Finn Kamper-Jørgensen

Health promoting outdoor environments - Associations between green space, and health, health-related quality of life and stress based on a Danish national representative survey

Aims: To investigate the associations between green space and health, health-related quality of life and stress, respectively. Methods: Data were derived from the 2005 Danish Health Interview Survey and are based on a region-stratified random sample of 21,832 adults. Data were collected via face-to-face interviews followed by a self-administered questionnaire, including the SF-36, which measures eight dimensions of health and the Perceived Stress Scale, which measures self-reported stress. A total of 11,238 respondents completed the interview and returned the questionnaire. Multiple logistic regression analyses were performed to investigate the association between distance to green space and self-perceived stress. Results: Danes living more than 1 km away from the nearest green space report poorer health and health-related quality of life, i.e. lower mean scores on all eight SF-36 dimensions of health than respondents living closer. Respondents living more than 1 km away from a green space have 1.42 higher odds of experiencing stress than do respondents living less than 300 m from a green space. Respondents not reporting stress are more likely to visit a green space than are respondents reporting stress. Reasons for visiting green spaces differ significantly depending on whether or not respondents experience stress. Respondents reporting stress are likely to use green spaces to reduce stress. Conclusions: An association between distance to a green space and health and health-related quality of life was found. Further, the results indicate awareness among Danes that green spaces may be of importance in managing stress and that green spaces may play an important role as health-promoting environments.

Part 3: International evaluation of Swedish public health research

1. Executive summary The Swedish government has asked for a description and evaluation of Swedish public health research (PHR) in order to compile background material for a government research bill to be submitted to the Swedish Riksdag. The National Institute of Public Health, Sweden (NIPH) and the Swedish Council for Working Life and Social Research (FAS) are responsible for producing various types of relevant material for the government – and separate material associated with this evaluation report has been produced by NIPH. FAS and NIPH – having cooperated in the planning of this independent international evaluation of PHR – appointed an international panel comprising experts from the USA, the United Kingdom, the Netherlands, Finland and Denmark.

High-throughput epidemiology: combining existing data from the Nordic countries in health-related collaborative research.

Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA & Århus University, Denmark, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark, National Institute for Health and Welfare, Finland and Nordic School of Public Health, Stockholm, Stockholm, Sweden, Tampere School of Public Health, University of Tampere, Tampere, Finland, Centre for Epidemiology, The Swedish National Board of Health and Welfare, Stockholm, Sweden, Department of Preventive Medicine, University of Iceland, Reykjavik, Iceland, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway, and Statistics Denmark, Research Services, Copenhagen, Denmark

Knowledge-base, evidence and evaluation in Public Health

The research community holds a basic value: It is important to produce knowledge – particularly new knowledge – based on sound scientific methods. Relevance and quality of research are two important dimensions related to this issue. This basic value has stimulated an interesting international discussion during the past decade under the heading of ‘‘evidence-based’’. It all began with clinical medicine – evidence-based medicine. Now it has spread to all fields of health including public health and health promotion and we read about evidencebased health promotion, evidence-based public health, evidence-based health policy, etc. Focus so far has been on evidence-based medicine. Some of the fathers of evidence-based medicine in the middle of the 90’es wrote a balanced editorial i British Medical Journal (1) defining what it is and what it isn’t: ‘‘Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about care of the individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research’’. In the editorial it was further stated that;

4th European Public Health Conference 2011 in Copenhagen: Public Health and Welfare - Welfare Development and Health

On 10–12 November 2011 the annual European Public Health Conference will take place in Copenhagen, Denmark. Pre-conferences will be held on 9 November. The theme is: Public Health and Welfare – Welfare Development and Health There is a strong tradition of participation among researchers and practitioners within public health from the Scandinavian countries – especially when the conference takes place in a Scandinavian country. Public health contributes to welfare by means of health promotion, health protection, disease prevention and health services. Such interventions represent investments in a better health and better life for populations – a contribution to welfare. At the same time, they contribute to a healthy labour force. The concept of welfare is usually associated with satisfying basic human needs, such as having access to food, shelter, education, work, an economic income etc. Often, health is included in the concept of welfare. Nations that have the economic ability and economic will to safeguard these needs for broad groups in society are often called welfare states. The reverse relationship between welfare and health is also a well documented historic fact. In particular wealth and economic well-being is one of the determinants of health, but this holds for other aspects of welfare as well – material as well as immaterial. During Copenhagen 2011 we intend, through keynote lectures, sessions and workshops, to give examples of the mutual relationship between public health and welfare and welfare development and health. The following keynote lectures are planned:

