Author(s): GELIUS, P., KILIAN, K., MANTHEY, J., MONS, U., RABE, S., SCHALLER, K., ALLEBECK, P., KLINGER, C., MÅNSSON, A., SEYFARTH, E., HUIZINGA, O., VON PHILIPSBORN, P. , Institution: UNIVERSITÉ DE LAUSANNE, Country: SWITZERLAND, Abstract-ID: 1899

Purpose: Physical inactivity is considered one of the major risk factors for noncommunicable diseases (NCDs), alongside tobacco use, alcohol consumption, and unhealthy diets. While systems to monitor the implementation of evidence-based policies to address these risk factors exist for each of the four fields, a composite instrument to systematically assess progress across the board is currently lacking. We developed an index that allows for scoring government performance on PA policy alongside the three other risk factors, and applied it to a sample of European countries.

Methods: We systematically searched for existing tools for assessing the adoption of policies to address key risk factors for NCDs. For tobacco and alcohol, we identified suitable and internationally established benchmarking tools. For unhealthy diets, a new index was developed assessing the adoption of six nutrition policy measures. For physical activity, we used data from WHO’s 2022 Global Status Report on Physical Activity to develop a simple additive score for government performance in the areas of active societies, active environments, active people, and active systems. Unlike the other three NCD areas, data were based on government self-reports rather than from independent sources. The four sub-indices were integrated into an overarching index ranging from 0 (no implementation of any policies) to 100 (full implementation of all policies). We then applied this index to 18 European countries.

Results: Among the 18 countries assessed, the Public Health Index ranged from 32 (Switzerland) to 72 (UK), with a median score of 50 (interquartile range: 43-64). The highest scoring countries (score ≥ 60) included the UK, Finland, Ireland, Norway, France and Lithuania, and the lowest scoring countries (score ≤ 40) were Luxembourg, Austria, Germany and Switzerland. Scores across the risk factors nutrition, alcohol and tobacco policy were correlated, in particular among lowest scoring countries. Scores in the physical activity policy varied less across countries, and correlated less with the scores of the other three risk factors.

Conclusion: The Public Health Index allows for a structured and systematic comparison of the adoption of policies for addressing four major NCD risk factors. In our sample, policy adoption varies considerably, but substantial gaps are evident across all countries. The index is highly useful for putting physical activity policy data into the larger context of countries’ general NCD policies. At the same time, the scoring for physical activity still lags behind the other three areas in terms of methodological rigor and data quality, thus warranting further efforts to meet international standards in NCD policy monitoring and to render results more comparable to those from other policy areas.