Health » Overview

Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

Building Healthy Communities - Reflecting on a Culture of Health
Building Healthy Communities - Reflecting on a Culture of Health
Salzburg Global Seminar 

Health happens where we live, learn, work, play, and pray. That’s just one of the thoughts participants considered on the first day of the Salzburg Global Seminar session, Building Healthy Communities: The Role of Hospitals.

Around 60 participants from 16 countries met at Schloss Leopoldskron, in Salzburg, Austria, on Thursday afternoon for the start of the five-day program, which is being held in partnership with the Robert Wood Johnson Foundation.

Over the next few days, participants will look at developing strategies to enhance effective collaboration and information-sharing between hospitals, social services and community organizations. They will also consider new approaches for hospitals to address the social determinants of health.

This session is part of Salzburg Global’s multi-year series Health and Health Care Innovation in the 21st Century.

John Lotherington, a program director for Salzburg Global, and Hilary Heishman, a senior program officer for the Robert Wood Johnson Foundation, kickstarted the session by taking part in an on-stage discussion.

Beginning the conversation, Heishman suggested health care in the United States was effective at treating people with illness but was less effective at keeping people healthy.

Things that contribute to being healthy in the long-term start early in life, participants heard. Heishman said several factors which enable people to be healthy don’t sound health-related. Education, work, housing, and civic engagement were some of the examples highlighted which can have an effect.

The Robert Wood Johnson Foundation, established in 1972, is committed to building a culture of health. Heishman said, “Within a culture of health, everyone has the opportunity to live the best life they can.”

While there are several obstacles to developing this culture, there are also opportunities to help make it more of a reality. This includes new work with data, information, and alternate payment models. As more people in health care understand the social determinants of health, it might become easier to set up appropriate systems.

In response to this discussion, participants considered the definition of health and what society’s expectations of hospitals were. One participant suggested if a hospital’s role was to change, consumer fears would have to be allayed along the way.

These talking points, and more, will continue to be discussed in the days ahead, as the session continues.


The session, Building Healthy Communities: The Role of Hospitals is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with the Robert Wood Johnson Foundation. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Amy Little - The Biggest Challenge is Raising Awareness that Dementia is a Medical Condition
Amy Little - The Biggest Challenge is Raising Awareness that Dementia is a Medical Condition
Oscar Tollast 

When Amy Little decided to attend the Salzburg Global session, Changing Minds: Innovation in Dementia Care and Dementia-Friendly Communities, she did so for one reason: “It’s a global session with people from all aspects of dementia and many different parts of the world, so that fits in perfectly with the work that I do…” she says, speaking in Schloss Leopoldskron's Robison Gallery.

Little leads the Alzheimer Society’s international work and is the executive lead of the Global Alzheimer’s and Dementia Action Alliance (GADAA). The latter of the two is a network of international civil society organizations looking to champion global action on dementia. Its steering committee includes the Alzheimer’s Society, Alzheimer’s Disease International, Age International and Dementia Alliance International.

“The premise of the network is that after the G8 global action on dementia that was initiated in 2013, there was a realization that we needed to mainstream dementia, and we needed the non-dementia world to realize the global problem and how they could actually be part of the solution.”

The Alliance acts as a bridge connecting international non-governmental organizations (INGOs). Little says, “[They] could be from the disability sector, human rights, older people and aging, women's organizations, international development. [It’s] looking at that spectrum of INGOs to help them realize that dementia is a global problem and that actually it can be part of their agenda as well.”

GADAA works with these organizations to raise awareness around dementia and support advocacy efforts. Further down the line, the network is looking at ways it can disseminate tools and best practices to interested parties.

In her role at the Alzheimer’s Society, Little helps share the UK’s experience of dementia and forges partnerships with other countries “to take global action on dementia forward.” The Alzheimer Society supports the UK Department of Health as a delivery partner. Little says, “One example is the Global Dementia Friends Network. We are working with 27 countries who have or are in the process of developing Dementia Friends. We want that number to go beyond 27 obviously. We have shared our program and resources so other countries can adapt those.”

