Reducing inequalities by investing in health-promoting care
- The problem: Our care systems are not equipped to deal with increasing demand for care, and offer unequal access to formal care.
- Why it matters: Our current systems often worsen inequalities faced by those who provide and those who need care, and might not be able to provide care for all who need it in the future.
- The way forward: New 'health-promoting' models of care use resources more effectively by promoting health and wellbeing of those receiving and giving care.
Reducing inequalities by investing in health-promoting care
– Rethinking care to meet growing demands, protect providers’ wellbeing, and foster an Economy of Wellbeing
People expect their governments to provide high quality, easy to access care. However, there are differences in how care is organised and how care and service providers interact with each other across the EU.
The demand for care is rising due to, among other things, rising levels of chronic diseases and the ageing of society. Our care systems might not have the financial means or human resources to provide for all who need it in the future.
What do we mean by 'care?
We refer to ‘care’ as the full range of activities that enable people in need of support to live as independently as possible, and to actively participate in society. Such care can be formal (professionally) or informal (unpaid and/or without social protection).
Current approaches to care often maintain and worsen inequalities
Carers tend to be poorly paid and work in difficult conditions. When a relative needs care, they are often forced to give up a paid job to provide informal care (unpaid and/or without social protection).
Those providing care services tend to be women. The gender inequalities they face often intersect with other inequalities, such as those related to living in poverty or having a migrant background or disability.
Inequalities also exist in access to care. Vulnerable groups, such as those living in poverty, refugees and under-served minorities, often experience more ill health across the life-course. In turn, they often require more care.
They often also face barriers when looking for formal care services. Subsequently, they might not speak the language or may not be able to afford formal care. As a result, their loved ones often resort to providing informal care.
Health-promoting models of care
Several new visions and models for the provision of care could make more effective use of resources. That is to say, this would improve the quality of life for those receiving and giving care which helps address inequalities that are often maintained by care systems.
The concept of health promotion, defined as ‘the process of enabling people to increase control over, and to improve their health’, lies at the centre of such approaches.
The impact of COVID-19
The COVID-19 pandemic demonstrated the importance of care and revealed intersecting inequalities in the provision of social care. it exposed and exacerbated the structural weaknesses of current care models.
Care as an investment towards an Economy of Wellbeing
Health-promoting care models can help reduce poverty, social exclusion and loneliness. By improving health and wellbeing, they contribute to sustainable growth, prioritises wellbeing.
These models enable informal carers, older people and those living with chronic illness or disabilities to become socially engaged and economically active, paving the way to an Economy of Wellbeing.
How can EU policies, tools and programmes strengthen care?
A range of EU tools are available to help national and local governments invest in health-promoting care. These include
- The European Pillar of Social Rights (EPSR), which fosters the provision of social rights across the EU.
- The European Care Strategy, which outlines EU-level measures to strengthen Member State action on social care.
- The European Child Guarantee and the EU Strategy on the Rights of the Child, which help ensure that children in need have access to key services.
- The EC Green Paper on Ageing, which underlines the challenges and opportunities of demographic ageing.
- The EU Strategy for the Rights of Persons with Disabilities, which aims to mainstream disability in policy formulation.
Policy in action
EuroHealthNet members are at the centre of health-promoting care.
The Austrian Care Reform Strategy aims to improve the nursing profession. It provides bonuses, training, and extended leave to nursing staff, and offers informal carers compensation. The Community Nursing Project also helps provide low-threshold and needs-oriented care close to home, with nurses acting as the central network point. The project is funded under the Austrian Recovery and Resilience Plan.
An umbrella bill defines long-term care (LTC) as a unique pillar of social security. Three pilot projects, financed in part by the European Social Fund, tested an eligibility scale for LTC and attempted to integrate health and social services by making independent living and e-care better. An evaluation of the pilots highlighted the importance of investing in the skills of health professionals, and protecting the wellbeing of informal carers.
The Andalusian Model for Early (Childhood) Intervention fosters coordination between health, education and social services that address children’s needs in early stages of life. Offering a coordinated response to the needs of children and their families. The model outlines protocols to create effective collaboration mechanisms and fast and agile communication channels.
Pathways to Progress:
To make our care systems more health-promoting, we recommend the following:
- To improve indicators around care to help check performance and support progress.
- To investigate how services to promote health can be incorporated into current care models.
- To exchange ‘best practices’ to strengthen collaboration between health, social, educational, and training sectors.
- To explore how digital technologies can support integrated models of care, and benefit and optimise the independence of users.
All things considered, implementation of health-promoting care must ensure that individuals have the skills to provide and to take-up such approaches. EU funds can help develop such skills, and strengthen health-promoting care.