The mind is ready, but a beer still suits well

Online Medical Journal, 02.07.2019

The political will to promote prevention is great, but many people fail because of their own weaknesses.

By Dirk Schnack

KIEL. In Germany, prevention has changed a lot in recent years. But how has this affected the fight against the causes of the disease, nicotine, alcohol consumption, lack of exercise and poor nutrition? Here, there is air up to the summit, as shown by an event of the group Ersatzkassenverband Schleswig-Holstein in Kiel.

Professor Reiner Hanewinkel, Director of the Institute for Therapy and Health Research (IFT North) in Kiel and Board Member of the Federal Association for Prevention and Health Promotion , painted a contrasting picture.

  • movement: According to him, middle-aged men often moan, but they do not perceive themselves as such. In addition to their own behavior and relationship prevention can be improved to facilitate exercise in everyday life, so Hanewinkel. As an example, he mentioned the network of bike paths in Germany that is underdeveloped compared to other European countries.
  • nutrition: Although there is a desire and many people also strive to adhere to a healthy diet. But this could be facilitated by appropriate framework conditions. Hanewinkel called for a traffic light, which could provide information on healthy or unhealthy foods and a "tax on sugar". Both options would already be used in neighboring states, according to Hanewinkel.
  • alcohol: Although Hanewinkel sees progress in the Enlightenment, total consumption is too high. "We have an alcohol problem in our society," he said. The causes are complex. One of the most important: the social acceptance of this substance causing addiction. This is reflected in particular in prices, some of which are significantly lower than in the Scandinavian countries. But also in the fact that advertising for alcohol in Germany on a wide front is allowed and that the product is available 24 hours. Hanewinkel also called the inconsistent regulation the limit of drink driving.
  • Nicotine: Here Hanewinkel sees the greatest progress. He attributes the decline in nicotine consumption to a set of measures. In addition to the massive restrictions on advertising, Hanewinkel called for price increases, warnings on cigarette packages, increased age for cigarette sales, and education campaigns.

Hanewinkel suggested using successful measures as a model for engagement in other areas. At the same time, he cautioned against too high expectations and the demand for measurable results through preventive measures. Before consumption declined significantly, he said that there were often intermediate steps that could be considered successful – such as increased knowledge and initial public awareness of the problem.

Money only against proof – this formula works in prevention at least in the short term.

Michael Kraus Health Planner at the City of Flensburg

Michael Kraus, who works in the public health department of the city of Flensburg as a health planner, also warned against exaggerated expectations, especially from payers. "Money only against the evidence" – this formula has a preventive effect, at least in the short term, "said Mr. Kraus, referring in this context to the behavior that has become customary for decades.

To change these with some courses, go beyond reality. For Kraus, the lack of human resources is a major obstacle to anchoring prevention in people's lives. "We need engines," Kraus asked during the discussion. Because the knowledge and skills of the population in prevention and health care could be transmitted only with a growing specialized staff, which also transmits this competence.

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