Various countries are at different stages of development when approaching dementia, which Little admits is a challenge. She says, “Sometimes I describe it as the elephant in the room. I come and talk about dementia, and at first, you get a blank face: ‘Why are you talking about dementia?’ There is still that stigma and assumption that dementia is a natural part of the aging process rather than a medical condition. The biggest challenge that we have is that awareness that dementia is a medical condition.”

Little says this challenge applies to every country, including those seen to be leading on dementia. “I have spoken to people from ministries of health who claim, ‘We don’t have this problem in our country.’ It is a big, big challenge we have got to meet.”

According to the World Health Organization, the number of new cases of dementia each year worldwide is nearly 7.7 million, suggesting one new case every four seconds. Last year, the Office for National Statistics revealed dementia was the leading cause of death in England and Wales in 2015. While data such as this highlights the impact of dementia, Little asks, “Why in that case don’t more people know about it?”

Speaking on the fifth day of the session, Little says she’s found the experience “very enriching” and is grateful for the time and space to talk more in-depth with her fellow participants. “It has gone too quickly,” she laughs. “Five days feels like a long time, but it has actually gone very, very quickly. It feels like there is so much more we can do and should be doing. It seems to me the purpose of the Salzburg sessions – or one of the purposes – is to foster those relationships that then more happens after as a result.”


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Building Healthy Communities - The Role of Hospitals
The session is being held in partnership with the Robert Wood Johnson Foundation
Building Healthy Communities - The Role of Hospitals
Mirva Villa 

People live longer than ever before. The average life expectancy of people has been climbing up dramatically over the 20th century. A recent study estimated that boys and girls born in 2030 can expect to reach their mid-80s or over in many developed countries like Japan, France, Switzerland, Germany and the UK.

These advancements in life expectancy are news to be celebrated. With the longer life, however, comes the challenge of maintaining health throughout a person’s life. Health care professionals today not only need to respond to the needs of the health care needs of aging population, they also need to take a more pro-active role in creating health.

Salzburg Global Seminar’s session on Building Healthy Communities: The Role of Hospitals brings together 60 participants from across the globe to discuss how the health sector could respond to these challenges. The five-day program, which begins on Thursday, is being held in partnership with the Robert Wood Johnson Foundation and seeks to discover new approaches for hospitals to address the social determinants of health.

Hospitals will need take up an increasingly active role in cross-sector initiatives, considering the impact of housing, education, food, public safety and employment on health. During the session, participants will aim to develop new strategies to enhance effective collaboration and information-sharing between hospitals, social services and community organizations.

Key questions that will be addressed during the session aim to support this all-encompassing approach on health. Participants will discuss the impact of financial incentives and application of new and older technologies, and the best practices for engaging other sectors, citizens and patients in the transformation needed to create a culture of health. 

The aim of the program is to provide opportunities for information-exchange and global networking among diverse sectors that have an impact on health, and to develop action plans with both local and global scope. Participants will co-create a Salzburg Statement identifying the best practices on how governments, businesses and civil society can collaborate with hospitals in supporting health initiatives.

Building Healthy Communities: The Role of Hospitals is part of the multi-year series on Health and Health Care Innovation in the 21st Century, launched by Salzburg Global Seminar in 2010. The forum has brought together a diverse range of health care experts from across the world to discuss various aspects impacting the future of health care and overall health, such as use of data in health care and improving health care in low and middle income economies.


The session, Building Healthy Communities: The Role of Hospitals is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with the Robert Wood Johnson Foundation. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Fellows to Produce Salzburg Statement Focused on Dementia-Friendly Communities
Fellows to Produce Salzburg Statement Focused on Dementia-Friendly Communities
Tomás De La Rosa 

Participants from 14 countries have agreed to develop a Salzburg Statement to use as a framework when approaching governments and organizations on dementia care issues.

The decision was made on the fifth day of the Salzburg Global session,
Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, which is part of the multi-year series Health and Health Care Innovation in the 21st Century.

Leading up to this, 40 participants had spent four and a half days discussing the stigma surrounding dementia and what a dementia-friendly community entails.

They also took part in plenary sessions addressing various aspects of life with dementia, including how innovations in dementia care can reduce the stigma surrounding the condition and make a difference in people’s lives. Participants also reflected on the benefits of a timely diagnosis and the role of arts in mitigating the impact of dementia.

