Policy Précis & Briefings


Policy Précis

Making the link: Working conditions, health and equity

Employment is one of the most important determinants of good health and wellbeing. However, simply having work is not enough – working conditions and job quality have a significant impact.  EuroHealthNet’s new Policy Précis Making the link: Working conditions, health, and equity sets out how changes in the way we work and working conditions can affect health and wellbeing. It further explores how investing in employment can help reduce health inequalities, in particular as part of a fairer and more sustainable recovery and resilience building in Europe.

Making the link: Gender, inequalities and health

While the COVID-19 pandemic has threatened everyone’s health, its impact has been different for men and women, reflecting underlying gender inequalities. This new publication Making the Link: Gender Equality and Health examines the pathways in which systematic disparities, such as the employment gap and the digital gender divide, lead to inequalities in health and social and economic wellbeing across the life course. It explores how the current pandemic further magnifies these inequalities. Examples of good practices from EU Member States illustrate how countries can move forward. These include anti-violence centres that also rehabilitate the perpetrators of violence, and gender-sensitive workplace health promotion.  

Find the policy précis here.


Policy Précis

European Pillar of Social Rights (EPSR) Factsheet

The European Pillar of Social Rights (EPSR) sets out principles and rights to support fair and well-functioning labour markets as well as social protection and inclusion everywhere in Europe. The EuroHealthNet factsheet The European Pillar of Social Rights: A key vehicle to improving health for all, explains different elements of the pillar, what they mean for health, health inequalities, and a European Health Union.


Making the link: Improving Health and Health Equity through Strong Social Protection Systems

Social protection systems are systems which help people meet needs in life and protect them and their families against risks. Those needs and risks can be associated with parental and caring responsibilities, sickness, healthcare, disability, old age, housing, unemployment, and social exclusion. Examples include social assistance and social insurance, as well as emerging minimum and basic income schemes. These are ‘safety nets’, and ways to reduce relative poverty and income inequalities. Social protection measures can also include social investments in creating healthy, resilient, and equal societies and communities. 

In Making the link: Improving Health and Health Equity through Strong Social Protection Systems, EuroHealthNet explores how the two are connected. It presents European initiatives that are shaping national changes in social protection, gives examples from European countries showing how changes to social systems are affecting health and provides examples of EU policies and programmes as well as recommendations for progress. 

The links between health, education, and inequality

The number of years spent in formal education is closely related to health outcomes, both amongst individuals and across populations. Equally, health status in early years and later in life affects our ability to participate in education and society. The main factor that determines both health and educational outcomes is socio-economic status. By investing in good quality, accessible education – especially in early years – we can start to break and prevent the cycle of poverty and social exclusion, and its harmful effects on mental and physical health.

The links between health, education, and inequality are explored in a new Policy Precis from EuroHealthNet. It provides an overview of related international and European programmes and policies, actions in individual countries, and recommendations for progress.

Policy Briefings

Recovering from the Covid-19 Pandemic and ensuring Health Equity – The Role of the European Semester

A new analysis of the European Semester process 2020 by EuroHealthNet and in cooperation with the Joint Action on Health Equity (JAHEE) has highlighted the potentially severe impacts of the COVID-19 pandemic on health inequalities. It also identifies several actions that will put the European economies on track for a healthy economic recovery which takes wellbeing into account. 

The European Semester is the EU’s annual cycle of economic and social policy coordination. For this analysis, EuroHealthNet conducted structured interviews with national experts, reviewed Semester Country Reports, Recommendations and associated evidence, and liaised closely with the national experts and authorities of the JAHEE consortium.

All experts highlighted the social and economic components of the COVID-19 pandemic and most noted a widening of inequalities. All said that it has affected access to health systems, including for chronic conditions. People without digital skills struggled more. Most interviews also indicated an inequitable impact on mental health.


Policy Précis

Factsheet: Health Equity in the EU

There continue to be big differences in health outcomes between groups of people and between countries in Europe. To address these inequalities and to improve health for all, we need to shift Europe’s narrative on fiscal and social policy to one where issues are addressed holistically; where spending in social and health protection and wellbeing is understood as an investment; where the interconnected nature of policy is recognised and valued; and where social sustainability is a foundation stone. It makes economic sense, as already a 50% reduction in gaps in life expectancy would provide monetised benefits to countries ranging from 0.3 – 4.3% of GDP.

