I write this editorial having just returned from a meeting at an economics think-tank. There, I was pleased to hear arguments for more investments in health promotion and disease prevention from the Economic and Financial Affairs Directorate General (DG) of the Commission – in the speaker’s words: “…this cannot be stressed enough”, while the Director General for Health concluded that “health promotion and disease prevention pave the way for a more effective and efficient health system”. Industry representatives highlighted the need to make a business case for prevention.
It became clear that we, as health promotors, need to ‘sit at the table’, because we are ‘on the menu’. I spoke about health inequalities and the need to also address underlying causes, “health is good for the economy, but it is also the other way around, the economy should serve health and wellbeing of people”. The need for health systems to transform is being recognised, and momentum has been built to shift investment to prevention, health promotion and addressing inequalities.
In November, the European Commission published the State of Health in the EU report, which I recommend you read. In particular the country profiles will be very helpful and are translated in various languages. The conclusions of the companion report are strong and important. They acknowledge issues we have known about for a long time, but we have also seen that it is very difficult to change vested interests within traditional health care systems.
Our health systems need to be sensitive to people’s diverse needs and specific socio-economic conditions or cultural backgrounds. We need to be vigilant that we maintain equal access for vulnerable groups, and deliver equitable health outcomes. The transformation of health systems will most likely see an increased ‘freedom of choice’, which means more individual responsibility for health. However, not everyone has the capability to take health in their own hands. We already see that people choose for unhealthy products and do not make optimal use of health services. We also know that not everyone has the same opportunities to choose. Not all choices are equal.
The same applies for the digital health agenda. New technologies will not reach everyone and innovation can exacerbate inequalities. Those older, poorer or digitally illiterate people will be left out and left behind. Issues related to privacy and security of data could influence health inequality as can digital marketing.
As the State of Health in the EU report states: “Health inequalities are one of today’s major public health challenges. It is a signal that current health systems are not sufficiently able to effectively deliver preventive and curative services to those populations with the greatest needs. “
However, I would argue that it is also a signal that other global, national, or local policies can be contra productive and even undermine health. Good health is not only an outcome from one sector or of health systems, but from coherent and comprehensive action by different sectors and policies.
For this reason I am delighted to present you with a diverse selection of articles in this 10th edition of the magazine, all of which reflect a proactive approach to working across sectors and adopting new solutions to long-term problems.
We look at a new initiative in Sweden to help public services become more results-oriented and at how social impact bonds can help fund public health interventions. From Italy, we learn how the Global Health Centre in Tuscany region is linking professionals to collaborate on migrant health. In Flanders, there is new updated guidance on nutrition and physical activity for the wider public.
We have some updates from the world of research too. We hear how a new research centre, CHAIN, plans to ‘create a global transformation in actionable health inequalities research.’ Can lay people do public health research? This question is considered in the article looking at a recently tested model to describe and analyse the benefits and challenges of citizen science in public health.
Several contributions show public health ‘in action’. Ongoing European initiatives which aim to improve health, reduce health inequalities, and benefit the environment can now be explored in the INHERIT database – inspiring for those of us who are keen to link health promotion with the sustainable development goals. We also have articles on the experiences of LGBTI people accessing health care – the barriers and discrimination they face and how they can be overcome, and on the shared experiences of vulnerable groups and what can be done to support them.
We also look at ‘health diplomacy’ in the past, present, and future following a new WHO publication on this topic.
This edition includes an interview on a new public health concern which is relevant to us all: digital marketing. How is the digital world changing the way we are ‘sold’ healthy and unhealthy lifestyles? What effect will this have on children in particular?
I hope you enjoy this edition of EuroHealthNet magazine. Information about contributing to the next edition in spring 2018 can be found in our updated submission guidelines.
Caroline Costongs is Director of EuroHealthNet.