The campaign "This Is Public Health" in Italy, set up by a team of Public Health Schools in Northern Italy.

Despite the great effort to raise awareness among health promotion, nowadays Public Health policies are not often recognized as important tools. For this reason, the Health in All Policies (HiAP) approach is instrumental in tackling this information gap. In 2018, the US Association of Schools and Programs of Public Health (ASPPH) launched an international campaign called "This is Public Health" (TIPH), whose aim was "to brand public health and raise awareness of how it affects individuals, communities and populations". The Association of Schools of Public Health in the European Region (ASPHER), in coordination with ASPPH, decided to create a European campaign to support and to reproduce the American one, by opening a challenge among the European Public Health Schools. The Schools and Programs of PH of Vita-Salute "San Raffaele" University, Milan, University of Parma, University of Pavia and Politecnico of Milan won this bid. In this "briefing on" we present a report on the Italian project for raising awareness of Public Health among general population and health care personell.

Introduction

It is well known among experts that Public Health (PH) activities are not always well perceived as strategic tools among the Governement policies not only for health protection of populations but also in view of socio-economic development. The general population, especially those working in non-healthcare related fields, underestimates the crucial role of Public Health policies as vaccinations, food & veterinary controls, energy saving, transport regulation, healthcare design and city planning (1-9): these activities are of increasing importance and need more attention from institutions, health care personell and other professionals (10-17). The Health in All Policies (HiAP) approach is instrumental in tackling this information gap (18, 19). Originally conceived in the EU, HiAP is now included in WHO’s Sustainable Development Goals.

In the United States, in 2018, the Association of Schools & Programs of Public Health (ASPPH) launched a campaign called “This is Public Health” (TIPH), whose aim was “to brand public health and raise awareness of how PH affects individuals, families, communities, and populations”(20). The Association of Schools of Public Health in the European Region (ASPHER), cooperating with ASPPH, determined to create a European campaign to reproduce the American one. An open bid was set, in which PH Schools affiliated to ASPHER were requested to formulate country-specific proposals. The winners were: Braun School of Public Health and Community Medicine, from Hebrew University-Hadassah, Department of International Health, CAPHRI, from University of Maastricht, Faculty of Public Health of Sofia Medical University, School of Health and Related Research (ScHARR), from University of Sheffield, Schools of Public Health of Vita-Salute “San Raffaele” University, Milan, University of Parma, University of Pavia and Politecnico of Milan (co-ordinated by the Accademia Lombarda di Sanità Pubblica). In addition, ASPHER was secured partial awards to Krakow Institute of Public Health, Jagiellonian University, University of Bologna, and the Faculty of Public Health of Lithuanian University of Health Sciences.(21)

The Accademia Lombarda di Sanità Pubblica (22) set up a proposal to increase PH awareness both in the general population and in healthcare workers.

Methods

The preliminary phase was dedicated to the Project setup and was conducted by the ten new Public Health Residents of the Vita-Salute “San Raffaele” University, with the coordination and supervision of the PI and the Schools’ Directors. The working group extensively discussed the need for an appropriate translation of the catchphrase and a new graphic rendering of the TIPH logo in Italian language. An agreement was finally reached to adapt all the elements of the campaign, re-elaborating them according to the Italian context. The word “health” has a double meaning in Italian (“salute” and “sanità”); furthermore, people with limited English proficiency are a large part of the target population. Finally the team eventually has decided for a non-literal translation (“Per la salute di tutti”).

To further boost the campaign online, the group created “This is Public Health Italy: Per la Salute di Tutti” accounts and pages on the main social media (i.e. Facebook, Twitter, Instagram), determining to set a weekly topic for the posts: they decided for the UN Sustainable Development Goals (SDGs), by examination of them in the scene of Italian situation nowadays.

Subsequently, the PI assigned tasks to each of the team’s members from the various PH Schools involved. The operational phase is currently underway, and a series of activities are already in schedule. As an instance, an achievement in progress is to contribute to the health environment of a series of hospitals, starting from San Raffaele Hospital in Milan (affiliated to Vita-Salute University), and Piccole Figlie Hospital, hospital affiliated to the Public health School at the University of Parma. The TIPH team propose is to adopt a number of healthy behaviors from the teaching hospitals connected to the Schools (i.e. healthy eating, not smoking, recycling): posters with specific slogans are being created, hospital attenders as target (healthcare providers, patients and patients’ relatives): this contribution has as a purpose to connect the aforementioned healthy gestures to the “This is Public Health – Per la Salute di Tutti” campaign logos (Figure 1).

Figure 1.

Official logos of the “This is Public Health” campaign from USA, Europe and Italy

In addition all laws and resolutions enacted by local governments (Lombardy Region and Emilia Romagna Region) are being thoroughly analysed, to assess their direct or indirect PH impact; this project will be accomplished in collaboration with the Public Health School of University of Bologna, which was awarded with a partial grant in the same APPH-ASPHER campaign.

Spreading the project will be a key for its success. In the next months, multiple promotional events will be organized, addressing both operators and the public at large.

Surveys will be administered before and after the events, both to assess baseline knowledge and attitudes towards PH initiatives, and to verify the interventions’ effectiveness in raising awareness.

Running a social media photo contest will be a useful option for targeting younger age groups, following in the steps of the US campaign.

Side events will be organized, such as congress, meeting, press conferences, with the purpose of giving the latest updates about the campaign and its importance, in line with the spirit of the project and the previous experiences (Figure 2).

Pictures of the “This is Public Health” campaign: a) launch day in Milan; b) TIPH event in the USA; c) proposal for an hospital-based campaign in Milan (San Raffaele Hospital).

Conclusion

Italy is a challenging country with a struggling economy but a public National Health Service (NHS) able to guarantee to all the population the most important health care with positive health indicators. Despite the current concerns regarding the sustainability of the NHS and a persistent geographic gap (North-South) for budgets and health care outcomes (23, 24) Italy Health System is considered as one of the best performing in the world according to recent international reports.

In light of this scenario, stronger recognition of the role and the importance of PH is essential. PH awareness is ultimately directed at informing policy makers and improving community health (25). While the potential impact of TIPH in Italy is still to be evaluated, the basis for its potential success can only lie in the delivery of a culturally appropriate message. TIPH-Italy is therfore a wonderful opportunity of making PH accessible and comprehensive to health care workers and the general population in an effective and entertaining way.