The current national focus on COVID-19 serves as a clear example of how our society revolves around health.
Health runs our life; it sets the agenda of daily living and constructs reality and normality for individuals and societies. It is no wonder then that when there is a threat to it, everything comes to a standstill.
The Faculty of Health Sciences at the University of Malta has always been at the forefront to acknowledge this. To this extent, the topic of this year’s annual conference, organised by the dean, Roberta Sammut, the vice-dean, Stephen Lungaro Mifsud, and their team has specifically been the Maltese environment and health.
The aim of the conference was to engage in workshops which address four health areas that have been set as a national priority, namely, the obesogenic environment, mental health, climate change and ageing.
The first workshop was targeted at the Maltese obesogenic (tending to cause obesity) environment. During the discussion, there was consensus that obesity and the obesogenic environment are not being given the importance they merit and so more can be done.
The need for policies directly related to children was specifically mentioned, in view of the high rates of childhood obesity. A health impact-assessment approach during the drafting of policies should be encouraged. Thus, the main recommendation was for the setting up of a unit where assessors would screen all drafted policies and make recommendations on how policies can be tweaked to maximise health benefits.
It was also noted that the inequalities and social gradient that are present in the Maltese society pushes health downwards on the priority list for individuals with a lower socio-economic status. In this view, measures such as taxation of unhealthy foods in order to reduce obesity may act as a ‘double-edged sword’. Alternatives would be to work with the food industries on the reformulation of some food product recipes and to promote the subsidisation of healthier foods such as fruits and vegetables.
Another workshop addressed mental health against a backdrop of the Maltese work environment. Inflexible hours, a lack of clear objectives, inadequate health and safety policies, contrasting and excessive demands, lack of resources and limited support from management/authorities were all discussed as factors that can create a toxic work environment and which can thus have a detrimental effect on mental health. Recommended counteractive measures include the nurturing of a team approach and further focus on family-friendly measures. Employees can also be helped to become conversant with coping skills and the importance of a positive attitude.
The healthcare- related carbon footprint amounts to 4.4 per cent of total global emissions
The impact of healthcare on climate change was the topic of interest in the third workshop that took place during the conference. As discussed at the beginning of this article, it is not negated that health deserves deity status. Yet its care is not without negative consequences on our climate.
For instance, it is acknowledged that the carbon footprint related to healthcare amounts to 4.4 per cent of total global emissions. The workshop centred on three recommended areas of improvement that are related to this topic.
Firstly, there are ways of reducing the carbon footprint. Some of these may involve structural changes such as the promotion of green healthcare infrastructure and transport systems. Procedural changes can also be implemented such as the mindful ordering of investigations, for example blood tests and food ordering within hospitals. The migration to electronic data recording systems will also limit paper consumption.
Secondly, the creation of resilient communities needs to be further considered. This can be achieved by launching educational campaigns that teach communities how to protect themselves against global warming and using the media to create ‘climate anxiety’.
The final area of discussion was related to the promotion of inter-sectorial collaboration in order to share resources, expertise and data.
The fourth conference workshop addressed the creation of age-friendly urban environments. The discussion set off by identifying local environmental challenges to healthy ageing. These included the lack of open spaces that are orientation-friendly, strategically placed and safe from violence and injury; a custodial and overprotective approach towards the elderly; limited support services and the challenge of finding affordable insurance coverage for people over the age of 65.
Discussed recommendations to combat these challenges included the pedestrianisation of town centres, collaboration with local councils, safer pavements and the introduction of small capacity shuttle electric vehicles to transport older people around towns.
Health and safety officers may also need education on how to cater for the needs of the elderly. Appropriate signage designed for older people and those with physical limitations will also help to enhance independence and facilitate orientation. Importantly, older people are the experts in the identification of their needs and so have the potential of acting as influencers in meetings and committees. Once again a call for inter-sectorial effort is being made.
To this extent, local councils, the Planning Authority and ministries can use their synergistic potential to implement health impact assessments for construction projects and to seek the active inclusion of elderly citizens in decision making and strategy building.
The recommendations that emerged from the conference will be forwarded to the necessary stakeholders as an important contribution from academic experts within the fields of interest.
Paulann Grech wrote this article on behalf of the Faculty of Health Sciences, University of Malta.
Paulann Grech, lecturer, Department of Mental Health, University of Malta