Reducing social and health inequalities is possible, represents a good investment, and has strong public support. The EU and its Member States have the tools to act. Improvements are achievable.

Digital Health Literacy: how new skills can help improve health, equity, and Sustainability

Digital health literacy PP

The effective and equitable digital transformation of health systems could have many benefits. People who are digitally health literate – those that can gain and use knowledge from electronic sources to solve a health problem – are more able to manage personal health and care issues. Better prevention models can be developed, and healthy behaviours supported.

However, there is a risk that the most vulnerable people are left behind in the transition.

People with lower social and economic status have a higher burden of disease. They also face more barriers to accessing and using information. Ensuring that they benefit from the digital transition requires action within health and other sectors; innovation within states and companies; the development of professionals and services; and wider improvements in education, and social justice and inclusion.

EuroHealthNet has published a Policy Précis examining digital health literacy and what it means for health equity. It examines what can and is being done to support those most in need.

Update: factsheet on childhood, health inequalities, and vaccine preventable diseases.

Vaccination Factsheet banner

EuroHealthNet has updated and relaunched its factsheet on childhood, health inequalities, and vaccine preventable diseases, first published in April 2018. It covers the current state of vaccination and inequality, what action is being taken at international and national levels, and what else can be done.

Not all people in Europe benefit equally from the many advantages of vaccinations. Social and financial inequalities in society are reflected in immunisation uptake. Whether or not a child is vaccinated is influenced by wealth, parental education level, place of residence, and gender.

Why and how Europe’s food systems need to change

This Policy Précis is also available in Italian, French or German.

Why and how Europe’s food systems need to change

What can be done to prepare Europe’s food systems for the future? In a new Policy Précis, released today, EuroHealthNet examines pathways, solutions and best practices to move towards healthier and more sustainable and inclusive food systems in Europe and beyond.

Despite growing concern about sustainability, Europe’s food systems still put undue stress on our environment. By restraining access to decent and affordable nutrition, our food systems perpetuate and drive up health inequalities. The Common Agricultural Policy (CAP) continues to subsidise intensive production of alcohol, meat, dairy fats and sugars, products that are known to contribute to the growing prevalence of obesity, and non-communicable diseases (NCDs).

Click here to download our Policy Précis, Towards a healthy, sustainable and inclusive European food system.

Current food systems account for up to 30 % of the EU’s total greenhouse gas emissions and large amounts of water use. Through transport and intensive production methods, these systems contribute to pollution and associated illnesses. Furthermore, 55% of adults and one in four children in Europe is overweight or obese. Levels of NCDs are growing and have a huge negative impact on both lives and health budgets. Additionally, as the number of suppliers and buyers has decreased, and marketing strategies have become more aggressive, high-quality food has become accessible mostly by the most literate and affluent consumers, adding to existing health inequalities. It is clear that the CAP is not fit for modern challenges in the context of climate change, rising obesity prevalence and social inequalities.

Recognition that solutions lie in integrated actions is growing. Policy coherence between health, social, environmental and economic goals is vital. Some countries are integrating health and sustainability in national nutrition guidelines, and there is an increasing number of innovative actions to shorten food supply chains and bring together relevant stakeholders.

However, more needs to be done. EuroHealthNet is calling for sustainable development indicators to be integrated within the flagship European Semester and Country Specific Recommendations (CSRs). Additionally, stronger regulatory measures to discourage excessive market consolidation and enable smaller economic actors and innovators to compete and survive are needed. The EU will inevitably need to transform its food system to achieve the Sustainable Development Goals by 2030.

To learn more, read our new Policy Précis Towards a healthy, sustainable and inclusive European Food System.

Come e perché è necessario modificare i sistemi alimentari europei

Quali interventi occorrono per preparare i sistemi alimentari europei per il futuro? In un nuovo report informativo, pubblicato in vista del Consiglio “Agricoltura and Pesca” che si terrà il 18 Marzo, EuroHealthNet analizza i percorsi, le soluzioni e le procedure ottimali nell’iter verso sistemi alimentari più salutari e più sostenibili ed inclusivi, in Europa e non solo. 

Malgrado le crescenti preoccupazioni in materia di sostenibilità, i sistemi alimentari europei continuano ad esercitare una pressione eccessiva sull’ambiente. Limitando l’accesso ad un’alimentazione adeguata e alla portata di tutti, i nostri sistemi alimentari perpetuano e fanno aumentare le disuguaglianze in termini di salute. La Politica agricola comune (PAC) continua a sovvenzionare la produzione intensiva di alcol, carne, latticini e zuccheri, prodotti che, notoriamente, contribuiscono ad una crescente diffusione di patologie come l’obesità e le malattie non trasmissibili (MNT). 

