Coelho, Mariana; Brazão, Roberto; Assunção, Ricardo; Alves, Joana; Lopes, Isabel; Guerreiro, Ana CristinaIntroduction: The Health Impact Assessment (HIA) is a combination of essential procedures, methods, and tools to assess the potential effects of policies, programs or projects on the health of a population, contributing to the decision making for health protection and equity. Within the scope of the Biennial Collaborative Agreement (BCA) between the World Health Organization (WHO) and the Ministry of Health, the Health Impact Assessment Workshop was held in November 2017 at National Institute of Health Dr. Ricardo Jorge (INSA, I.P.). This workshop presented the methodologies of health impact studies, as well as established working groups to carry out an exercise of application of the addressed contents, focusing on concrete cases where the HIA showed relevance. This working group intends to study the health impact of the gradual reduction of salt content in bread consumed in Portugal, in line with the goals identified in the protocol recently established between the Directorate-General for Health (DGS), INSA I.P., and Portuguese bakery associations. This exercise intends, on the one hand, to put into practice the methodology to carry out HIA (delivered in the workshop) in a "Learning by Doing" approach, on the other hand, to reinforce the importance of reducing the salt content in the occurrence of cardiovascular diseases with a special focus on the reduction of arterial hypertension. The working group includes member of the Departments of Health Promotion and Prevention of Non-Communicable Diseases (DPS), Food and Nutrition (DAN) and Epidemiology (DEP) of INSA, I.P. as well as representatives of the Regional Health Administration of Algarve (ARS Algarve) and Directorate-General for Education (DGE). In order to carry out this study, national data from projects in which INSA, I.P. is/was coordinator entity or participant will be used, such as INSEF - National Health Survey with Physical Examination and IAN-AF - National Food and Physical Activity Survey. All activities carried out in this field have been accompanied by the WHO international experts who participated in the Health Impact Assessment Workshop.