On the fifth day of the session, participants presented six sets of recommendations addressing different elements that make up dementia-friendly communities and how to apply them in a global context.

After their presentations, participants agreed a Salzburg Statement would be the prime vehicle to bring together these proposals and take decisive action moving forward.

The first group, which addressed community empowerment, produced a strategy oriented toward giving self-confidence to people with dementia and the people around them through education and tools, active engagement in professional care, and knowledge of their legal rights and how to access them.

Through this approach, they hope to help create more safe spaces for people with dementia through professional acceptance of family leadership, community networking and social conversation platforms, and the creation of a general environment of inclusiveness and dignity.

The second group looked into research priorities within dementia-friendly communities. These were established based on the needs of those living with dementia and their carers. The first of these priorities focused on issues such as the role communities can play in screening and addressing people with dementia and caregivers at the time of diagnosis and providing initial educational and care plans.

The second priority was community-based care and services, which includes focusing on support for challenges people with dementia may face, caregiver support, and supportive social structures. The last priority suggested looking at alternatives to institutionalization for people with disabling dementia, how to manage complications, and how to make end-of-life care more humane.

The third group designed a roadmap providing guidance for effective dementia education and training programs. Its elements included target groups; skills, knowledge, and attitudes at different levels; consideration of needs; learning methods; insurance of accessibility; and culturally appropriate systems. Through it, the group hopes policymakers, educators, local communities, researchers, individuals, and institutions, would be able to design more effective dementia-friendly communities.

Inspired by their meetings in Schloss Leopoldskron's Max Reinhardt Library, the fourth group proposed the creation of an information library on dementia. It would be publicly accessible and professionally curated in consultation with dementia-friendly initiatives. The library would also introduce Wiki-style entries for dementia-friendly projects and organizations, which would contain work details such as their mission, goals and progress, contact details, location, and crowdfunding links.

The fifth group focused on dementia-friendly innovations in medical care. Their project looked into how communities and individuals can have a role in health facilitation for front-line staff, such as medical carers, to learn the needs and wants of people with dementia. Through this, they’d be able to provide care navigation, resources to a wider team in more complex issues, and prepare for life-course stages.

The final group explored the steps to build on to further awareness in dementia-friendly communities. This "Global Communication Network on Dementia" would help transform ideas into actions across various countries. This group suggested the moment is prime for introducing the project, as there is a "worldwide need for an open source network." Among other actions, this would allow people to exchange best practices for care and build awareness of how communities can be dementia-friendly. The network’s core belief is, "Together we can build bridges, relationships to broaden horizons and inspire each other to improve the lives of people with dementia and carers."

Veronique Roger, a representative from session partner Mayo Clinic, said the outcomes from this session would allow the different parts of dementia care to be more synergistic. To finish she added, "We have an opportunity to go after the goals we have set for ourselves [...] It will never be enough, but if we start now we will have more than what we started with."


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovation in Dementia Care - Building Inclusive Communities
Innovation in Dementia Care - Building Inclusive Communities
Salzburg Global Seminar 

The third day of Changing Minds: Innovations in Dementia Care and Dementia Friendly Communities started with two different panels on dementia-friendly work.

The sentiment echoed throughout the morning was that becoming a dementia-friendly community is an ongoing process. Participants debated what it meant to be dementia-friendly, and whether being dementia-friendly always means being dementia inclusive and dementia capable as well.

The first panel enabled participants to develop a greater understanding of the work that takes place in dementia-friendly communities and what happens behind-the-scenes.

The conversation began with Jason Foo explaining the ongoing work in Singapore, which has included training Dementia Friends and dementia-friendly organizations. More dementia day care centers have also been set up.

Foo, the chief executive officer of the Alzheimer’s Disease Association in Singapore, said he and his colleagues recently explored the question: is having a dementia-friendly community the same as being dementia inclusive? As an add-on to that matter, what does dementia inclusive entail?

For something to be dementia inclusive, it must be empowering and provide freedom of choice for the person with dementia, Foo said. This way of thinking was reaffirmed when Foo and his colleagues had a conversation with someone with younger onset dementia. She told Foo and others she had the right to claim back her pre-diagnosis life.

