Inequalities in health have been an important part of the work of the European Union (EU) since 1992 when specific competencies for public health were included in the Maastricht treaty. However, large differences in health still exist between and within all countries in the EU, and some of these inequalities are widening. Examples of inequalities between countries are:
Video ‘Reducing Health Inequalities in the European Union’ (European Commission)
These inequalities have significant economic implications for the EU and for member states. When health is valued as a capital good, inequalities related losses have been estimated to cost around €141 billion in 2004 or 1.4% of GDP. This rises sharply to €1,000 billion or 9.5% of GDP when health is valued as a consumption good (Mackenbach, 2007).
The EU institutions significantly contribute to reducing health inequalities across the social gradient through a variety of strategies, policies, programmes and initiatives which affect the socio-economic determinants of health.
In June 2010 the EU adopted its new strategy – Europe 2020: A strategy for smart, sustainable and inclusive growth. The document sets out the proposed economic, social and environmental development for the EU over the next 10 years. Although the strategy does not directly address health inequalities, it clearly acknowledges the need to fight inequalities as a prerequisite for growth and competitiveness. The EU has indeed committed to lift 20 million people out of poverty by 2020. This will be pursued through the European platform against poverty and social exclusion, one of the Commission’s seven ‘flagship initiatives’ i.e. the mechanisms through which the EU 2020 strategy will be delivered. This process will undoubtedly impact health inequalities between and within EU countries.
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At the sixtieth session of the WHO Regional Committee for Europe (September 2010), Member States and partners gave WHO/Europe a strong, clear mandate to develop the new European health policy, Health 2020, to accelerate progress towards achieving the European Region’s health potential by 2020. The new European policy for health will be presented for approval to the 53 Member States in the European Region at the 62nd session of the Regional Committee in September 2012.
Emerging trends such as increasing health inequities within and between countries, shrinking public service expenditures due to the financial crisis, and a growing burden from non-communicable diseases, indicate an urgent need to promote and protect health, particularly for the most vulnerable segments of the population, and to ensure that appropriate care and support is available to those who are ill.
Health 2020 will:
Innovative projects promoting health development can receive EU funding from the EU Health Programme – a list of funded health inequalities projects can be found here. The priority areas and criteria for funding actions are set out each year in a work plan, followed by calls for proposals for projects, operating grants, conferences and joint actions. An example of an important initiative that is currently ongoing, is the Joint Action on Health Inequalities, the Equity Action:
Action to tackle health inequalities is required at EU, national, regional and local level, with a wide range of stakeholders across a range of policy areas. The challenge for Equity Action is to assist the Member States involved to develop tools to better enable health inequalities to be addressed in cross-government policy making, to access the evidence, and to engage with key stakeholders especially regions.
The general objectives of the Joint Action are to help reduce health inequalities by:
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In 2010 a Call for Proposals was launched under PROGRESS programme with the aim to take forward the actions outlined in the Commission Communication on health inequalities, specifically by providing support to national/regional authorities in PROGRESS participating countries to strengthen policies to address health inequalities.The list of awarded grants can be found here.
Examples of more health inequality projects and initiatives – implemented at either EU, national or regional level – can be found in the Project Database.
An overview of relevant EU publications addressing health inequality issues can be found in our publications database.