Europe's increasingly unequal health outcomes

Increasingly evidence suggests that in many parts of Europe, the difference in health outcomes between socio-economic groups is increasing whilst the link between status and health outcome is becoming stronger. Additionally, the gap between member states is increasing. This is troubling news not just to health care professionals, but to governments and wider civil society as well- even more so when we consider that many poor health outcomes are avoidable by reasonable means.

The rising inequalities have consequential costs to society, both in terms of individual health and wellbeing, as well as lost economic contributions and high health and social care costs. Solutions to these problems exist, despite their complex and deeply embedded roots. The severity of the situation is growing, but so is desire for change.

In January this year 30 organisations, led by EuroHealthNet, issued a call for action on health inequalities.

European Institutions and member states are urged to recognise the central role that health and health equity play in building strong and sustainable social market economies, to put health inequalities at the forefront of their priorities, and to adopt equity as an indicator of system performance. Some specific recommendations for progress have also been made.

Health Equity should be a strategic objective, with progress measured against defined indicators. This will require the input of, and evidence from, a wider range of sectors than have previously been considered.

Cooperation across sectors needs to be improved, at EU and national levels, to ensure that development is sustainable and holistic, covering all socio-economic groups.

All must have access to health care. This will require special focus on regulations, legislation, and policies which currently restrict access to marginalised groups. Restricting access violates individual rights and eventually increase health costs.

The principle of universal access applies to health professionals, too. The work of all actors in health systems need to be valued; they must have access to the necessary knowledge and training to provide person centred services. They also need the capacity to recognise and address inequalities as they have an essential role of bridging across sectors.

A greater focus on health promotion, disease prevention, and health literacy is needed targeting the most disadvantaged in particular. Legislative measures which prevent ill health across the population, like smoke free legislation and minimum unit pricing for alcohol which have been proven to reduce inequalities should be further considered.

To properly assess inequalities and measure the efficacy of interventions there must be investments in comparable disaggregated data at local, regional, and national level which considers gender, socioeconomic status, migration status, and national origin or ethnic background. There must also be investment within health administrations to analyse this data.

Much can be done at national, regional, and local levels, but the European Institutions have policy and finance mechanisms available which will improve the situation.

This year will see a major development in European Policy: The establishment of the European Pillar on Social Rights which will identify common principles, needs, and challenges in employment and social policies amongst Eurozone states. Health inequalities need to be considered from the outset, and a consideration of the impacts on the health of all socioeconomic groups should be ingrained.

The full statement, background paper, and further information about health inequalities can be found on the EuroHealthNet website www.eurohealthnet.eu and at www.health-inequalities.eu. Interested bodies can still add their endorsement to the statement.

EuroHealthNet is the European Partnership for improving health, equity, and wellbeing; its members are public bodies at all levels of governance across Europe. It works with members and the European Institutions to develop and implement evidence based and effective health policy, support health in all policies, and ensure knowledge exchange and development between organisations and across borders.