7.4 Healthy lifestyles and healthy nutrition
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As mentioned above, the legal framework of health policy is set by the Constitution of Finland, the Sports Act, the Local Government Act, the Youth Act, the Health Care Act and relevant decrees issued by the Ministry of Social Affairs and Health (for more information, see: Youth Wiki/Finland: 7.2 Administration and governance). This legislation promotes healthy lifestyles as well. For example, the Youth Act explicitly mentions that the implementation must be based on healthy lifestyles.
Sexual health & fighting risky behaviour
The Ministry of Social Affairs and Health guides and manages the promotion of sexual health nationwide. The Action Plan on Sexual and Reproductive Health 2014–2020 is based on the Ministry of Social Affairs and Health's Action Plan on the promotion of sexual and reproductive health 2007–2011. On commission by the Ministry, the Finnish Institute for Welfare and Health updated the action plan in collaboration with experts and organisations. The action plan on sexual and reproductive health aims to improve the population's sexual and reproductive health and, thereby, reduce health and social inequalities. According to the Action Plan, sexual and reproductive health is promoted by providing more information, by enhancing co-operation, and by developing related services. Priority action areas in the action plan include sex education, good care at birth, multiculturalism, as well as male sexual and reproductive health.
The Action Plan follows the standards set by the WHO. Upper secondary vocational education and training and general upper secondary school must provide services, which promote sexual health (e.g. sexual and relationships guidance, including supporting sexual orientation and preventing infertility, sexual violence and venereal diseases). If a young person needs further guidance, which a school cannot offer, a school is responsible to direct them to further treatment.
Finnish Institute for Health and Welfare implements School Health Promotion Study every other year, and the latest report was published in September 2021. The national study includes questions about sexual health practices, such as use of condoms and need for extra information about STDs, pregnancy and puberty, for students in 8th and 9th grades, in general upper secondary schools and in vocational studies. The latest report shows, that while the young people’s need for information on their sexual health practices has not changed significantly from the year 2019, sexual harassment, experienced by girls especially, has increased significantly in recent years. According to researcher Lotta Virrankari (in Finnish), young people, who have experienced sexual harassment or sexual violence, are clearly less inclined towards participation than other young people. Sexual harassment and sexual violence weaken a young person's well-being in many ways, and the recently-observed connections to lower levels of participation deepen the understanding of the harmful effects. The ongoing reform for sexual offenses in the Criminal Code of Finland, which would significantly toughen punishments for sexual crimes against children, would thus also have a wider impact on the well-being of children and young people. For more information, visit: Youth Wiki/Finland: 7.8 Current debates and reforms.
Family Federation of Finland provides a chat service for young people aged 13–19, who want to talk anonymously about their sexuality, sexual activity and well-being with professionals. They also have a Q&A-platform, where young people are able to ask about puberty, close relationships and sexual well-being and other thought-provoking themes with sexual counselors and therapists. The Family Federation of Finland has additionally collected a long list of articles, online lectures, video materials and podcasts about sex-related themes for young people on their website.
The promotion of healthy eating habits is part of Finnish education system. According to the Basic Education Act, a pupil who is attending basic education shall be provided with a balanced and appropriately organised and supervised meal on every school day. Nowadays, approximately 900 000 pupils and students enjoy a free meal in school. A provided meal must support the objectives of health education. Free school catering has been practised since 1948 and it promotes healthy eating habits, well-being, and Finnish food culture. Also, pupils have the right to participate in planning school catering, which supports their participation and community spirit.
Curriculums at a local level, which are based on the national curriculum, usually include a plan of school catering as part of student welfare and education. Special diets and allergies are taken into account. In some places the minimum timeframe for lunch is set, in order to ensure that pupils do not have to eat in a rush. In Helsinki and Vantaa, public schools have had a weekly vegetarian food day for over ten years, by decree of the board of education. Based on a council initiative made in 2018 (in Finnish), Helsinki decided to halve consumption of meat and dairy products by 2025.
The National Core Curriculum for Basic Education also includes content about healthy life habits and nutrition. In grades 7 to 9, health education is a mandatory subject for all the students.
