Reducing health inequalities

July 2017

Dealing with health inequalities is not a new challenge. We have more than 30 years of experience in this field. Yet, inequalities remain a constant problem despite improvements in data, knowledge, policies, and interventions. In our communities, health inequity is a circle that needs breaking. It is both the catalyst and product of unequal economic, social, and environmental conditions. This is inherently unfair, unjust, and avoidable.  Reducing health disparities is important, and the upward trends for such differences call for further innovative, collaborative actions at all levels.

At EU level there is a stack of policies that show where action is needed and why. Some of these carry a health label [Solidarity in Health (EC 2009), EU Council conclusions on Health and Equity in All Policies (2010) and Towards Modern, Responsive & Sustainable Health Systems (2011), the EC/WHO Joint Declaration (2010) and Health 2020]. Others also have a profound strategic relevance e.g. EU Cohesion Policy 2014-2020 [COM (2011) 615 final], Europe 2020, the EU Charter of Fundamental Rights, as well as the Territorial Agenda of the European Union 2020 (TA2020).

Recent work undertaken by HCN includes commissioned work for WHO EURO and co-developing and being a partner in a project led by Prof Helmut Brand at the University of Maastricht.

WHO EURO – HCN was commissioned to write a policy briefing paper How health systems can address health inequities through improved use of Structural Funds (WHO EURO 2010). This paper was a deliverable for the WHO/European Commission joint project on equity in health (2006WHO03). It is one of six briefings on policy issues produced through the project, which has as its focus improving health intelligence, building capacity and know-how for policy-makers and practitioners on tackling socially determined health inequalities as part of health system performance.

HealthEquity-2020 – HCN drew on EUREGIO III, EU policies and the WHO Briefing Paper to co-develop and manage a 42-month long EU project, HEALTH EQUITY-2020 (HE2020). This looked at how tackling health inequalities in EU regions could be done differently, putting in place sustainable foundations for effective actions.  The project took a highly interactive approach with participating regions. The general objective  was to assist Member States & regions to develop evidence-based regional action plans on reducing health inequalities, which also informed the use of Structural Funds in the present and new programming period. Specifically, it was examined how participating regions tried to align local needs and priorities to the priorities and opportunities of national and regional strategies e.g. ESIF Partnership Agreements, ESIF Operational Programmes, national health strategies and, occasionally, previous work to address health inequalities. The key learning points from the process were

  • the need for evidence-based planning  to tackle health inequalities,
  • a menu of regional support methods need to be offered as regions are eager to exchange ideas, policies, actions and talk about stories, successes and even failures with other regions about tackling inequalities, including in the wider context of regional development
  • inequalities is a multifaceted problem that requires intersectoral work to have impact and sustainability and is a learning process in its own way
  • we need to maximise the impact of regional planning  by building on the work of regional/local action groups in prioritising local needs and getting priorities for tackling health inequalities integrated into a regional or even a national planning cycle is one of the biggest challenges for regions
  • alternative sources of funds are necessary to be involved. e.g. regional action plans developed by regions to address factors contributing to health inequalities should fully appraise ESIF options, as well as  fitting health within the European Structural and Investments Funds (ESIF) 2014-2020 and to help regions thinking ’outside the health box’ when securing funding for actions.

Tools to support the recommendations above have been developed and disseminated by the HE2020 consortium and can be accessed at

Published by

Jonathan Watson

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