For example, while building more dementia day care centers is a positive step, people with dementia who attend them shouldn’t be made to feel they are being locked up. Foo said he and others considered how places and activities could be made more dementia inclusive, which is one step further from being dementia-friendly so that people with dementia can have a real quality of life and dignity.

DY Suharya, founder of Alzheimer Indonesia (ALZI), and the regional director of Alzheimer’s Disease International Asia Pacific Region suggested a dementia-friendly community is defined as a place or culture where people with dementia and caregivers are empowered, supported, and included. This means understanding their rights and recognizing their potential.

When she established Alzheimer Indonesia, she paid particular attention to its branding and the messages it communicated. The tagline, “Do not underestimate memory loss,” was created following two months of discussion. Suharya said every country and city could have their own methods for raising awareness, but the bottom line is activating people’s potential to support people with dementia.

Fellows from Indonesia shared an example of the campaign held by ALZI, where people wearing purple campaign shirts take photos of themselves at famous landmarks. This encouraged more and more people to get involved, causing a snowball effect.

When identifying a dementia-friendly community, it is important to establish who the primary service provider is and its level of capability. That was the view of Kate Gordon, a health policy analyst and grassroots advocacy strategist. Just because a program may have served people with dementia for a long time, it doesn’t mean it is the most capable.

Organizations that provide services for people who potentially live with dementia should strive for training periodically to make sure staff know best practices when it comes to recognizing the condition, have effective communication skills and be able to refer people with dementia and their caregivers to specialized services.

Participants were introduced to a free tool which can assess organizations and how capable they are. In some cases, organizations may feel attacked when having to review their performance, but this is an efficient way of helping communities move forward. It is also a useful tool for decision-makers to see what progress has been made.

Reducing stigma was once again brought forward as a method to make communities more dementia-friendly. In countries like Nigeria, where a word for dementia doesn’t exist, providing more information on the condition through the work of the ambassadors has proved to be a valuable way to help the local communities. One participant noted that southern states in the United States often had similar challenges to countries like Nigeria, regarding lack of knowledge and their attitudes toward dementia. Promoting understanding of the condition would help ensure high-quality care.

The possibility of creating a global symbol for dementia-friendly initiatives was discussed. While the benefit of unified symbols was seen, a participant said the focus should be on breaking down the unique problems of each sector and the challenges posed by different public institutions.

Another participant remarked that labels are not important. Ensuring that the community steps in to help is the key, and people don’t shy away when they see a confused person.

Building a movement around dementia care, and activating existing communities is a positive way of moving forward. A participant from the UK noted volunteers want to become increasingly involved in the dementia cause.

Collaboration, identifying the champions and reaching out to them was seen as the key to building a successful campaign. Several participants said there was a need to keep the individual with dementia in mind – whether it was to plan movements, evaluate services or build inclusive communities.

Global networking, sharing successful case studies across the world, and pooling together the knowledge of caregivers were other valuable means.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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William Hu - “There’s a lot of good work going on, but not enough credit is given to the people”
William Hu - “There’s a lot of good work going on, but not enough credit is given to the people”
Mirva Villa 

“I hope that we can come up with a concrete action plan to disseminate and share the best practices in dementia-friendly initiatives and communities,” says William Hu, speaking on the third day of Changing Minds: Innovations in Dementia Care and Dementia.

Hu, an assistant professor of neurology at Emory University, has his eyes set on the future. Trained
as a neurologist and neuroscientist, Hu spends a lot of his time working toward improving the early diagnosis of dementia, and for the past two years has been involved in promoting dementia-friendly communities.

“We have been trying really hard to have an international forum where the lessons from the countries that have been doing dementia-friendly communities for some time can be shared with other countries that are just gearing up to do this.”

When Hu heard about this Salzburg Global session, he saw its potential in contributing to global efforts on improving dementia care.

“I was very excited when I heard that this was happening,” he says. “This really is a continuation of the global effort to talk about what a dementia-friendly community actually means, and how we get there.”

There are great efforts globally toward creating dementia-friendly initiatives and promoting inclusive communities, but several challenges hinder the rate of progress.

Hu says, “One is finding a driver for the initiative. Most of us are doing this as addition to our day jobs, and so finding somebody who will take it on as their primary focus has been a challenge not only felt in the States but also elsewhere.

