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EACEA National Policies Platform


7. Health and Well-Being

7.8 Current debates and reforms

Last update: 11 March 2024

In the Croatian health care system, young people hold a significant position, and their health is regarded as a value that must be constantly promoted, improved, and protected. In case their health is jeopardised by a disease, it is treated by providing health care and social welfare in accordance with the individual’s needs. There are numerous strategic and legal frameworks prescribing and envisaging programmes for improving, preserving, and enhancing youth health. However, the youth remain unrecognised as an integral group by the health care system. They are often divided into other age groups, such as children and adults, as the health care system has adapted over time to the perspectives outlined in other frameworks. Accordingly, Croatia still lacks a fully developed system for comprehensive monitoring of youth health. This underscores the need for a continuous efforts to improve and establish targeted, age-specific public health policies for youth. In general, the health care system remains disconnected and largely fragmented. As a result, psychiatric patient care, rehabilitation, and counselling efforts are still quite fragmental. While preventive and promotional activities on the national level are strategically well defined, the system for implementing and evaluating them on a local level is not yet developed. It is often the case that there is no continuous cooperation or division of responsibilities among relevant professions, leading to a lack of coordination among individual stakeholders. It is relevant to point out that certain areas are still not covered by national policies or have not been fully implemented.

There is a need to move beyond the provision of services and work towards implementing structural changes incorporated in Health in All Policies (HiAP) or health impact assessment initiatives. Systematic social inequalities in adolescents (applicable to both genders and for all three subjective health outcomes) are found in eight countries and regions. Croatia should review local policies to determine the extent to which they address social determinants and how they should be tackled. Gender differences are present in all measures, with girls reporting lower levels of perceived health and life satisfaction, along with more frequent health complaints. These differences increase with age and efforts need to be made to address this clear gender-difference issue. Screening and counselling for more sensitive mental health issues should be incorporated into routine preventive care to ensure a balance between physical and mental health. In addition to family wealth, other well-recognised and interrelated social determinants of health in adolescence, such as access to high-quality education, the development of personal skills, social support, and safe neighbourhoods, should be addressed to enhance understanding of pathways and mechanisms of inequity.

While overweight and obesity remain stable during adolescence or show a slight decrease with age, perceptions of overweight and dieting behaviour markedly increase in girls during this time. Clear gender differences are apparent, with boys tending to be more overweight in most countries and regions. Higher overweight prevalence is associated with lower affluence in some cases, but findings must be interpreted with caution due to the self-report nature of height and weight data used to categorise body mass index (BMI) status. Gender and age patterns in relation to body image and weight-reduction behaviour seem consistent with previous findings: girls are more likely to be discontented with their body weight regardless of country or region. Being female is a stronger predictor for self-perceived fatness and weight-reduction behaviour than BMI or family affluence. The prevalence of overweight and obesity is not increasing but remains high in many countries and regions. The World Health Organisation provides leadership, advocacy, and evidence-based recommendations for international action to improve dietary practices and increase physical activity through its global strategy on diet, physical activity, and health. It also promotes and supports research in priority areas to facilitate programme implementation and evaluation. A systemic approach is needed to address high overweight and obesity rates and enable young people to foster positive thoughts and feelings about their bodies, ultimately enhancing well-being. Communities, families, and individuals need to work together to address this issue. International and national support is needed to protect children and promote health through the provision of healthy and nutritious food, safe neighbourhoods, safe activities, and opportunities for physical activity and sports participation. Identifying shared risk and protective factors for overweight and body dissatisfaction can support the development of relevant interventions for a broad spectrum of weight-related problems.