Current salt reduction policies across gradients of inequality-adjusted human development in the WHO European region: minding the gaps.
OBJECTIVE
To assess current salt reduction policies in countries of the WHO European Region against the backdrop of varying levels of human development adjusted for income, education and health (longevity) inequalities.


METHODS
Population-based, cross-sectional study, with data gathered through systematic review of relevant databases and supplementary information provided by WHO Nutrition Counterparts.


METHODS
Member States of the WHO European Region.


METHODS
Inequality-adjusted Human Development Index scores were analysed against assessed levels of development and implementation of national nutrition policies and initiatives targeting population-level salt reduction.


RESULTS
Within the WHO European Region, Inequality-adjusted Human Development Index values among countries with no existing salt reduction initiatives (mean 0·643 (se 0·022)) were significantly lower than among those with either partially implemented/planned salt initiatives (mean 0·766 (se 0·017), P < 0·001) or fully implemented salt initiatives (mean 0·780 (se 0·021), P < 0·001).


CONCLUSIONS
Where salt reduction strategies are implemented as an integral part of national policy, outcomes have been promising. However, low- and middle-income countries may face severe resource constraints that keep them from emulating more comprehensive strategies pursued in high-income countries. Care must be taken to ensure that gaps are not inadvertently widened by monitoring differential policy impacts of salt policies, particularly regarding trade flows.
1Institute of Tropical Medicine and International Health,Charité-Universitätsmedizin,Charitéplatz 1,10117 Berlin,Germany.
Rodrigo
R
Rodriguez-Fernandez
2Faculty of Food Science and Nutrition,University of Porto,Oporto,Portugal.
Margarida
M
Siopa
3School of Public Health and Community Medicine,University of New South Wales,Sydney,Australia.
Sarah J
SJ
Simpson
4Department of Community and Global Health,Graduate School of Medicine,University of Tokyo,Tokyo,Japan.
Rachel M
RM
Amiya
5Noncommunicable Diseases and Health Promotion,World Health Organization Regional Office for Europe,Copenhagen,Denmark.
Joao
J
Breda
6Division of Mental Health & Wellbeing,Warwick Medical School,WHO Collaborating Centre for Nutrition,University of Warwick,Warwick,UK.
Francesco P
FP
Cappuccio
D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003906:Developing Countries; D004032:Diet; D005060:Europe; D006801:Humans; D007182:Income; D018673:Nutrition Policy; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D014944:World Health Organization
D017673:Sodium Chloride, Dietary