Three ways forward in a post COVID-19 world

By Caroline Costongs, EuroHealthNet Director.

There are three important ways forward in addressing the pandemic and its impacts on health and wellbeing in the years to come. Firstly, working with other sectors is fundamental to deal with the myriad of mitigation measures in the best possible ways. Secondly, investing in the social side of crisis preparedness is as important as biomedical preparedness. And thirdly, strengthening health promotion needs to finally get off the ground, as many of its components, notably community action, personal skills development, supporting environments and reorienting health services are more needed as ever.  Action can be taken, as exemplified by the many articles of this edition of the online EuroHealthNet Magazine.

Work better together

Health and other inequalities were rising even before COVID-19. We can find evidence of this from the Marmot review in England, and growing social unrest such as the yellow vests movements in France. People have been left behind and this pandemic will have made their situation worse. We need a dedicated approach to address the health and wellbeing of all people in Europe. This includes working more closely with the social sector on poverty, unemployment, addressing inequalities in education, in environment etc. Working in the health silo is no longer feasible. We can no longer ignore action on the so called ‘SEEDs’ (social, economic, environmental determinants) of health.

Invest in the social side of crisis preparedness

The scale of investments needed is huge. We have seen a large mobilisation for funds towards crisis preparedness. This has mainly been to help equip health professionals and hospitals, and increase medical capacity following a bio-medical approach. However we also need to finance preparedness through a psycho-social approach. Some of the articles in this magazine demonstrate how investing in resilience, in mental health, social support can be done. I am also proud to say that EuroHealthNet recently launched an e-guide on financing these upstream approaches to health. We did this in the context of the WHO Coalition of Partners and the EU Programme for Employment and Social Innovation (EaSI). It is an underdeveloped area and much more work is needed to advance financing prevention and promotion as well as social investment.

Strengthen health promotion

The COVID-19 pandemic accelerated work in a relatively new area, namely on behavioural sciences and insights. It is an important approach, including studies to find out whether people comply with the behavioural rules to prevent the virus from spreading. Behaviour change has since long been at the heart of health promotion. We learnt that for many people, behaving in healthy ways or making a healthy choice is a luxury. Many groups have no choice. We need to create opportunities and enhance the capability of people to improve health, while addressing the commercial determinants of health. This is the time where we should scale up health promotion as an urgent and vital approach to address COVID-19 and other crisis in the near future. The health promotors under our readership should feel empowered to sit at the various decision-making tables at European, national, regional as well as local levels providing behavioural insights alongside cultural, socio-economic and environmental insights.

I hope you will enjoy the articles in this edition of the magazine. They inspire us to work with other sectors, to address the upstream factors related to crisis preparedness and strengthen health promotion approaches to tackle one of our most widespread health challenges of the century.

In this edition

This 15th edition examines how members from the EuroHealthNet Partnership responded to the COVID-19 crisis. We hear from Italy, the first European country to be hit with the virus, about trying to understand the spread of the disease and the impact of health and health inequalities while under immense pressure. Colleagues Italian National Institute of Health (ISS) explain their role in advising the government on appropriate measures and disseminating information and highlighting the links to social and economic factors.

We also learn about the practicalities and results of nation-wide surveys aims at informing and supporting policymakers and government during the pandemic. Santé Publique France’s survey examines population mental health, which significantly worsened in the first weeks of the lockdown. RIVM’s Corona Behavioural Unit specifically explores human behaviour during the pandemic – how well people comply with the different measures, and whether different population groups respond to measures in different ways.

As the crisis has laid bare deep-rooted health inequalities, the Health Foundation looks at lessons learnt from the Marmot reviews and how these can help prevent widening of those inequalities post COVID-19. More than ever, we need to build long-term cross-government strategies to tackle health inequalities that empower communities to improve health and wellbeing for all.

The pandemic has changed the way we think about and do mHealth and tele-health. In this edition, we look at some of the ways service delivery has changed in times of physical distancing, and existing practices we can build on.

During times of confinement, the Slovenian National Institute of Public Health (NIJZ) used its primary care centres to offer mental health support by phone. Meanwhile, the Municipality of Riga responded to changing mental and psycho-emotional health needs, especially of families, children and teachers, by increasing cooperating between different institutions and care providers. Colleagues from the Bulgarian National Center of Public Health and Analyses (NCPHA) share lessons from their pilot study, designed before the pandemic arrived, that aimed to empower patients to prevent developing diabetes through the use of an app.

Age and isolation have been much discussed in the context of COVID-19 but are far from new topics. NIJZ tells us about an international project to enable ageing populations in remote areas to live independently for as long as possible. How can we coordinating efforts from different sectors and governmental levels to create tailored initiatives to respond to territorial needs?

Nearly all of us have seen changes to our working lives this year. Indeed, COVID-19 might have permanently changed the world of work. As working from home remains the norm in many countries, FGÖ offers practical guidance on how to make telework more health-promoting. We also cover gender-sensitive workplace health-promotion. FGÖ shares with us the results of an extensive analysis of literature and good practices on the topic, resulting in a set of criteria and a checklist to gender-prove every workplace health promotion initiative.

Caroline Costongs
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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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