Those who experience social and economic disadvantage are more likely to be in poor health and have shorter lives than more advantaged peers. Full analysis of the risk factors for and trends in health inequalities is complex and requires comprehensive and comparable health and social data. When national and regional authorities have such data which can be disaggregated by socio-economic status, gender, ethnicity, and education, they can plan and execute policies and interventions which tackle inequalities in cost-effective ways. In the latest issue of Policy Précis, EuroHealthNet examines what systems and measures for the collection of data are currently in place in Europe and Member States, and what improvements should be made.
Policy Précis & Briefings
Using Health and Social Data to monitor Health Inequalities
Making the link: mobile Health (mHealth)
mHealth is referred to as “medical and public health practices supported by mobile devices”. Mobile devices can now be used to monitor, record, analyse, alerts and communicate health information to reach people and professionals remotely. It may deliver behavioural interventions to support individuals to start, reinforce or reduce specific health behaviours. mHealth has the potential to increase accessibility and to contribute to a more person-focused healthcare system, support shifts towards prevention, and improve system efficiency. It could also contribute to making access to healthcare more equitable.
This issue of Policy Précis takes stock of relevant EU policies and programmes relating to mobile health (mHealth) and the significance for health inequalities. It also looks at best practice and how progress can be made.
This policy précis has been translated in to Italian by DoRS Regione Piemonte (a EuroHealthNet member)
Making the link: Gender Equality and Health
Sex refers to the biological differences between men and women, whereas gender refers to the socially constructed characteristics of women and men such as norms, roles, and relationships of and between groups of women and men. These relations influence people’s susceptibility to different health conditions and diseases. They affect employment of good mental- and physical health, and levels of wellbeing. These relations also have a bearing on people’s access to and uptake of health services and on the health outcomes they experience throughout the life-course.
This Policy Précis analyses gender-based differences in social determinants and related health outcomes and why they persist. It looks at EU policies and programmes, as well as national initiatives (in Austria, Finland, Germany and Ireland) to redress the balance which are already in place, and how further progress can be made.
What is the European Pillar of Social Rights, and what does it mean for health?
Building a more inclusive and fairer Union is a key priority for the European Commission (EC). In March 2016, the EC presented a preliminary outline of the European Pillar of Social Rights and launched a broad public consultation. One year later, the EC published its final proposal for the European Pillar of Social Rights. The Pillar sets out a number of key principles and rights to support fair and well-functioning labour markets and welfare systems and more resilient economic structures. The Pillar is designed as a compass for a renewed process of convergence towards bett er working and living conditions. It is primarily conceived for the euro area but open to all EU Member States.
Making the link: Health and Youth Exclusion
This policy précis examines the link between health and youth exclusion. It looks at the situation in Europe today, and at existing and proposed European legislation in this field. It describes some of the best national practices designed to tackle youth exclusion, and gives some policy recommendations for the future.
The link between ill health, air pollution, and inequalities
The European Semester: A health inequalities perspective
Will the 2017 European Semester process contribute to improving health equity?
EuroHealthNet’s 2017 analysis of the European Semester
The European Semester is an annually applied mechanism for policy coordination at EU level. It is used to analyse EU Member States’ economic situation, monitor progress and provide country specific recommendations towards the EU2020 strategic objectives. EuroHealthNet considers more can be done and achieved through the EU Semester process to ensure action is taken which responds to social and health needs of people from different socio-economic groups. By providing recommendations to Member States in social and economic areas, the EU Semester process can be important for addressing health inequalities and the social determinants of health.
In this document EuroHealthNet takes a closer look at three key social determinants of health and how they are represented in the EU Semester while providing examples from the country specific recommendations and the Country Reports of three countries: Austria, Slovakia and Ireland . We analyse the Annual Growth survey 2017, and compare 2016 Country Specific Recommendations with 2017 country progress reports and 2017 recommendations in light of the available evidence in three key themes. What is positive, what is missing and what can be done better? This analysis highlights the entry points and opportunities for tackling health and social inequalities within the EU Semester process. It also considers the relevance of using and applying the principles of the European Pillar of Social Rights (Social Pillar) and its Social Scoreboard to increase the impact of the EU Semester as a coordination tool for social, health and well-being policies.
EuroHealthNet welcomes WHO action on migration, health and sustainable development
The European Pillar of Social Rights and its relevance for health and social equity
Will the 2016 EU Semester process contribute to improving health equity?
The European Semester is the EU’s economic policy coordination mechanism of the Europe 2020 Strategy. It undertakes a detailed analysis of EU Member States' reforms plans and provides them with Country Specific Recommendations (CSRs) following extensive consultation with stakeholders at European and national levels. The publication of the CSRs entails a potential political programme for each member state for the coming semester period.
EuroHealthNet’s interest in the EU semester is reinforced by the fact that CSRs also address questions related to the priorities and investments of member states in the field of social affairs and health. As such, CSRs represent an opportunity to ascertain the extent to which they may – or may not – contribute to health equity.
