Bringing health care as close as possible to where people live and work

The famous WHO Alma-Ata Declaration (1978) stated that primary health care (PHC) is key to attain a health level sufficient to lead a socially and economically productive life - referring to people with paid work, the majority of the world population. ‘Alma-Ata’ also stated, that PHC can bring “… health care as close as possible to where people live and work”.  This powerful declaration has induced many positive developments. However, the link with work was lost somewhere down-the-line, although work-related, often chronic health problems are frequently presented to PHC - especially musculoskeletal and mental disorders. But the relation between health complaints and work often  remains undetected, so unnecessarily exposing workers/patients to risks. . Cooperation with occupational health care - if available - is almost non-existent. This ‘Blind Spot for work’ - a lack of attention for work-related health problems – is recognized in many countries. Many countries also acknowledge that PHC offers good opportunities for early detection, intervention and maybe even primary prevention. Moreover, there is growing evidence, that getting/keeping a job is a crucial prerequisite for health and wellbeing, while loss of work has just the opposite effect. Because only 10-15% of the global work force has access to some kind of specific occupational health care, it seems worthwhile to explore possibilities, obstacles and prerequisites for PHC to pay more attention to ‘work’. That requires answers to questions like: What can explain the blind spot? What are the consequences? Which data do we have? And how can healthcare reforms help to overcome this blind spot? These topics are on the agenda of the WHO conference Connecting Health and Labour, end 2011 in The Hague, co-organized by TNO and the Dutch government. Results will be presented during ICOH 2012.