The 2016 Annual Growth Survey insufficiently highlights the role of health and social investment as a key part of a sustainable economic recovery

The publication of the 2016 Annual Growth Survey (AGS) kick-started the EU’s economic cycle for the year. The AGS sets out the economic priorities for 2016, aiming to foster growth and prevent excessive macro-economic imbalances, as well as contributing to EU 2020 targets. Yet the 2016 AGS insufficiently values health and social investments, which are key enablers of a sustainable recovery.

Labour market flexicurity, but not long-term precarious employment

The AGS states that labour market reforms should promote flexibility and security, so as to avoid labour market segmentation. This should be complemented by social protection and active labour market policies which help people during transitions between life stages and jobs. Furthermore, EuroHealthNet is pleased the AGS also makes the case for promoting work-life balance and gender equality as part of labour market reforms.

Focus in recent years, however, has been more on flexibility than security, resulting in increases in temporary (and often precarious forms of) employment. At the same time, cuts have been made to social protection systems, removing a vital safety net for people in need.

Research from the FP7 DRIVERS and SOPHIE projects suggest that employment that is perceived to be unfair by workers leads to psychosocial stress and mental ill health[1]. It is true that temporary work can be beneficial for some job seekers, by providing opportunities to try new jobs or work for short periods. Yet in many other cases, particularly when temporary employment becomes long-term and inescapable, it leads to frustration, inability to progress with life plans (e.g. start a family), reluctance to take up social rights, lack of self-esteem and feelings of inequity[2]. Reform of the labour market should therefore avoid increasing the prevalence of precarious employment, and instead aim to ensure that jobs are created that promote feelings of worth and social integration.

Essential precursors to a healthy workforce – health promotion, disease prevention and improved mental health

Mental ill health is a common cause of labour market exclusion. It is a significant drag on well-being, a loss of human potential, and increases costs on social protection systems. The early onset of mental ill health negatively affects educational outcomes and the transition into professional life. In addition, people with mental illness face high levels of under-treatment and unmet health service needs, exacerbating their health problems. Health and well-being are intrinsically linked to employment, education and training, poverty and social exclusion, but these need to be backed up by adequate funding for health promotion, disease prevention and mental health services[3].

EuroHealthNet found that the 2015 Country-Specific Recommendations were characterised by a contradiction: they focused on cost-effectiveness, performance and ‘efficient’ use of resources, without mentioning disease prevention, health promotion, the importance of promoting mental health, or the need to tackle health inequalities[4]. Yet cost effectiveness is simply not possible without focusing on these latter issues, as they help to prevent the need for health services in the first place. We urge a much greater focus on these issues in 2016.

Increased involvement and ownership by regional and local authorities in the European Semester would increase implementation

The European Semester must include regional and local authorities, bodies responsible for health and social affairs and other stakeholders in its discussions so as to increase ownership, legitimacy and efforts towards achieving EU 2020 targets. Regional and local authorities have a major role in implementing strategies associated with EU 2020 and Country Specific Recommendations in the fields of health, education, social and employment services. Nonetheless, potential partners are too often overlooked in the process of identifying priorities. This is a missed opportunity, as it fails to harness expertise and improve implementation of EU 2020 or efficient use of the European Structural and Investment Funds.

The Sustainable Development Goals: a win-win for health, social and environmental sustainability

EuroHealthNet welcomes the fact that the 2016 AGS commits to take the Sustainable Development Goals (SDGs) into account in the review of the EU 2020 strategy and developing longer-term goals. Many SDGs relate directly to poverty reduction, decent employment, health and health equity and the need to respect natural resources. The SDGs therefore represent a potential win-win for health, the environment, social fairness, and for a sustainable economic recovery.

We look forward to helping support implementation of the SDGs, and providing research evidence through the Horizon 2020 Inter-sectoral Health and Environment Research for Innovation (INHERIT) project, which EuroHealthNet will coordinate next year. Links to the AGS 2016 and EU Semester will be made and closely monitored, while involving our national and regional partners as important health stakeholders”, concludes Caroline Costongs, EuroHealthNet’s Managing Director.


[1] See DRIVERS - Here   and SOPHIE - Here .

[2] Bosmans K, Hardonk S, De Cuyper N & Vanroelen C (2015) Explaining the relation between precarious employment and mental well-being. A qualitative study among temporary agency workers. Work. A Journal of Prevention Assessment & Rehabilitation. DOI:10.3233/WOR-152136.

[3] OECD. 2015. Fit Mind, Fit Job. From Evidence to Practice in Mental Health and Work - Here

[4] Farrer L, Palumbo L, Costongs C, Oliveira A & Hines P (2015). Will the 2015 Country Specific Recommendations contribute to health equity? EuroHealthNet. Available here