The Republic of Slovenia is a parliamentary democratic republic with 2 million people. Slovenia joined the European Union and NATO in 2004, and the Eurozone in 2007. Slovenia has a strong economy and a stable democracy, with a nominal per capita GDP of $36,566 (2018 est.). The country scores relatively high on equality parameters. Slovenia is organised into 211 municipalities with local autonomy and 62 administrative districts. The districts function as sub-units of government administration. Regional differences in wealth are pronounced with large gaps between the east and the west. These disparities are echoed in health as large regional differences exist in alcohol consumption and related death rates. The risk of alcohol-related death is nearly three times higher in eastern compared to western Slovenia.
Life expectancy at birth was 80.9 years in 2015. Yet life expectancy at birth for Slovenian men is six years less than for women
and nearly seven years higher for men with a university education than those with lower secondary education. There are marked socioeconomic disparities and people with the lowest level of education are more than two and a half times as likely to live with diabetes and almost 40% more likely to live with asthma as those with the highest level of education. Behavioural risk factors are more common among population groups with lower income and lower levels of education. There is a pronounced gap of nearly five percentage points in daily smoking rates between adults with lower educational (16.4%) and higher educational (11%) attainment. Plus, the level of obesity in the population with lower education is more than two times that of the higher educated population. In 2015, Slovenia spent EUR 2 039 per head on health care. This equals 8.5% of GDP. However, its health system is one of the most expensive among the newer Member States.
The first initiative has taken place in 2000, when regional development agenda aimed at reducing regional disparities and included health. Also, financial measures were put forward by the Ministry of Health for innovative regional projects which aimed to tackle health inequalities. Two main policies, the “Strategy to Tackle Health Inequalities” and the “Health Promotion Strategy and Action Plan for Tackling Health Inequalities in Pomurje” have been considered as pilot initiatives. From 2005 onwards, when the debate on health inequalities strengthen also at international level, politicians become aware of the broader social determinants concept and this moved the debate at national level. However, only since 2009, social issues started to be more frequently connected to health.
The Slovenia Ministry of Health use Health Impact Assessment and cross-sectoral policy development as tools to address health inequalities. These efforts also take on a cross-governmental character, as a broad range of governmental policies has recognized the importance of social determinants of health inequalities. These include the labor market and fair wage policy, the social protection policy, the social inclusion policy, the pension policy, the balanced regional development policy, the fiscal expenditure policy and the housing policy. However, qualitative research and data is currently missing that indicates what approaches are working and why and also effective cross-sectoral mechanisms that would foster better cross-sectoral action are still lacking.
There are currently two important developments that may put health inequalities higher on the political agenda, and make it easier for stakeholders to advocate for the issue. Firstly a recent report on health inequalities in Slovenia, which for the first time linked health and access indicators to social economic status and thus took the broader determinants into account. Secondly, the National Health Plan 2016-2025 addresses key problems of health in Slovenia and the Slovenian health care system. One of the priorities of this document is health promotion and prevention of chronic/noncommunicable diseases. It prescribes the main tasks and actions needed to be taken. There is also specific focus on health inequalities and the socioeconomic gradient. The system of health care (accessibility to quality programmes of preventive medicine, treatment and rehabilitation) has, along with other determinants of health (education, economic-social class, culture, environment, ethnicity), an important impact on health inequalities. The National Health Plan strongly promotes “Health in All Policies”.
An overview of policy responses addressing health inequalities in can be found in our Policy Database.
An overview of projects and initiatives that are currently taking place or that have successfully been finalized, and that are addressing health inequality issues, can be found in our Project Database.
Please find below an overview of key actors in Slovenia working on health inequality issues:
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Please find below an overview of relevant documents addressing health inequality issues in Slovenia. Further publications can be found in our Publications Database.
- Health Inequalities in Slovenia (2011) WHO Europe, Slovenian Ministry of Health, Slovenian Institute of Public Health and the Center for Health and Development.
- National Action Plan of Social Inclusion 2004-2006 By the Ministry of Labour, Family and Social
- Parental Leave and Family Benefits Act (Slovene only)
- National Health Plan 2016-2025 “Together for a society of Health”
Are you aware of any other key resources that should be added to this list?
Please let us know!