Score map of the regions of Europe
To measure the work in progress of the long process that from a social proposal leadsb to laws, budgets and implementation in each of 271 European Region , through aspecific algorythm it will be proposed a score map for a rapid understanding of the state of art , using a coloured scale.


The villages of health
A lot of small town rich of natural terapeutical resources are dying since young people try to find work in big cities. For health promotion programmes they're very importanty, expecially for healthy ageing projects. They've a lot of empty houses just ready to be used.


Training initiatives
A first Master on “Equity in Health Manager” was organized by Bologna University (Italy) , while a particular workshop about a Model of Health Production on a Large Scale at local level was organized from Regione Puglia involving local health authorities, municipalities, school managers, trades and associations and general practitioners


Yearly greenbook of Health Promotion and Equity in Health
The Peer Experts Group will propose and vote the “Topic of the Year” inside EHI philosophycal approach and towards an European Public Health System The topic that will reach the higher score will be studied and a Greenbook will be produced. It will be send to Meps, States, Regions, Local Health Authorities, Universities, Trades, Stakeholders, Enterprises, Networks, Professionals etc.


The Model of Hp & Eh
Italian Institute for the Quality of Life - Equity in Health Institute
 Open document send us your suggestion at .
Producing health model:
 Possibility, potentiality and criticality of planning on a large scale.
 Proposal and implementation of pilot "Models of Promotion and Production of Health on a large scale"-
MPPH in the European context.



The launch of the second European Plan for Health 2008-2013 marks a historic step for climate: the issue of promotion, protection and production of health is now universally accepted as the emerging type of costs in the near future, given the obvious impossibility
to maintain the current system of resource use as the sole mode' spending. And given the impossibility to entrust to a culture compilation (cuts and roofs) the sensitive issue of constitutional right to health.
The delicate relationship between
"rights & budgets" in the field of health shows significant developments: how you cannot confuse the right to healing with the right to health, so no one cannot confuse the budget for healing with that for health . It cannot be ignored the fact that the increase in longevity mass cannot be managed, as mentioned above, with the policy of cuts and roofs. The Report EUROSTAT 2008 confirms the need to give utmost importance to the growthg of the phenomenon of mass. No one cannot rationalise in the intentions and then ration in practice. 
There are at present, even if present in extremely pulverized way, multiple and valid scientific evidence, good practices, principles, criteria and experiences that comfort about the possibility of counter events in terms of avoidable morbidity' and mortality ', reaching double objective of improving the quality of life and hinder the development of major diseases. 
However, we must affirm that there is no particular attention to the issue of implementing policies and experimentation, where the case, tends to reproduce patterns occasional shaped and with little consistency in the territory.
In short it is to lose the "sum" of the various interventions when these, however valid, should be carried out in different territories and distant.
An equally important issue is the impact on people, resulting very insignificant when they produced experience with few numbers.
Health producing is a social conquest if you stop at the statement, certainly not yet if we look at the numbers. When you think of an application on a large scale (and others could not be, talking about health)you need to design specific strategies, tactics, methodologies and tecnomethodologies. We need a specific plan for that concerns the fundamental pivot: the participation of the patient at the new location, new habits, that should provide a "time" to devote to their health.

So that the idea to imagine and implement a model of implementation on a large scale and with wide popular participation has a precise meaning: to make the instrument of action by failing to produce only principles, criteria and good practices. Making the consent and participation of the elements of news.


This initiative indicates that:


    1. There is a widespread and shared conviction of having to implement production systems of health, within the guidelines of modern "health in all policies"
    2. There are well-established evidence of efficiency and effectiveness of practices relating to produce health, albeit in pulverized form and at different times and on numbers.
    3. We must point decisively to issues of implementation on a large scale and with broad popular participation for this purpose by starting a specific model inspired by the concept of large reclamations in health and a reasoned review and shared the new budget for health
    4. Perhaps the problem is not that Italy, with its 8.5% of GDP on Sanita' is the lowest tail, but that the whole of Europe underestimates the resource requirements for population’s health
    5. The patient economically fragile and elderly with chronic diseases, new forms of poverty , the weakening purchasing power of wages (or if you want their particular inadequacy, not only in Italy) pose with urgency the question of how to produce health as a huge institutional duty.


 As fallout from this experience:


    1. Experimentation of new figures (health manager, general practitioner sentinel for health etc,) at the level of local health institutions in about 4 European countries
    2. Analysis of new infrastructures, equipment and intangible assets to produce health, to ensure the monitoring of the interception of avoidable events and efficacy of actions taken , for training continues, for health education, information and communication, for provision of assistance needed (register of producers of health, the citizen as self producer of health, the issue of incentives change of habits etc.)
    3. Acquisition of elements for a clinical econometric actuarial to better understand the complex dynamics of cost of health and disease over time.
    4. Check in theory first and then gradually practice, possible impact the allocation of additional 5% of the budget local sanitary institutions in supporting the Model Promotion and Production of Health (MPPH) than morbidity 'and deaths' avoidable


Good contacts for today


At European level: The Actors "Producer of health"


  • Age-Platform ( the Italian Institute for Quality of Life is Member)
  • EFGCP (European Forum for Good Clinical Practice) ( dr. Felli, President of the Italian Institute for Quality of Life is Member)
  • EPHA (European Public Health Alliance) ( the Italian Institute for Quality of Life is Member)
  • European Partners for Equity in Health
  • FERPA (European Federation of Retired Persons and Older)EUREGHA