Fare clic qui per scaricare il nostro report informativo: Verso sistemi alimentari europei sani, sostenibili e inclusivi.

Gli attuali sistemi alimentari sono responsabili di almeno il 30% delle emissioni totali di gas serra e di una larga fetta del consumo idrico da parte dell’Ue. A causa dei trasporti e dei metodi di produzione intensiva, tali sistemi contribuiscono all’inquinamento e alle patologie correlate. In Europa, inoltre, il 55% degli adulti e un bambino su quattro sono sovrappeso od obesi. I livelli delle MNT sono in aumento e hanno un enorme effetto negativo sia sulle vite dei cittadini, sia sui finanziamenti nel settore della salute. Inoltre, dal momento che il numero di fornitori e acquirenti è sceso, e le strategie di marketing sono diventate più aggressive, gli alimenti di alta qualità sono ormai accessibili solamente per i consumatori più colti e abbienti, con un conseguente incremento delle disparità esistenti in termini di salute. È evidente che la PAC non è idonea per affrontare le moderne sfide relative ai cambiamenti climatici, alla costante diffusione dell’obesità e alle disuguaglianze sociali.

C’è pertanto una sempre maggiore consapevolezza che le azioni concertate offrano le soluzioni migliori. È inoltre essenziale implementare politiche coerenti e con obiettivi comuni in ambito sanitario, sociale, ambientale ed economico. Alcuni Paesi stanno inserendo la salute e la sostenibilità nelle linee guida nazionali sull’alimentazione, e vi è un numero crescente di interventi innovativi per accorciare le filiere alimentari e coordinare tutti i soggetti coinvolti. 

Tuttavia, c’è ancora molto da fare. EuroHealthNet chiede l’integrazione degli indicatori di sviluppo sostenibile nelle procedure principali del Semestre Europeo e nelle sue Raccomandazioni annuali. Urgono inoltre misure normative più stringenti per scoraggiare un eccessivo consolidamento del mercato e garantire la competizione e la sopravvivenza di attori e innovatori economici di dimensioni ridotte. L’Ue dovrà necessariamente trasformare il proprio sistema alimentare per raggiungere gli Obiettivi di sviluppo sostenibile entro il 2030.

Per saperne di più, consultare il nostro report informativo: Verso sistemi alimentari europei sani, sostenibili e inclusivi.

Pourquoi et comment les systèmes alimentaires européens doivent évoluer

Que peut-on faire pour préparer les systèmes alimentaires européens à l’avenir ? Dans un ‘Policy Précis’ publié en avance de la réunion du Conseil AGRIPECHE du 18 mars, EuroHealthNet étudie les pistes, les solutions et les bonnes pratiques qui permettront d’instaurer des systèmes alimentaires plus sains, durables et solidaires en Europe et dans le reste du monde. 

Malgré un souci croissant de durabilité, les systèmes alimentaires européens continuent de mettre à mal notre environnement. En limitant l’accès à une alimentation correcte et abordable, ils perpétuent et aggravent les inégalités en matière de santé. La politique agricole commune (PAC) subventionne encore la production intensive d’alcool, de viande, de matières grasses laitières et de sucre, autant de produits dont on sait qu’ils contribuent à la prévalence croissante de l’obésité et des maladies non transmissibles (MNT). 

Cliquez ici pour télécharger notre nouveau compte-rendu de politique, Vers des systèmes alimentaires européens sains, durables et solidaires.

Dans l’Union européenne, les systèmes alimentaires représentent actuellement jusqu’à 30 % des émissions totales de gaz à effet de serre et une grande partie de la consommation d’eau. En raison du transport routier et des méthodes de production intensives qu’ils utilisent, ces systèmes contribuent à la pollution et aux maladies qui y sont associées. En outre, 55 % des adultes et un enfant sur quatre en Europe sont en situation de surpoids ou d’obésité. Les taux de MNT augmentent et ont un impact négatif énorme sur la vie et le coût de la santé. De plus, à mesure que le nombre d’acheteurs et de fournisseurs a diminué et que les stratégies commerciales ont gagné en agressivité, l’accès à une nourriture de qualité est devenu réservé aux consommateurs les plus aisés et les mieux informés. Cette situation contribue à la croissance des inégalités existantes en matière de santé. La PAC n’est manifestement pas adaptée aux défis du monde actuel, avec l’accélération des changements climatiques, l’essor de l’obésité et l’aggravation des inégalités sociales.