Substance abuse prevention
The Action Plan on Alcohol, Tobacco, Drugs and Gambling supports the statutory substance abuse prevention work done in municipalities and regions. On the national level, the Ministry of Social Affairs and Health is responsible for coordinating the organisation of substance abuse prevention as well as other aspects of health policy. In practice, substance abuse prevention is developed and coordinated by the Finnish Institute for Health and Welfare on the national level and by the Regional State Administrative Agencies on the regional level, together with other authorities. In the future autonomous health and social services counties will provide support to municipalities for organising prevention work. The provided support can, for example, be in the form of scientific data, information packages, materials, seminars for professionals and interactive consultation visits.
According to Maria Normann, Heidi Odell, Mari Tapio and Elsi Vuohelainen, the implementation of youth substance use prevention can be divided into three modes of operations: 1) social strengthening; 2) universal prevention; and 3) risk prevention. Social strengthening and universal prevention concern all young people. Risk prevention focuses on those young people who have a higher risk for substance use and/or who already have a substance-related problem in their lives. In an ideal situation, risk prevention is only a small part of substance abuse prevention. Generally, substance abuse prevention is based on promoting a substance-free way of life. In this way, it can be said that all people who work with young people are doing substance abuse prevention. (See: Youth Substance Use Prevention – let’s do this together!)
EHYT Finnish Association for Substance Abuse Prevention has worked since 2020 as a member of three youth work centres of expertise: The Centre of Expertise for Municipal Youth Work Kanuuna (Cannon), the Centre of expertise Nuoska - Youth work at schools and educational institutions, and Into – Association for Outreach Youth Work and Workshop Activities. Their role is to develop the competence of youth workers and other professionals working with young people in preventive substance abuse work by collaborating with their partner organisations on training courses, networks and operating models.
For more information, visit:
- Finnish Substance Abuse and Addiction Strategy – common guidelines for 2030
- Ehkäisevän päihdetyön toimintaohjelma (Action Plan on Alcohol, Tobacco, Drugs and Gambling – Interim evaluation and measures to be intensified until 2025, In Finnish)
- Laki ehkäisevän päihdetyön järjestämisestä (In Finnish)
Sports and health education both are mandatory subjects in educational institutions. As mentioned above, in vocational upper secondary education sports and health education are combined into one study module, which supports the maintaining of working capability as well (for more information, visit: Youth Wiki/Finland: 7.3 Sport, youth fitness and physical activity). Topics of health education include healthy eating and nutrition and preventing risky behaviour. Sex education is a mandatory part of health education in single-structure basic education, upper secondary education and vocational upper secondary education. According to the Family Federation of Finland, this has been the most effective way to carry out sex education in schools. Health education is a standalone academic subject, which is taught in all comprehensive schools and it must have a dedicated teaching staff. This ensures that teachers effectively self-select to study this subject, and they are interested and able to teach it (UNESCO - Comprehensive Sexuality Education: The Challenges and Opportunities of Scaling-up Sex education).
Sex education includes emotional and biological aspects of sexuality. The starting point is to offer information for young people in order to support their sexual identity and to help them to see sexuality as a source of resources, which brings joy and happiness to their life. Relationships, communication, safe sex, availability of sexual health services, sexuality in media, sexual violence, venereal diseases, and anatomy are mandatory themes of sex education.
Current sex education in schools has been also critisized fo having a too heteronormative approach and not giving enough information about the diversity of genders and sexual orientations. It has been also argued that sex education starts in schools too late and should be taught ealier, in an age appropriate manner. According to the National Youth Work and Youth Policy Programme 2020-2023 of the Ministry of Education and Culture, “equality and sex education must be stepped up, ensuring that all young people recognise their and other people’s right to physical integrity”.
Single-structure basic education supports peer-to-peer learning by supporting working as a group and/or with one’s peers. According to the national curriculum, one of the goals of health education is to guide pupils to think about individuality, communality and equality from the perspective of health and to support pupils’ ability to make responsible choices.
Also, studying in upper secondary school must support communality, participation and well-being by strengthening communication and cooperation skills. Teamwork and peer learning are encouraged. The goal is to offer possibilities to invent solutions together, to share knowledge and know-how and to support peer review.
“Maintaining working capability, sports and health education” study module in vocational upper secondary education and training may include team sport and peer review and supports communality as well. Tutoring is an important part of vocational upper secondary education and training as well as upper secondary education. Tutoring supports peer-to-peer approaches and participatory activities as well as strengthens communality among students in educational institutions. These are part of educational institutions’ student welfare.