Editorial: The healthy city

The basic environmental factors air, soil, water, sewage have a healthy state and are under control. Traffic accidents and leisure time accidents have been minimised Access to physical exercise is facilitated by easy access to facilities, green space, and open places in the city In local communities and local areas, we find a high degree of social capital and cohesion among the citizens A well-developed involvement of citizens in community development and local decision making A good ecological balance in the city based on the principle of sustainability, as is also to energy The city is a beautiful sight and an aesthetic experience The broad concept of health created by WHO has been implemented at city level in political thinking and in decision making

Chief Editor’s introductory comments

Scandinavian Journal of Public Health now and then publishes a supplement focusing on special issues and selected topics. The Research Council of Norway wanted to present high-quality research funded by the Public Health Programme of the Research Council. I responded positively towards this wish. Some years ago I was Chairman – initialized by the Norwegian Research Council – of an international evaluation panel evaluating Norwegian Public Health Research. A formal report was published [1] identifying strengths and weaknesses and recommending developments for the future. I was personally left with a very good impression of the high-quality work in a number of institutes and scientific environments, and I saw a fine potential for strong scientific developments in the future. The fairly positive evaluation apparently later stimulated further investment in a Public Health Research Programme. Some of this outcome of stimulating research is found in this supplement. For me as Chief Editor it was easy to accept the proposed idea by the Research Council. As can be seen from the introduction by Professor Margareta Wandel, the Research Council selected 14 studies funded by the Research Council. This supplement is also sponsored by the Research Council. Wandel’s introduction presents an overview. Two co-editors were appointed to assist me in the editorial process – Gun Roos, Senior Researcher, PhD, National Institute for Consumer Research, Oslo, and Siri Forsmo, Associate Professor, MD MPH PhD, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim. I am grateful for their contribution. All 14 articles have been through the usual critical scientific external review.

Public health information systems -- and EUPHIX.

In public health, we are moving towards the third generation of public health information systems. The two articles in this issue [1,2] demonstrate how a cross-national European system has been developed as an integrated knowledge system (EUPHIX), and how a national system (Norhealth) can develop along the same lines. The first generation of public health information systems comprised a data system collecting important basic data on a population and the health of a population, such as births and deaths. Over time, the vital and mortality statistics proved to be a very useful and informative tool. Such statistics have existed for hundreds of years, partly to provide the king of a country with information on the power that he possessed through the size of the population, and partly to obtain knowledge about population health. When the discipline of epidemiology emerged, strict concepts and definitions such as mortality rates and incidence rates were developed. The second generation of public health information systems is characterized by combining time-series data and international comparative data with comments related to the data – for example, comparing ageand sex-standardized mortality rates of lung cancer over time and in different European countries. The public health consequence of such comparisons was an increased focus on highmortality countries and attempts to understand causal pathogenic links between risk factors and disease and mortality – and intervention, e.g. with regard to tobacco smoking. A growing interest in measuring health and disease in live populations and outside institutions developed from the middle of the 20th century. Health interview surveys and health examination surveys of nationally representative populations began to appear in the literature, and lately we have been seeing European attempts to standardize such information systems through standardization of the measurement instrument: the questionnaire. The second generation of public health information systems is also characterized by data collection based on a theoretical concept of health and disease rooted in a multifactorial understanding. Health and disease is determined by many factors, including lifestyle, living conditions, genetics, health system interventions and population structure. The World Health Organization (WHO) programme in Europe, ‘‘Health for All by the Year 2000’’, has been very important and instrumental in the development of relevant health indicators measuring health policy targets. Now – at the beginning of the 21st century – we meet the third generation of public health information systems. I use the term ‘‘integrated knowledge system’’ because it integrates data, descriptive and analytical information, and digested and evidencebased knowledge. Electronic data handling, information technology and the Internet have revolutionized the possibilities of creating integrated health information.

New editor and new publisher for the Scandinavian Journal of Public Health

As we enter 2008, the Scandinavian Journal of Public Health (SJPH) enters a new era. SJPH is now published eight times a year. This issue also sees the introduction of a News Section at the back of the journal, beginning with policy statement reviews from the Nordic Ministers for Health on the five most important political decisions or events in 2007. The first contributions are from the Finnish and Icelandic Ministers for Health. I also intend to introduce photographs of authors in the journal from late 2008 or 2009. SJPH is an international forum of Nordic as well as international public health research and policy. SJPH has a vision to:

Message from the Chief Editor to all authors on waiting time

We have a large database of reviewers. We typically initiate the process by inviting two or three persons to review. Stepwise, we make sure that at least two reviewers have agreed to the invitation. When we get negative responses, new persons have to be approached. The worst case was an approach to a total of 25 persons. All this takes time. Many reviewers decline to review − they feel that the burden of just another review is too heavy.