De plus en plus de parties prenantes se rendent compte que la seule solution consiste en la mise en œuvre d’actions intégrées. Il est impératif d’instaurer une cohérence entre les objectifs et les politiques en matière de santé, de société, d’environnement et d’économie. Certains pays intègrent la santé et la durabilité dans leurs directives nationales pour la nutrition, et de plus en plus d’initiatives innovantes sont mises en place pour raccourcir les chaînes d’approvisionnement alimentaires et favoriser la collaboration entre les différentes parties prenantes. 

Cependant, cela ne suffit pas. EuroHealthNet demande l’intégration d’indicateurs de développement durable au programme et aux recommandations Annuelles du Semestre européen sur les politiques économiques et sociales. Des mesures plus sévères doivent également être prises pour décourager une consolidation excessive du marché et permettre aux innovateurs et acteurs économiques modestes de subsister et de rester compétitifs. L’UE devra inévitablement transformer son système alimentaire pour atteindre les Objectifs de développement durable d’ici à 2030.

Pour en savoir plus, consultez notre nouveau ‘Policy Précis’, Vers des systèmes alimentaires européens sains, durables et solidaires.

Warum und wie müssen sich Europas Lebensmittelsysteme ändern?

Was kann getan werden, um Europas Lebensmittelsysteme auf die Zukunft vorzubereiten? In einer neuen Policy Précisveröffentlicht in Erwartung Des Rat "Landwirtschaft und Fischerei" am 18. März, untersucht EuroHealthNet Wege, Lösungen und bewährte Praktiken für den Übergang zu einem gesünderen, nachhaltigeren und integrativeren Lebensmittelsystem in Europa und darüber hinaus. 

Trotz wachsender Bedenken im Hinblick auf die Nachhaltigkeit setzen Europas Lebensmittelsysteme unsere Umwelt nach wie vor einem unnötigen Stress aus. Durch die Einschränkung des Zugangs zu angemessener und erschwinglicher Nahrung erhalten unsere Lebensmittelsysteme gesundheitliche Ungleichheiten aufrecht und treiben diese hoch. Die Gemeinsame Agrarpolitik der EU (GAP) subventioniert weiterhin die intensive Produktion von Alkohol, Fleisch, Milchfetten und Zucker; Produkte, die bekanntermaßen zur wachsenden Prävalenz von Fettleibigkeit und nicht übertragbaren Krankheiten (NCDs) beitragen. 

Klicken Sie hier zum Download unserer Policy Précis „Wege zu einem gesunden, nachhaltigen und integrativen Lebensmittelsystem in Europa“.

Aktuelle Lebensmittelsysteme sind für bis zu 30 % aller Treibhausgasemissionen und große Mengen an Wasserverbrauch der EU verantwortlich. Durch Transport und intensive Produktionsmethoden tragen diese Systeme zur Umweltverschmutzung und zu damit zusammenhängenden Erkrankungen bei. Außerdem sind 55 % der Erwachsenen und jedes vierte Kind in Europa übergewichtig oder fettleibig. Das Maß an nicht übertragbaren Krankheiten nimmt zu und hat erhebliche negative Auswirkungen auf Leben und Gesundheitsbudgets. Darüber hinaus sind aufgrund der gesunkenen Zahl der Anbieter und Käufer und der aggressiveren Marketingstrategien qualitativ hochwertige Lebensmittel nur für die gebildetsten und wohlhabendsten Konsumenten zugänglich geworden, was die bestehenden gesundheitlichen Ungleichheiten noch vergrößert. Es ist offensichtlich, dass die GAP den modernen Herausforderungen im Zusammenhang mit dem Klimawandel, der wachsenden Prävalenz von Fettleibigkeit und sozialen Ungleichheiten nicht gewachsen ist.

Die Einsicht, dass Lösungen in integrierten Aktionen liegen, wächst. Die politische Kohärenz zwischen gesundheitlichen, sozialen, umweltbezogenen und wirtschaftlichen Zielen ist von entscheidender Bedeutung. Einige Länder integrieren Gesundheit und Nachhaltigkeit in nationale Ernährungsleitlinien und es gibt immer mehr innovative Maßnahmen zur Verkürzung der Lebensmittelversorgungsketten sowie zur Zusammenführung einschlägiger Interessenträger. 

