SDG3 not only aims to reduce major epidemics of communicable and non-communicable diseases, it also focuses on fighting the behavioural health risks such as alcohol and tobacco addiction, environmental issues like air and water pollution, as well as traffic accidents.

https://youtu.be/2NR4_5dt7JA^[1]

This chapter is going to cover the most serious health and well-being challenges facing the world right now, strategies and actions to transform them into opportunities, and provide examples of businesses and social projects making a positive change in the European region.

There are many prominent health problems around the world, especially in the developing countries in Africa and South-East Asia, where disease epidemics and insufficient maternal and child medical care are present. Although these problems might seem foreign to many people living in developed countries, the European region faces other challenges that are a part of the same - well-being - phenomenon:  Drug and alcohol abuse, obesity, traffic accidents, and mental health problems. Though, SDG3 mainly focuses on improved sanitation and hygiene as well as better medical care, especially for the most vulnerable members of society, there are many fields that need to be improved. Promoting a healthy lifestyle and ensuring the overall well-being of the society is a crucial part of sustainable development.

 Challenge No. 1 - Substance abuse

• The risks and consequences of abusive alcohol consumption are known by the majority of the population, yet, high levels of alcohol are still consumed all around the world. It is widely considered that excessive use of alcohol over a short period of time creates many different health problems, and that is the kind of alcohol use that is the most prevalent in the Eastern European region. Despite the dangers of abusive alcohol consumption, it still has a somewhat positive image in different societies. However, the health problems associated with alcohol consumption, such as kidney and liver diseases or mental illness, heavily outweigh the stated benefits of moderate consumption – especially since the same heart-related benefits of moderate consumption can be achieved with a healthy diet and an active lifestyle. Beyond health consequences, the harmful use of alcohol brings significant social and economic losses to individuals and society at large^[2].

•  Using tobacco is often associated with ill-health, disabilities, and death from non-communicable chronic diseases. However, tobacco is also linked to an increased risk of developing communicable diseases^[3]. It is also important to mention that, compared to the rest of the world, the European Region has one of the highest proportions of deaths associated with tobacco use, according to the World Health Organisation. WHO has estimated that all kinds of tobacco use is currently responsible for the death of about six million people around the world every year. In the European Region, using tobacco is currently responsible for 16% of all deaths in adults over the age of 30, with many individuals dying prematurely. It is also important to mention that there are around 600,000 people who are also estimated to die from second-hand smoking.

Since alcohol and drug abuse are still prevalent problems in the modern world, the United Nations issued out these targets listed below to combat harmful narcotics and alcohol use:

3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

3.A Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.

Challenge No. 2 - Overweight and obesity

According to the 2018 WHO report, worldwide obesity has nearly tripled since 1975. In the 2008 report, over half of both men and women in the European Region were overweight, and roughly 23% of women and 20% of men were obese^[4].

• Overweight and obesity contribute to many non-communicable diseases, affecting the quality of life and significantly shortening life expectancy. In recent decades, the obesity epidemic has developed as a result of the changing social, economic, cultural, and physical environments and it is one of the most serious public health issues in the European Region.
• Overweight and obesity mostly affect individuals in lower socioeconomic groups, also increases healthcare and other inequalities. A particularly important concern is the rapid rise of overweight and obese children, and it is crucial to recognize the problem and the negative impact it will have on the quality of life and well-being of the people as well as society as a whole^[5].

Recognising that tackling obesity requires shared societal responsibility, United Nations issued out this target related to combating the obesity epidemic:

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

Challenge No. 3 - Mental health

Lastly, the most serious problems, that are highly prevalent today, are mental health problems. Mental health and mental disorders are one of the most important public health issues in the European Region. Less opportunities to find employment, lack of resources, and poor social skills highly affect a person’s overall well-being.

• Almost a third of the population suffers from mental health disorders each year (most commonly depression and anxiety). Only about half of all people suffering from mental disorders receive effective professional help and even less receive adequate help. Mental disorders mainly affect the most vulnerable people because the poor population is the group in which most risk factors occur (drug and alcohol use, poor diet, obesity, lack of physical activity, etc.) and has the least access to appropriate services. However, mental disorders affect men and women differently: Depression is twice as common in women, while men commit more suicides.^[6] It is extremely important to grant proper funding and draw attention to mental health issues since many of the mentioned problems like traffic accidents, alcohol and drug abuse, and obesity are associated with neglected mental health problems.
• Suicides can be prevented, yet every 40 seconds a person dies by suicide around the world and many more attempt suicide. Suicides take place in all parts of the world and affect people of all ages. It is important to note that suicide is the second leading cause of death between young people (15-29 years of age) worldwide^[7]. It might seem like a serious public health issue affecting only the developed countries, but in fact, it is quite the contrary: Most suicides occur in low and middle-income regions where mental health services and resources are extremely limited or do not exist at all. Lack of universally available treatment and appropriate interventions make suicide such a prominent public health problem that needs to be addressed accordingly.^[8]

United Nations are recognizing the promotion of mental health and well-being and have issued target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

SOLUTIONS

Even though there are many health-related challenges, there certainly are ways to tackle them. Various studies show that providing appropriate healthcare and wellness programs to employees greatly increases their productivity and overall satisfaction with the occupation.

Action No.1 - workplace substance abuse prevention policy

• Alcohol consumption and drug abuse among workers creates medical, social, and many other problems that not only affect employees and employers, but also causes expenses. Substance abuse among workers can put the public in danger, impair work performance, and threaten their own safety, not to mention the loss of productivity in cases when employees do not show up to work or struggle completing tasks because of hangover/withdrawal. Research shows that workers are more likely to have an alcohol or drug problem if their occupation is stressful, boring, isolating, or promotes drinking culture.^[9]
• To tackle this problem, companies can adopt a workplace substance abuse prevention policy, that could require drug tests or define needed emotional support individually or in groups. It is also important to note that providing mental healthcare, looking for ways to reduce stress levels at work, and promoting a healthy lifestyle can also help create a better work environment.

