Working across Sectors
The European Structural and Investment Funds offer great opportunities for the improvement of health and health equity. Although health (equity) is not explicitly mentioned in the eleven thematic objectives and has not been allocated any specific budget, health is explicitly included in priorities relating to, for example, ‘Improving Employment’ and ‘Social Inclusion and Combating Poverty’. Public health actors should thus consider other ‘non-health’ sectors to identify funding opportunities for efforts to reduce health inequalities.
Other project ideas for ESIF investment in health can be found here.
THE 11 PRIORITIES
The European Commission encourages linkages between initiatives funded under this priority and other EU funding programmes, such as the Horizon 2020, which includes ‘Inclusive, innovative and secure societies’ as a funding area. The public health and health promotion sectors must identify opportunities to improve health and health equity through improved research, development and innovation. ESF and ERDF can be used to improve research capacities and promote transnational networking between education, business, and research.
Initiatives that address environmental problems such as indoor and outdoor air pollution, poor water quality, poor sanitation and the release of hazardous chemicals can contribute to the reduction of respiratory and cardiovascular diseases, cancer, asthma, allergies and reproductive and neurodevelopmental disorders. People in low income groups are most likely to suffer from the consequences of inefficient use of energy or of environmental degradation, and have the least access to green spaces. The public health and health promotion sector can get involved in this thematic priority by ensuring that measures taken in these areas place a special emphasis on the needs of people with lower socio-economic status. They can e.g. undertake initiatives to consider the relationship between socio-economic status and pollution or chemical exposure and make the case for action in deprived areas. Similarly, it is generally vulnerable groups like the poor and older people are likely to be worst affected by the health risks associated with climate change, like heat waves and flooding (TO 5).
Health, poverty and social inclusion are closely inter-related. Initiatives that promote health can contribute to a reduction in poverty and social inclusion and vice-versa. The health sector can therefore take part in advancing this thematic priority by instigating or contributing to initiatives that promote social inclusion of marginalised groups like those on low income, migrants, or older people. It can also initiate regeneration projects, to maximise the health benefits of e.g. housing and planning initiatives, and stimulate initiatives that enhance social capital, which has been linked to stronger health equity outcomes. The public health sector can also take forward this priority area by establishing low threshold one-stop community centres for health and social services.
This can benefit individuals and health systems by facilitating the provision of e-inclusion, including eHealth and/or mHealth. Technological innovations in eHealth or mHealth are receiving increasing attention due to their potential to fill the gaps between the growing demand for health and long-term care, the shortage of health professionals and financial restrictions. Such innovations can radically reshape the way health services are structured and delivered. eHealth and mHealth developments include e.g. monitoring technologies, behaviour supporting technologies, online information resources, and online health communities. While people with low income, older or disabled people as well as those in under-served, remote areas can benefit from such technologies, they may not be fully included in the implementation and design of such programmes. If ICT technologies such as eHealth or eGovernment applications and solutions are not practically influenced by equity considerations, it can increase health inequalities. The public health sector can help to ensure that relevant strategies, programmes, and initiatives relating to this thematic area also focus on how they can reach and improve the lives of marginalised groups.
It is crucial that the public health sector is involved in these initiatives. The public health and health promotion sector should ensure that related initiatives promote walking and cycling, and are implemented in ways that maintain air quality and minimise noise pollution and road accidents. They should also ensure that transport related strategies enhance access of more deprived people and communities to services, nutritious food options, and employment. People in lower socio-economic groups tend to be most exposed to the negative consequences of transport infrastructure development.
Educational achievements influence access to employment, income, housing and other underlying determinants of health. Education and lifelong learning are important to developing good life-skills and to attaining and maintaining employment as well as to social inclusion and well-being. The health sector can become involved in achieving this thematic priority by providing health education in schools and ensuring that school facilities and educational programmes promote health particularly in deprived areas. The public health sector can also help ensure that education and training courses are accessible to low-income and other vulnerable groups like older people and migrants, since this can provide them with life skills, prepare them for employment, and contribute to social inclusion, thereby also reducing health inequalities.
SMEs are a key driver of growth, job creation and cohesion in EU regions, providing two out of three private sector jobs and contributing to 58% of the total value created by businesses in the EU. They can contribute to greater health equity by generating employment in deprived areas. They can also contribute to health equity by developing innovative products and services that improve access to social and health services for all, a low-carbon economy and resource efficiency. The health sector can get involved by ensuring that strategies, programmes and initiatives to enhance the competitiveness of SMEs (TO 3) generate good employment opportunities in deprived areas, while contributing to sustainable development and the social economy.
Employment also enables individuals to e.g. achieve fulfilment, structure time and have social contacts. It has been identified as one of the most effective ways to achieve social inclusion. The material constraints and psychosocial stress resulting from loss of employment affect both the individuals concerned and their families. High levels of employment are important for society as a whole since they lead to productivity, competitiveness and sustainable welfare systems. However, employment conditions must be good, so that they don’t undermine physical and mental health. Good health, in turn, is necessary for individuals to attain and maintain employment. The public health sector can therefore contribute to TO 8 through initiatives that create new employment opportunities and that promote the physical and mental health of unemployed people, and improve their chances of attaining and remaining in employment. It can in this respect include health promotion elements in employment generating projects led by others, to maximise health-related outcomes. The public health sector can also take part in initiatives to promote healthy workplace conditions in, for example, SMEs.
This thematic priority o offers opportunities to co-fund initiatives that aim at better regulation and good governance, as well as capacity building for stakeholders delivering health, education and social policies at national, regional and local government. The public health sector can use this opportunity to encourage whole-of-government approaches to ensuring health equity in all policies. It can also organise training for public health staff on health inequalities strategies, and build institutional capacities to address health inequalities within and beyond the health sector by for example improving skills to measure health inequalities and assess the health equity impacts of policy measures.