Inequalities on the rise

By Caroline Costongs, EuroHealthNet DirectorCaroline Costongs

Working together to tackle health inequalities in Europe is more important than ever before. Inequality and the socioeconomic divide is on the rise, as we can see daily in the news. It is threatening the sustainability of our society, and clearly affecting our health and wellbeing. The recently published Health at a Glance: Europe report makes for uncomfortable reading. Increases in life expectancy have stalled in many EU Member States. Since a steady 2-3 year life expectancy increase between 2001-2011, these improvements slowed down to just half a year. The progress is slower in the Western European countries and most likely due to the effects of austerity measures on health and other public spending. In the US we even see a decline in life expectancy, which is a worrying signal for Europe.

Moreover, life expectancy continues to be marked by clear inequalities: across the EU, people with a low level of education can still expect to live six years less than those with a high level of education. In some countries, this difference can be even up to ten years. Inequalities in Healthy Life Expectancy – the number of years lived free of activity limitations due to health problems – are much larger. In addition to a decreasing quality of life for many people in Europe, this has marked economic consequences due to a less productive workforce, earlier retirements and higher long-term care needs. Mental health problems alone already lead to a cost of €600 billion per year in the EU! Even though Europe is one of the wealthiest continents on the planet, we seem not to be able to respond effectively to these problems.

So, what can public health people do? The Health at a Glance report recommends four areas of action: as a first priority it highlights the need to strengthen prevention and health promotion measures. Then, ensuring effective and people-centred health systems, improving access to health care for all, and building more resilient health systems. The report indicates that up to one-fifth of health spending is wasteful and could be reallocated to better use without compromising access or quality of care – for example to preventive and health promotion measures.

We should not only look at health care budgets alone. We need to be much smarter and tap into budgets of other sectors by implanting health promoting suggestions in their work. Such as health awareness training in job centres, sexual health education in school settings, more bike lanes and green areas as part of transport and urban planning, healthier nutrition in social care homes etc. In several articles of this 12th edition of the EuroHealthNet magazine, you can read about the good work being done across Europe. In addition, legislative measures that improve health and wellbeing can be very cost-effective. Taxation of health harmful products can even bring more money in. You may be interested to read

Bike Photo by Cristiana Raluca from Pexels

EuroHealthNet’s seminar report on “smart investments in health promotion and prevention’’, or our health equity analysis of the proposed long-term EU budget. One article in this edition of the EuroHealthNet Magazine describes how public health actors can make better use of European Structural and Investment Funds.

You might notice that this edition of our magazine looks very different. We have completely redeveloped the magazine in order to more effectively bring you the information you want. I hope you enjoy our new look – and the many interesting articles from our Partnership and beyond.

For example the article from The Netherlands provides insights into how their public health situation would change in the future, if no action would be taken. Alongside demographic changes, there will be an increase in the number of people suffering from chronic diseases and loneliness. Social and health issues would accumulate among lower socio-economic groups.

In this edition we also have two articles on food and nutrition from Belgium, both taking different approaches to making their communities healthier and more sustainable. In one article (available in both English and French) we hear about troubling levels of undernutrition amongst residents of care- and nursing homes and the solutions that have been developed. The article from Flanders is about Ghent en Garde, a city- wide food policy which aims to transform the local food system and to ensure that everyone has access to sustainably produced, healthy, and affordable food.

We also hear about European and national policies affecting public health. There is an explanation of the European Semester, the EU’s annual cycle of economic and social policy coordination, and how public health bodies can use it to support their work and steer the direction of public health in their countries. If you work in public health planning or strategy, you may wish to familiarise yourself with these high level processes.

In terms of national policy, we included an article about the new German prevention act, and the work underway to explore and use the links between health, unemployment, and health promotion. That article is available in both German and English. From the regional level, there is an article on integrated care and in particular on the use of a newly developed model to facilitate exchange and learning between regions, and used in Puglia and Scotland.

Finally we touch on child and young people’s health. We hear from Hungary about a study to identify different groups with similar health-related behaviour, and how this information can be used to tailor effective interventions. In Wales, we found encouraging work done for young people. While implementing an initiative to reduce the risk of sexual exploitation, it was discovered that many young people with learning disabilities or autism were not receiving sex education, and those who were, were getting the wrong kind. But today, thanks to SAFE – Sexual Awareness for Everyone – those same young people have the opportunity to learn and discuss sexual health, safety, and other aspects of sexuality with their peers.

Tackling health inequalities is an issue of solidarity and social justice. Above all, it is key to a sustainable and human society.

Caroline Costongs
Director at | + posts

Caroline Costongs is Director of EuroHealthNet. She leads a multi-disciplinary team that acts on EU and national policy, advocacy, research and capacity building. Caroline represents the Partnership at various European events and platforms of EU Institutions, is part of the WHO Coalition of Partners on strengthening public health services and is member of the International Congress Council for the 16th World Congress on Public Health in Rome in 2020.

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