 Action No.2 - physical activity at the workplace

• Since overweight and obesity are highly associated with many other health problems like diabetes, back pain, high blood pressure, some cancers and heart diseases, it can be said that it highly affects one’s quality of life and productivity at work. While it doesn’t necessarily mean that obese or overweight employees take many more days off work because of their poor health, it is also an issue, when workers are present at the workplace, but their health conditions are affecting their abilities to do their tasks properly.
• Lost productivity costs companies notable amounts of money, so it is essential to take action and implement health-promoting activities, wellness programs, or even measures to increase physical activity while at the workplace. Companies can also provide their workers with free access to the gym and organise educational events regarding a healthy lifestyle.

 Action No.3 - stress reducing work environments

According to a 2018 study in Great Britain^[10], depression, stress, and anxiety were the cause of 44% work-related ill health cases and 57% of all lost working days were related to poor health. These numbers show that employee mental health can play a major role regarding productivity and presence at work.

• Focusing on the well-being of the workers and providing them with stress-reducing activities and mental healthcare programs can definitely improve the environment at the workplace and eventually bring better results for the company. For example, a new trend can be seen: In recent years, many new businesses started installing spaces in their offices where employees can exercise, play games, and relax. It is assumed, that even taking simple measures like this can reduce stress levels and increase motivation and creativity in the workplace.

 Best Practice

Overweight and obesity is also a notable problem in Lithuania since 25% of male and 31% of female population was obese in 2016^[11]. Therefore, it is important to use effective measures to stop this growing epidemic that is affecting not only adults, but also a large population of children.

"Lobesity" is a Lithuanian association for the prevention of obesity and being overweight – at its core it is a non-governmental, non-medical, and non-formal education organization in Lithuania to help both the education and health sectors to obtain systematic innovative knowledge in health behavior-related subjects and help health authorities apply lifestyle changes in children’s, teens’ and adults’ lives. 

Operating since 2016, the company already has reached over 14,000 children, health practitioners, educators, and parents and has provided significant impact in the area of lifestyle transformation. In 2018, the company received a grant from Lithuanian Health Ministry to proceed with family-centered interventions for teens and adults with overweight and obesity problems in Lithuania, which made the service free of charge for those families in need.

“Teenshapers” is an organisation developed by “Lobesity” that provides camps and educational activities for children and teenagers who are suffering from eating disorders. They also actively educate parents and teachers and provide various programs on healthy lifestyles. “Camp Teenshapers”, created by Artiomas Sabajevas, gained recognition in 2015, when it received an award from a Scandinavian foundation called “Reach for Change”.

This initiative addresses the United Nations target 3.4, which is:  By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. “Teenshapers” are succeeding in contributing to this target:

• The main goal of this camp is to help children and teenagers lose or gain weight in a healthy way and overcome eating disorders all the while using innovative and effective measures and activities.
• The camp offers physical activities, puts a strong focus on food, and, most importantly, provides group and individual discussions with certified psychologists and dietologists. In addition, “Camp Teenshapers” focuses on implementing healthy habits that are meant to promote permanent lifestyle changes and help young people maintain their achieved results.

Conclusions

While it may seem like many health problems around the world like disease epidemics or insufficient maternal and child care are being eliminated, new problems arise. In the European region, a notable amount of people are struggling with obesity, drug and alcohol abuse, mental health issues, and not to mention the prominent road traffic fatalities.

Even though improving overall health and well-being of people around the world would certainly require better funding from the government, innovative and effective soft measures carried out by dedicated people show that well-thought-out initiatives can surely make a difference. Since many said problems can be attributed to poor mental health, it is essential to make treatment available to all and work towards eliminating the stigma surrounding mental health issues.

^[1] ©2017 Paxton/Patterson

^[2] https://www.who.int/news-room/fact-sheets/detail/alcohol

^[3] WHO global report on trends in prevalence of tobacco smoking 2015. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/156262/9789241564922_eng.pdf;jsessionid=3A09DAFF7CAECBB05ED60DB222A0362B?sequence=1 [Accessed on 2019-01-10]

^[4] Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Retrieved from: https://www.who.int/nmh/publications/ncd-profiles-2018/en/ [Accessed on 2019-01-20]

^[5] Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Retrieved from: https://www.who.int/nmh/publications/ncd-profiles-2018/en/ [Accessed on 2019-01-20]

^[6] The European Mental Health Action Plan 2013-2020. World Health Organisation 2015. Retrieved from: http://www.euro.who.int/__data/assets/pdf_file/0020/280604/WHO-Europe-Mental-Health-Acion-Plan-2013-2020.pdf [Accessed on 2019-01-25]

^[7]  Preventing suicide: a global imperative. Luxembourg: World Health Organisation 2014. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf?sequence=1 [Accessed on 2019-01-19]]

^[8] Preventing suicide: a global imperative. Luxembourg: World Health Organisation 2014. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf?sequence=1 [Accessed on 2019-01-19]]

^[9] Alcohol and the Workplace. National Institute on Alcohol Abuse and Alcoholism 1999. Retrieved from: https://pubs.niaaa.nih.gov/publications/aa44.htm [Accessed on 2019-01-29]

^[10] Work related stress, depression or anxiety in Great Britain, 2018. Health and Safety Executive 2018. Retrieved from: http://www.hse.gov.uk/statistics/causdis/stress.pdf [Accessed on 2019-02-01]

^[11]  Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Retrieved from: https://www.who.int/nmh/publications/ncd-profiles-2018/en/ [Accessed on 2019-01-20]