Es muss jedoch noch mehr getan werden. EuroHealthNet fordert, dass Indikatoren für eine nachhaltige Entwicklung in den wirtschaftlichen und sozialen Vorzeigeprozess des Europäischen Semesters und in die jährlichen Empfehlungen integriert werden. Darüber hinaus werden stärkere Regulierungsmaßnahmen benötigt, um eine übermäßige Marktkonsolidierung zu unterbinden und es kleineren Wirtschaftsakteuren und Innovatoren zu ermöglichen, wettbewerbsfähig zu bleiben und zu überleben. Die EU muss ihr Lebensmittelsystem unbedingt transformieren, um die Ziele der nachhaltigen Entwicklung bis 2030 zu erreichen.

Um mehr zu erfahren, lesen Sie unsere neue Policy Précis „Wege zu einem gesunden, nachhaltigen und integrativen Lebensmittelsystem in Europa“.

Policy Briefings

The European Semester 2019 from a Health Equity Perspective

The European Semester is the EU’s annual cycle of policy coordination. It reviews the economic and – since recently – social situation in Member States and in the EU as a whole. It makes country specific recommendations at national level to bring Europe towards commonly agreed goals.

EuroHealthNet’s report contains guidance for both the European Commission and public health actors to help to assess and enhance their efforts in making full advantage of using the Semester, the European Pillar of Social Rights and EU funding mechanisms to improve public health and health equity.


Policy Précis

The role of vaccines in reducing health inequalities

Vaccination Fatsheet image

Vaccination is a highly cost effective health intervention, but not all children benefit from it. It seems that the most vulnerable children in our societies are the least likely to be fully vaccinated. The new EuroHealthNet factsheet on Childhood, health inequalities, and vaccine-preventable diseases explores the links between social and economic inequalities and childhood vaccination, and what can and is being done to improve vaccination rates for people in low socio-economic groups.

Using Health and Social Data to monitor Health Inequalities

Policy Precis Banner Health Information Systems

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 Briefings

The European Semester 2018 from a health equity perspective

EuroHealthNet logo

EuroHealthNet has engaged with its national, regional, and local health experts to analyse how the European Semester process can affect the health and wellbeing of European citizens, and address existing inequalities.

The European Semester is the EU’s annual cycle of policy coordination. It reviews the economic and – since recently – social situation in Member States and in the EU as a whole. It makes country specific recommendations at national level to bring Europe towards commonly agreed goals.

EuroHealthNet’s report contains guidance for both the European Commission and public health actors to help to assess and enhance their efforts in making full advantage of using the Semester, the European Pillar of Social Rights and EU funding mechanisms to improve public health and health equity.

Analysis of the Multiannual Financial Framework 2021-2027

MFF analysis

Health is an enabler of social and economic participation. It is therefore vital to address key factors that undermine people’s opportunities for good health and wellbeing.

Earlier this year the European Commission published a set of proposals for the next EU budget 2021-2027, the Multiannual Financial Framework. Many of the areas affected by the EU budget are relevant to health – an issue most Europeans want more EU action on[1]. EuroHealthNet has therefore produced brief analyses of 14 budget proposals from a health and health equity perspective.  They cover a diverse range of topics including research, education, agriculture, investment, the digital agenda, and structural reform as well as those traditionally associated with health and social issues.

Download the report

[1] 70% of Europeans want to see more EU action on health and social security. http://www.europarl.europa.eu/external/html/eurobarometer-052017/default...


Policy Précis

Making the link: mobile Health (mHealth)

Policy Precis mHealth image

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

Policy Precis Gender

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?

Elements of the Social pillar

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

Policy précis 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

Policy Briefings

The European Semester: A health inequalities perspective

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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.



Policy Précis

EuroHealthNet welcomes WHO action on migration, health and sustainable development

The European Pillar of Social Rights and its relevance for health and social equity

The European Pillar of Social Rights and its relevance for health and social equity

Policy Briefings

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] Herbig et al. (2013) - Health in the long-term unemployed. Dtsch Arztebl Int. See 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.

[ii] Norström et al. (2014) - How does unemployment affect self-assessed health? A systematic review focusing on subgroup effects. BMC Public Health. Available here


Policy Précis

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

Policy Briefings

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.


Policy Précis

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

Policy Briefings


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