The European Structural and Investment Funds support investments in national, regional, and local projects that contribute to job creation and a sustainable European economy. In this article, we look at a recent project that explored the impact the ESI funds have had on health and the lesson learnt for health promotion.
By Andrew Barnfield
The European Structural and Investment Funds (ESIF) are a set of instruments that have been designed by the European Union to implement its regional policy. The idea behind the funds is to help lessen regional disparities in terms of income, wealth, and opportunities. As such, the poorer regions of Europe obtain more support. However, all European regions are eligible for funding under the different funds and programmes that are available. Over the period 2014-2020, the total budget is nearly €640 billion, which represents more than half of the total EU budget with the most relevant funds for health investments being the European Social Fund (ESF) and the European Regional Development Fund (ERDF).
EuroHealthNet worked within a consortium of partners on the ESIF for Health project to explore the impacts the ESIF had on health in 2014-2020 period by mapping Member State programming and project spending. The idea was to uncover the extent to which the funds are supporting different types of health-related interventions. The project also compared spending trends with the main EU policy objectives, as well as relevant national objectives set out in the European Semester process, which coordinates economic, fiscal, and recently social policy across the EU. The objectives relate to the need to manage public spending pressures that have been caused by population ageing and the growing prevalence of chronic diseases. They also refer to encouraging labour participation by preventing health-related exits from the workforce.
The project involved a review of funded projects that found 7,404 health-relevant projects of which 2,535 projects across twenty-three member states addressed health promotion and disease prevention, healthy ageing, and healthy workforce. The number of projects in this area corresponds to 34% of all the funded projects. The value of these projects amounts to EUR 1.9 billion or 24% of the total budget. The average size of the funded projects was EUR 0.8 million. The highest number of projects was found to be in Poland (1,776 projects) and Germany (216 projects). A significant number of projects were also recorded in Belgium, UK, and Estonia. As expected the highest level of spending were found in Poland with the UK, Slovakia and Latvia being among the other leading recipients. Overall, due to ESIF health-investments, 41.7 million people in the EU will benefit from funded health projects during 2014 to 2020. The large number of projects and relatively low amount of money means that projects in this area are smaller than other areas, and that the structural funds attracts projects that are trials or exploratory projects that cannot find funding from national budgets. On the whole, the ESIF project signifies that health promotion finance needs to be reassessed for future health and societal challenges.
In terms of health promotion we see a lot of projects that are fairly small in terms of funded amount. This means that the ESIF are an important opportunity for organisations, institutes, and managing authorities to find funding for promising projects that cannot be funded with national funding. In some cases once the projects were seen to be working they could then turn to national funding to guarantee the project’s future. In Croatia, the Institute of Public Health is leading an EU 4 million project (Healthy Living) that aims to improve the health of the population by reducing behavioural, biomedical, and socio-medical risk factors through the creation of supportive environments enabling good health and high-quality life for the citizens of Croatia. Specific objectives of the project are improving knowledge and attitudes on the importance of healthy nutrition and physical activity for the prevention of overweight and obesity for all society.
Other projects funded through ESIF funds include two that are a partnership between Estonia, Finland, and Latvia that tackle healthy ageing, social exclusion, and child health. The first, Let us be active! (EUR 264,007) developed new volunteering activities for seniors in the cities of Pärnu, Riga, and Turku to tackle social exclusion and improve healthy ageing. The project sought to make connections between the cities to share experiences and co-develop the most appropriate support system. The second, EmpowerKids (EUR 261,460) addressed the problem of social exclusion and inadequate health information and social advice for children from low-income families. The project developed an online, user-friendly game targeted at children aged 6-12. This tool gives the opportunity for social and health professionals to discuss with children the topics of nutrition, physical activity, and daily routine and family resources and provide advice in an attractive way. A comprehensive database of health projects funded through European Structural and Investment funds is available at esifundsforhealth.eu
During an ESIF for Health workshop that focused on health promotion, led by EuroHealthNet President Mojca Gabrijelčič-Blenkuš, held in Zagreb, Croatia discussions focused on the need to take a health equity approach to future funded projects. The ESI funds should focus on projects that effectively reduce health inequalities and new life burdens (media messages, different environment affects, and smart interventions). This would signal to countries and to other stakeholders that ESIF have a social purpose that is specifically aligned to reducing health inequalities and rooted in a social determinants of health approach. There is a clear need to educate the educators and help to instigate a change in the mindset within the medical field. Health promotion needs to be actively inserted in all projects that feature health or healthcare. Education of the policy decision makers in ‘Health in All Policies’ principles and in public health issues should also be a priority. The EU Commission should engage in this sort of long-term strategic thinking in association with the European Structural and Investment Funds.
EuroHealthNet runs a help desk for partners interested in using European Structural and Investment funds for their work, to help guide them through the process.
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