The Actors "Producer of health"


    1. The Citizen (selfproducer of health, for which, reaching the goals of health will be studied appropriate incentives)
    2. The system of Motor Sciences (there is a vast scientific output, appeared on culminated in Circulation in 2007, which shows a linear relationship between quantity 'motion and reduction of cardiovascular risk)
    3. The system of Nutrition Sciences (foods as determinants of health)
    4. The system of the Social as Therapy (furniture of the time, art, culture, combating loneliness etc.)
    5. The system of bio-strengthening - make Chronic the Health (new generation of drugs, vaccines, spas etc.)
    6. The system of Small Townships - Villages of Health City of Itaqua Project of Italian Instiutute for Quality of Health (the environment as a place and an instrument of therapy, weather stations, treatment climate,suntherapy etc.)
    7. The system of Communication ( to produce new habits and attitudes not fleeting and to use ICT finally also to grow )


What are the changes needed in the field of professionals? 
For example, the figure of the Manager of Health (Director District?), The Medical Sentinel of Health (MMG, young MD?)

Relationship between MPPH and Regional Health System

The MPPH should not be thought of as a separate entity than the Public Health, there is no dividing line between organic healthy and sick (in a hypothetical Gaussian the infinite shades of gray are very large majority compared to white and black).
There is a diagnostic work (clinical and instrumental) that must be applied to MPPH. There is a risk diagnosys and therapy , which still has to be developed.
We must therefore think MPPH integration with the hospital and its territorial structures (diagnostics, day hospitals, shelters short etc.) in order to:


    1. monitoring and documentation of the effects over time of MPPH on the functioning of organs and systems
    2. removal through integratation between public health and MPPH of avoidable events (metabolic syndrome, low motory activity syndrome, anxious-depressive syndromes, mitigating the effects of chronic conditions, etc)
    3. promote the culture of ex ante and not ex post
    4. ensure flexibility of quantity and quality of benefits and rehabilitation in particular, depending on the specific loads (breaks, chronicity, rare diseases, addiction, poverty etc.)
    5. promote MPPH full and equal dignity respect of local health institutions in Regional Health System (RHS)


Relationship between MPPH and Social Protection 

The prolonged discomfort , in whatever form it occurs, is however, directly or indirectly pre-pathological or pathological. The RHS collects the "fruits" in terms of social pathologies to be treated.
It is a huge issue that certainly deserves a discussion aside, but in the MPPH that we are going to submit it occupies a strategic position: the deprivations are never only a concept. They are chronic conditions which lead to mortification of the psycho neuro endocrine and immune therefore "mothers" of many diseases, invisible because deferred over time.
A characteristic of MPPH and is that of a
holistic view of the time. Today it is piecemeal and fragmented: you note the predictable event only if there is a specific culture "actuarial" of the evolution of diseases. You’ve to see contemporarly past, present and future of the patient if you want to be really useful to avoid hillness.
An important topic is that of motivational, relational, cognitive and motory decline, which add to the economic decline: without adequate action of MPPH diseases land on budgets as paratroopers without parachute.

The cooperation of local authorities, improving the quality 'of this proposal in Zone Plans are other strengths of MPPH.


Prevention measures

We analyze the basic form: the Model of Promotion and Production of Health (MPPH) designed by Italian for Quality of Life for the Region of Puglia-FG ASL.
The point of departure of MPPH are 500 General Practitioners for TRAIL MEDICINE: recruit a gradually increasing number of patients agreeing with the patient himself a path where the patients take exact vision of the objectives and tasks / duties to their own health , having as a reference the document on the state of health of the population of the Province of Foggia, for the proper analysis of prevalence of avoidable and predictable events, with respect to economic and social conditions for the establishment of priorities.
The GP , true and proper "Sentinels of Health" will be the directors of the definition of structures and physical infrastructure and intangible assets that the territory should contain and interaction among GP,RHS and Social Services, with the collaboration of all experience at European level and THE KNOWLEDGE OF REGULATORY FRAMEWORK IN THE EUROPEAN, NATIONAL AND REGIONAL level.
The Manager of Health, public figure (director of district?) will be their direct contact to build the entire route, acting SUPPORT OF COMMUNICATION (MEDIA, SCIENTIFIC INFORMANTS for HEALTH, ACTIONS STATISTICAL - EPIDEMIOLOGICAL, EVOLVED MODELS OF BUDGET Etc.)


The start up

The opening of the producing areas of health, the support of continuity of participation of the patient, control of the results, will see them (GP)committed to interface, ACCORDING TO SPECIFIC SUBPROJECTS, with:


    1. The Citizen (selfproducer of health)
    2. The system of Motor Sciences
    3. The system of Nutrition Sciences (foods as determinants of health)
    4. The system of Social Therapy (furniture of the time, art, culture, combating loneliness etc.
    5. System of Specific bio-strengthening (vaccines, spas, etc.)
    6. The system of Small Townships - Villages of Health (the environment as a place and an instrument of therapy, weather stations, treatment climate, suntherapy etc.)
    7. The system of Communication (produce new habits and attitudes not fleeting)





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