Collaboration between schools and youth work has a long tradition in Finland. In recent years, the youth work done by municipalities in schools and educational institutions has increased significantly (Kiilakoski 2014a, 8–14; Kalliomaa & Ahonen-Walker 2019, 22–23). According to the Finnish Youth Research Network, school youth work is nowadays perceived even more compellingly as a means to support the well-being of young people both at the individual level and at the group level. Strengthening multi-professional cooperation and especially youth work in basic education and in vocational training is one of the sub-goals of the National Youth Work and Youth Policy Programme 2020–2023 for the more general goal of a smooth everyday life for young people and towards the reduction of marginalisation.
The Centre of Expertise Nuoska, which is coordinated by South-Eastern Finland University of Applied Sciences’ Youth Research and Development Centre Juvenia, focuses on developing youth work models at schools and educational institutes regionally and nationwide. Their main tasks are:
- Gather, publicise and disseminate good practices in cooperation with youth and education departments, which will make youth work in schools and educational institutions more common.
- Model and develop forms and aspects of youth work in schools and educational institutions, so that youth work is high-quality and evaluation-based.
- Strengthen the bilingualism of centres of expertise activities by coordinating with the Swedish-language activities in all six centres of expertise.
Legally, the Youth Act obliges outreach youth work and education providers to collaborate in certain situations, which may threaten a young person’s health and well-being, such as:
- An education provider must deliver information about a school-leaver who has not sought or gained entry to post-compulsory education
- An education provider must deliver information about a person under 25 years of age who discontinues their studies in vocational or general upper secondary education
- The Defence Forces and the Non-military Service Training Centre must deliver information about a person under 25 years of age who has exemption from military or non-military service owing to non-fitness for service or who discontinues the service.
An education or training provider may decline to disclose information on a young person if they judge, based on the information available and in consideration of the young person's situation and need for support as a whole, that the young person is not in need of services of outreach youth work.
The Student Welfare Act, the Basic Education Act and the Governmental Decree on Maternity and child health clinic services, school and student health-care, preventive oral health care for children and young contain provisions on collaboration between social and health authorities and education providers. According to legislation, a young person is entitled to have school health-care, dental care, contraception and other sexual health counselling for young people. Also, an examination by a child or youth psychiatrist to determine their mental health status must be available if necessary. The national core curriculum requires collaboration as well: education providers draw up local curriculums in cooperation with the local executory social and health authorities. The education provider shall also determine the organisation of home school cooperation and of pupil welfare laid down in the core curriculum.
The upcoming health and social services reform requires strong cooperation between different authorities. Starting from January 2023, the Health and Social Services counties must ensure the coordination of healthcare and social welfare services in cooperation with other well-being services counties, and coordinate their healthcare and social welfare services with municipal and central government services. According to the law, student support services will still be organised as local services, also in remote areas and small educational institutions.
According to the reform plan (in Finnish), “it is the responsibility of the education organiser to provide functional school health care for pupils and students. This requires that the training provider and the welfare area agree on common operating methods. Cooperation between education organisers has been found to be increasing in areas where student support services have been under the responsibility of municipal associations. This has also enabled the joint development of community work in the region.” For more information, visit: Youth Wiki/Finland: 7.8 Current debates and reforms.
Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people
Since physical activity is strongly connected to the healthy lifestyles and well-being of young people, On the Move – national strategy for physical activity promoting health and well-being 2020and Finnish Schools on the Move should be taken into account as youth-targeted information campaigns as well as concrete measures to increase young people’s physical activity. For more information, visit: Youth Wiki/Finland: 7.3 Sport, youth fitness and physical activity.
In addition, there are information campaigns, which focus on different themes in the area of healthy lifestyles. For example, the Family Federation of Finland, the National Institute for Health and Welfare and the Ministry of Social Affairs and Health organise the campaign ("Kumita!"), which promotes safe sex practices and offers condoms free-of-charge to young people, and several non-governmental organisations organise the campaign ("Selvin päin kesään"), which aims at increasing information about drinking among young people. The goal is to encourage young people to party without alcohol.
Besides youth-targeted information campaigns, information providers have been established and counselling has been made available to young people. Schools are one of the most important places to disseminate information and raise awareness about healthy lifestyles among young people (e.g. health education, physical examinations, school health-care). For more information, visit: Youth Wiki/Finland: 7.3 Sport, youth fitness and physical activity. Secondly, public health-care may offer counselling specifically tailored to young people. Thirdly, NGOs may offer health services to young people as well, but according to legislation, local authorities are primarily responsible for arranging such services. For more information, visit: Youth Wiki/Finland: 4.6 Access to Quality Services.