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Health Inequalities in the EU

Introduction
The European Union
WHO/Europe: Health 2020
EU projects and initiatives
Relevant publications

Introduction

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:

  • More than five times as many babies die before the age of one in some countries than in others;
  • In 2007, between Member States, there was an 8-year difference in life expectancy at birth for women and a 14-year gap for men;
  • Large differences of up to 20 years exist in the number of years lived in good health (Healthy Life Years);
  • Roma populations can expect to live 10 years less than the majority population in some countries.
  • Differences in life expectancy at birth between lowest and highest socio-economic groups reach 10 years for men and 6 years for women.

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 European Union

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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WHO/Europe: Health 2020

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:

  • Integrate health-related policy areas and renew the commitment of the Regional Office to public health;
  • Be developed through participatory process with Member States, sectors and partners;
  • Be informed and underpinned by a European review on social determinants of health and a number of evidence gathering studies addressing the implications of major drivers and trends for governance and health in the European Region;
  • Renew emphasis to further developing public health systems, capacities and functions and promoting public health as a key function in society;
  • Clarify the linkages between public health, health care system, in particular primary health care, in the context of the Tallinn Charter, 2008;
  • Position health as a critical development sector, and make linkages with the other sectors to promote health as a responsibility across the whole of government; and
  • Be an inspiration to Member States to develop, renew and update their national health policy and strategies

EU projects and initiatives

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:

Equity Action (the Joint Action on Health Inequalities)

logo_equityaction_rgb_smallAction 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:

  • Developing knowledge for action on health inequalities
  • Supporting the engagement of Member States, regions and other stakeholders in action to tackle socio-economic health inequalities
  • Sharing learning between Member States and other actors
  • Supporting the development of effective action to tackle socio-economic health inequalities at the European policy level

For further information, click here.
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.

Relevant publications

An overview of relevant EU publications addressing health inequality issues can be found in our publications database.

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