Dear Colleagues

Dear Colleagues,
We are celebrating 10 years of publishing the Journal of Health Inequalities, which has become a key part of public health, both in Poland and Europe. It seems to have played a particularly important role in recent discussions on the development of public health in Poland, providing a forum for open access to evidence-based research in public health.
In the late 1980s, the health of adult Poles was disastrous, and its prognosis was very poor. After a brief period of health turmoil (1988-1991) resulting from political transition, Poland unexpectedly began to see a recovery. Almost all health statistics started to improve. Between 1991 and 2001, the infant mortality rate fell from 15.0/1,000 to 7.7/ 1,000 live births. For the first time in 30 years, the negative trend in premature adult mortality was reversed. Overall mortality rates declined across all age groups, particularly among young and middle-aged individuals. At the same time, mortality from cardiovascular diseases decreased dramatically in both sexes.
Following the political disruption of the late 1980s, several fundamental changes beneficial to public health took place. First, the Anti-Tobacco Act was developed and implemented in 1995. This served as the basis for the national anti-tobacco program, which was annually assessed by the government and adopted by Polish parliament. Extensive health education campaigns were launched. Periodic interventions were carried out, such as the nationwide “Quit smoking together with us” (“Great Polish Smoke-out”) campaign, which was considered the largest and most effective public health campaign in Europe at the time. In subsequent years, the parliament implemented national government programs for cancer and heart disease control, with significant budgetary resources. Substantial funds were also allocated to primary and secondary prevention. Another important element of health building was the rapid change in dietary structure resulting from the introduction of a market economy, and the new availability of various food products. This led to changes in fat consumption patterns (compensating of n-3 fatty acid deficiency, increased consumption of vegetable oils, and decreased consumption of animal fats) as well as an increased accessibility of fruits and vegetables, which became relatively inexpensive and available year-round. At the end of the 20th century, it seemed that Poland had followed the path of Western, highly developed countries, embarking on a sustainable path to health improvement. In fact, health improvement in Poland in the 1990s was among the fastest in Europe, and premature adult mortality (before age 65 years) decreased significantly. The health gap between Poland and the West appeared to be narrowing.
However, in recent decades, Polish policy-makers have subjected society to a gigantic “natural” experiment. In 2002, excise tax on spirits was reduced by 30%, and beer advertising laws were liberalized. This led to a sharp increase in alcohol consumption from around 6 to around 10 liters of pure alcohol per capita, which resulted in a deceleration (from 2003) and then a freeze (from around 2013) in the increase of life expectancy in Poland.
After numerous alarms, including those raised in the Journal, the debate on public health challenges in Poland has intensified. The need to return to the development of intersectoral public health strategy and to amend the Public Health Act, leveraging the experience of all professional groups in founding preventive programs, is becoming increasingly vocal. In this discussion, we strive to utilize knowledge-sharing platforms, such as public health conferences in Poland. We are pleased that the University of Kalisz, supported by secured funding, is organizing a conference next fall to discuss closing the health gap between Poland and other European countries. Despite strong economic development, many health indicators in Poland still point to a deteriorating health condition. Furthermore, public impatience regarding the lack of an effective public health strategy is evident, as demonstrated by political reaction to the failure to reduce the economic affordability of alcohol once again in Poland.
We invite you to explore a range of publications, which continue the discussion on the role of alcohol and ciga­rettes in health (pp. 101, 106, 112), and address other important topics, such as hypertension (pp. 119), dietary supplement use (pp. 127), and healthcare access inequalities in Europe (pp. 139). We also encourage you to actively participate in this discussion and publish your work on the development of health situation in Poland in the Journal.