This document brings together two areas amenable to policy actions that can improve health and reduce health inequalities: children and families; and health systems from a health promotion perspective. For children and families, the analysis aims to ascertain the scope and inclusiveness of CSRs related to children and families and to find out whether the suggested measures are a step towards improving health and reducing health inequalities. For health systems we try to examine whether the 2016 CSRs are likely to stimulate reforms that reduce health inequalities and support investment in health promotion and disease prevention.
These topics were selected based on EuroHealthNet’s previous work on health systems, child development and health promotion. This document aims to compare findings of 2016 with those of 2015 analysis and responds to the announcement of the Annual Growth Survey 2017 in November 2016, which marks the beginning of a new EU semester process.
This year analysis found that:
- There is an increased awareness of the need for policies related to children and families, especially in the light of labour market and social inclusion.
- The need for fiscally sustainable health care systems is recognised among most CSRs relating to health, yet the call for strengthening primary care, disease prevention and health promotion or looking at health in an integrated way is limited.
- Access to health is increasingly raised in CSRs related to health in comparison to the analysis of CSRs in 2015. However, vulnerable people, children or migrants are not directly mentioned.
- Children, vulnerable people and migrants are mentioned in connection with social inclusion and labour market integration.
Several steps have been identified as promoters of greater health equity:
- Ensure that children and families are on the agenda of all CSRs.
- More focus should be put on coverage and access to quality of health care.
- Improve health system governance and support inter-sectoral work and cooperation.
- A stronger focus and consideration should be given to the impacts of the economic crisis in terms of resources; investing in health promotion and disease prevention should be one of the measures to support health systems fiscal sustainability.
The European Council’s Recommendation on the integration of the long-term unemployed to the labour market
The link between unemployment and ill health is well established[i]. Scientific knowledge goes deeper, suggesting that unemployment is worse for health for lower socio-economic groups, and less deleterious for health for those who have larger social networks[ii]. Unsurprisingly, long-term unemployment sees effects on ill health compounded: people experience negative pressures on their physical and mental health from a variety of sources for longer. Indeed, a recently published review of the scientific literature found that “The long-term unemployed carry a markedly higher burden of disease, particularly mental illness, than employed persons and those who are unemployed only for a short time. The burden of disease increases with the duration of unemployment”[i].
Long-term unemployment is not only a tragedy for the individuals concerned but also threatens economies: it reduces tax receipts, increases expenditure on social protection and health, and has negative effects on the skills and knowledge of the workforce – thereby reducing the potential for future economic growth.
This EuroHealthNet policy briefing examines a recent initiative at the European Union level, which has been agreed upon but not yet responded to by national authorities and others responsible for its implementation: The European Council’s Recommendation on the integration of the long-term unemployed to the labour market. The briefing describes the main modalities by which the initiative aims to return the long-term unemployed back to the labour market, and certain avoidable bad practices that could exacerbate the difficulties faced by people experiencing long-term unemployment.
Read our policy briefing published here.
[i] See for instance: 1) Wanberg CR: The individual experience of unemployment. Annu Rev Psychol 2012, 63:369–396. 10.1146/annurev-psych-120710-100500PubMedView Article. 2) Jin RL, Shah CP, Svoboda TJ: The impact of unemployment on health: a review of the evidence (Reprinted from Canadian Medical Association Journal, vol 153, pg 529–40, 1995). J Public Health Pol 1997,18(3):275–301. 10.2307/3343311View Article.
Health Promoting Systems Can Help Inclusive Employment in Europe
Building People-Centred and Integrated Health Services for Health Equity
Health equity and alcohol
Building Sustainable Societies in Europe and Globally
Will the 2015 Country Specific Recommendations contribute to health equity?
EuroHealthNet has been monitoring the European Semester process for a number of years and working with its members to argue for a stronger focus on public health, health promotion and preventive services . EuroHealthNet’s two main objectives are to improve health between and within European states and to tackle health inequalities.
This document brings together three linked analyses of the CSRs carried out by EuroHealthNet, covering statutory retirement ages, children and families, and health promotion and sustainable health systems. These three topics were selected based on EuroHealthNet’s previous work on healthy and active ageing, child development, and health promotion. They represent areas amenable to policy actions that can improve health and reduce health inequalities, and areas where inequities in health could challenge policy reform and implementation.
Health equity and long term care
Health, welbeing and the economic and financial crisis in Europe
Mental health, equity and work
Social Inclusion and Health Equity
RECOMMENDATIONS ON EU SUPPORT FOR LOCAL AND REGIONAL ACTION ON HEALTH EQUITY
Following the conference organised by EuroHealthNet's Swedish partner - the Swedish Association of Local Authorities and Regions, together with Euregha and EuroHealthnet, EuroHealthNet has published some recommendations on EU support for local and regional action on health equity (attached document).
Health is a value in itself as well as a prerequisite for the achievement of the EU 2020 objectives of smart, sustainable and inclusive growth. People´s health influences economic outcomes in terms of productivity, labour supply, human capital and public spending. In many of the member states of the European Union, however, health inequalities are increasing. This is a joint challenge for society that needs to be addressed and tackled by all levels of government.
For more information, contact Leonardo Palumbo