“Number two, [the] challenge really is the resources and funding. How are you going to get the signage [and] the website hosting? How are you going to pay for travels to learn dementia-friendly practices from elsewhere?

“And finally, a huge challenge is convincing decision-makers that this is something worthwhile doing. The decision-makers usually have a set of goals of their own, and now we’re trying to convince them that having a dementia-friendly community or practice is a positive thing. But how do we compete with other goals such as profit margins, quality measures and the request of shareholders?”

Hu’s day job is closely linked to the dementia cause. His laboratory focuses on using spinal fluid, plasma imaging and neuropsychological measures to provide the most accurate diagnosis as early as possible.

“What that means is that whenever somebody has very mild symptoms of forgetfulness or word-finding difficulties, we can tell very early on whether the Alzheimer’s changes are present in the brain,” says Hu. Part of his research is patient-oriented, which has allowed him to frequently meet people with dementia, with the conversations going beyond the clinical responsibilities of Hu’s work.

“We get to hear a lot about their concerns on the day-to-day level, which is really what got me into dementia advocacy and dementia-friendly communities.”

Speaking further on what kind of actions he hopes to come out of the session, Hu hopes to see ways of recognizing and promoting the work of ordinary people in dementia care.

“I know firsthand that there’s a lot of good work going on but not enough credit is given to the people who do the good work. A lot of the time it’s the people who have been trained by the professionals, so it’s regular citizens doing the good work. How do we feature these people?”

Hu reflects on the story of two customs officers at Heathrow Airport, who went out of their way to help out a woman confused about where she was traveling. “I’m sure that was not in their job description, but they did it. So how do we reward them, and how do we provide incentives for others to follow their example? That’s what I’d like to get out of this.”

A lot remains to be done for dementia-friendly communities. What motivates Hu to keep working in this field?

“The spirit of people living with dementia and their caregivers. It’s very inspiring to talk to them and hear of their life’s accomplishments and what they still hope to accomplish in spite of the disease. There is a strong human will in illness that comes out, and I’m constantly humbled by interacting with people living with dementia and hearing what insight they have into the disease, but also bigger things in life.”


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Supporting People with Dementia From the Point of Diagnosis
Albert Mulley co-chairing a panel on the advantages and disadvantages of earlier diagnosis
Supporting People with Dementia From the Point of Diagnosis
Salzburg Global Seminar 

“Earlier diagnosis is not optional; it is a human right.” This was one argument put forward during a late morning discussion on the second day of Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

Session co-chair Albert Mulley invited participants to share their views on the advantages and disadvantages of earlier diagnosis and the net value it would bring in different contexts.

Participants also considered how families and supporters could be better assisted after diagnosis in planning and shared decision making for the future.

Mulley, managing director for global health care delivery science at The Dartmouth Institute, suggested earlier diagnosis provided the potential to identify populations at risk. One participant, who lives with dementia, said a timely diagnosis did allow him to explain his irregular behavior, but it
was more important to him to have the correct diagnosis.

One participant indicated diagnosis as a concept hadn’t been examined enough, arguing, “We say diagnosis, but we mean prognosis. We want to know what happens in the future.”

A timely diagnosis could serve both a social and medical function, participants heard. It enables people to explain how they’re feeling and allows their peers to understand what they’re going through.

If someone receives a timely diagnosis, they are able to access the best kind of support: that of their peers. One participant said, “How can you have access to peer support if you don’t know who your peers are in the first place?”

An early diagnosis does not come without its downsides, however, as the group soon learned.

One participant argued moving up the time of diagnosis allows people to be able to control further aspects of life, as well as giving more peace of mind. He added, “On the other hand, earlier diagnosis has the chance of increasing stigma.”

Participants were also reminded to err on the side of caution when scanning for certain diseases before they became medically apparent. One participant warned it was more likely non-progressive diseases would be found.

The downside of an early diagnosis, and the potential of misdiagnosis that comes with it, could be the risk of the patient developing mental health conditions, such as anxiety or depression. If a timely diagnosis is to be made, it is important to ensure the structure of both public and private health systems are renewed.

While highlighting an area of the Pacific Islands that only has access to two dementia specialists, a participant used this as an example to argue how important it was to develop tools that allow timely diagnosis regardless of context and location.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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