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Wellbeing in a Box: Health Advice from the Government of Finland

By: Maija Ehlinger ‘Health’ has a complicated definition today.  ‘Global health’ tends to be defined by buzz phrases like ‘AIDS in Africa’ or ‘famine in Nigeria.’ Such terms make it so that providing humanitarian care becomes more about Western intervention during times of tragedy and disaster, while largely ignoring basic ‘health’ promotion on a day-to-day basis.  On the domestic side, ‘health’ has been compartmentalized into services provided through pharmaceutical companies and large-scale hospital systems, again focusing on disease rather than overall health promotion.  Clearly, Americans’ views of health distribution, on both the national and international level, largely ignore the preventive medical practices that could stop dangerously, and costly, downstream medical problems.

But what if we looked at a country that does not usually make front line news when it comes to international affairs in order to find more successful public health strategies?  Perhaps the United States could learn something about domestic and international health from a country like Finland.

Why Finland?  Well, this Nordic country is known the world over for excellence in education[1] and high-tech driven economic growth.  But at a time when foreign affairs focuses more on countries like China or Syria, our relationship with a country like Finland is often overlooked.  But, studying Finnish health standards and mortality rates can give us a better perspective on domestic and international health.

While The United States has decreased infant, neonatal, and post-neonatal mortality rates by 85% since 1940,[2] rates still linger around 6.87 deaths per 1,000 births.  In the same time span, Finland has been able to drop its infant mortality rates to around 3.38 per 1,000,[3] with rates reaching as low as 2.7 in 2007.[4]

And the way they achieved these significantly low numbers may surprise you – with a cardboard box. That’s right; a small, government-issued cardboard box is used as a child’s first crib and as a starter kit for new parents.[5]

Each new mother leaves the hospital with a maternity box, which includes clothing for all types of weather, a small mattress to transform the box into a safe bed, and bathing material.  Costing 140 euros, about $180, experts believe this type of investment is the key to creating a healthier generation that is less likely to experience negative downstream health conditions.

The reality surrounding the current conversation about domestic and international health is that this dialogue is neither comprehensive nor suitable to fit the needs of a growing population.  In the United States, our healthcare system tends to look for a quick panacea without spending more on preventative care.  In fact, investing in long-term health from infancy is neglected by families and hospitals for the sake of more cost effective measures.  Many might say that distributing such boxes would be too costly in a country like the United States, which has a population substantially larger than Finland’s 5.4 million citizens.  Public health officials, however, believe most of the one million babies who die each year around the world could have been saved by simple interventions that cost less than $6, including “bag-and-mask devices to help babies breathe, antiseptic to prevent umbilical cord infections, antibiotics to treat infections, and steroids to delay pre-term labor.”[6]

As the US and the UN work to reach the fourth Millennium Development Goal (reducing under-five mortality rate by two-thirds by 2015), they are making a commitment to sustained and positive change around the world. However, these goals cannot be viewed as statistics and objectives just to be reached in the Third World; the United States’ dismal public health statistics suggest that we can learn a lot about health and development from countries like Finland.  A May 2013 report by Save the Children found that the US has the highest infant mortality rate of all industrialized countries, with 11,300 of the 1,000,000 infants who died in their first day alone coming from the United States.[7] Without a strong plan to change American infant mortality rates, the health of our nation will continue to be at risk.

At the same time, we may be able to use the Finnish maternity box model as a way to positively impact international health. As we look for ways to honor the looming Millennium Development Goals targets, we must find sustainable health prevention methods that create healthier, stronger generations.  This is the only way to ensure strong economic opportunities are available in all corners of the globe, since the WHO understands that “good health is linked to economic growth through higher labour productivity, demographic changes and higher educational attainment.”[8]

By looking at Finland’s commitment to preventive medicine from the beginning of life, we may be able shift focus away from current health standards and discover new ways to create a healthier next generation both domestically and internationally.

 

Maija Ehlinger, a rising senior at Emory, is a history major and global health minor in the college.  Her main academic interests are in international and domestic health policy, and she hopes to pursue a career in public health communications after graduation.  She is currently spending the summer in Chicago as a marketing intern for a philanthropic consulting firm. 


[1] LynNell Hancock, Why Are Finland’s Schools Successful? Smithsonian.com. September 2011.  http://www.smithsonianmag.com/people-places/Why-Are-Finlands-Schools-Successful.html

[2] Abby Goodnough, U.S. Infant Mortality Rate Fell Steadily From ’05 to ’11, The New York Times. April 17, 2013.  http://www.nytimes.com/2013/04/18/health/infant-mortality-rate-in-us-declines.html

[4] Päivi Rautava, “A comparison of perinatal and infant mortality rates in British Columbia and Finland: Similarities and differences,” National Institutes of Health and Welfare Helsinki, Finland. March 2012.

[5] Helena Lee, Why Finnish Babies Sleep in Cardboard Boxes, BBC News.  June 4, 2013. http://www.bbc.co.uk/news/magazine-22751415

[6] Tara Culp-Ressler, REPORT: The U.S. Had The Highest First-Day Infant Death Rate In The Industrialized World.  Think Progress. May 7, 2013.  http://thinkprogress.org/health/2013/05/07/1973341/us-infant-mortality-rate/?mobile=nc

[7] Tara Culp-Ressler, REPORT: The U.S. Had The Highest First-Day Infant Death Rate In The Industrialized World.  Think Progress. May 7, 2013.  http://thinkprogress.org/health/2013/05/07/1973341/us-infant-mortality-rate/?mobile=nc

[8] Trade, foreign policy, diplomacy and health, World Health Organization website, http://www.who.int/trade/glossary/story019/en/

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