EuroHealthNet

Health inequalities can be defined as “systematic differences in health between social groups” and populations.[2] Health inequities, on the other hand, are unfair, “avoidable inequalities” of populations within and between countries.[3] The WHO’s Committee on the Social Determinants of Health stated that the social gradient, - systematic differences between populations - was unfair; “killing people on a grand scale”.[2]

Perhaps the clearest example of health inequalities can be seen in life expectancy. The difference between life expectancy at birth can vary by over a decade between European Union member states. For example, in 2012 the life expectancy at birth for Swedish males is 81 years, whereas in Lithuania a baby born could expect to only live until 68.4.[4] In terms of healthy life years (years of life lived without disability) the gap is even greater, with Estonian males born in 2012 predicted to have 18.4 fewer healthy life years than their Maltese counterparts. These disparities in life expectancy don’t just exist at the macro scale, but can be seen right down to the neighbourhood level; with differences reaching into the decades.[5] Such disparities are found worldwide, with a whole area of research looking at demographics and improving life expectancy.[6]

Inequalities in health have been an important part of the work of the European Union (EU) since 1992 when specific competencies for public health were included in the Maastricht Treaty. However, as noted above large differences in health still exist between and within all countries in the EU, and some of these inequalities are widening. The EU institutions contribute to reducing health inequalities across the social gradient through a variety of strategies, policies, programmes and initiatives which affect the socio-economic determinants of health.

The Health programmes, the latest being 2014-2020, are one of the Commission’s main instruments for implementing policies aimed at reducing health inequalities. In 2009 the European Commission recognised the challenges and importance of reducing health inequities.[7] In June 2010 the EU adopted its new strategy - Europe 2020: A strategy for smart, sustainable and inclusive growth.[8] The document sets out the proposed economic, social and environmental development for the EU over the next 10 years. Although the strategy does not directly address health inequalities, it clearly acknowledges the need to fight inequalities as a prerequisite for growth and competitiveness. The EU has indeed committed to lift 20 million people out of poverty by 2020. This will be pursued through the European platform against poverty and social exclusion, one of the Commission’s seven 'flagship initiatives’ i.e. the mechanisms through which the EU 2020 strategy will be delivered. This process will undoubtedly impact health inequalities between and within EU countries.

EuroHealthNet seeks to address the factors that shape health and social inequalities, building the evidence base for public health and health-related policies and health promotion interventions in particular to level up the social gradient in health. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, economic or social condition. EuroHealthNet therefore stimulates and supports the implementation of integrated approaches addressing the social determinants of health by operating at all levels and across the political spectrum in relevant health, social and employment fields.

• Determine (2007-2010)[9] An EU wide initiative to stimulate action to address the social and economic determinants of health (SDH) and to improve health equity in the EU and its Member States
• GRADIENT (2009-2012) [10] Identifying and evaluating policies which could level-up the socio-economic gradients in health among children and young people in the EU
• Spread (2011-2012) [11] Development of scenarios of sustainable lifestyles in 2050 focusing on sustainable living, moving, consuming and healthy living
• Crossing Bridges (2011-2012) [12] Advancing the implementation of Health in all Policies (HiAP) approaches in EU Member States
• Equity Action (2011-2014) [13] Assisting the Member States to develop tools to better enable health inequalities to be addressed in cross-government policy making
• IROHLA (2012-2015) [14] Identifying, validating and presenting evidence based guidelines on addressing health literacy needs of the ageing population in Europe
• DRIVERS (2012-2015) [15] Addressing the strategic determinants to reduce health Inequity Via 1) Early childhood development, 2) Realising fair employment, and 3) Social protection
• Quality Action (2013-2016) [16] Using practical Quality Assurance (QA) and Quality Improvement (QI) tools to increase the effectiveness of HIV prevention in Europe
• CHRODIS (2014-2017) [17] European Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (CHRODIS-JA)
• INHERIT (2016-2019) [18] INter-sectoral Health and Environment Research for InnovaTion (INHERIT)
• CHRODIS PLUS (2017-2020) [19] CHRODIS PLUS is a high-level response by the EU to support Member States by stepping up together and sharing good practices to alleviate the burden of chronic diseases.
• Joint Action Health Equity Europe (JAHEE). JAHEE is a collaborative action between 25 European countries financed by the third Health Programme[20] (2014-2020), a funding programme managed by the Directorate-General for Health and Food Safety (DG SANTE) and the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA).

EuroHealthNet is a non-profit partnership and receives funding from:

• DG Employment, Social Affairs and Inclusion (DG EMPL) through the Employment and Social Innovation (EaSI) financing instrument
• Its members and associate members in annual fees decided by the General Council
• Its members and associate members through specific grants or donations
• The European Commission for co-funded work in Framework Contracts, specific policy or research projects, Joint Actions, tenders, studies and reports

Members are national and regional institutes, academic and research centres, national and regional authorities and government departments. They operate networks in their communities comprising regional and local authorities, practitioners and professional bodies and non-profit organisations, and have wide communications and consultation links with wider stakeholders. Members receive core services but also participate in the three EuroHealthNet platforms (PRACTICE, POLICY, RESEARCH).

• Austria: Austrian Health Promotion Foundation (FGOE) [21]
• Belgium: Agency for a Life of Quality (AVIQ)[22]
• Belgium: Flanders Institute for Healthy Living[23]
• Bulgaria: National Center of Public Health and Analyses (NCPHA)[24]
• Czech Republic: National Institute of Public Health (SZU)[25]
• Denmark: Zealand Region [26]
• England: The Health and Europe Centre, NHS Kent & Medway [27]
• Finland: National Institute for Health and Welfare (THL) [28]
• Finland: Finnish Federation for Social Affairs and Health (SOSTE)[29]
• France: National French Agency of Public Health[30]
• Germany: Federal Centre for Health Education (BZgA)[31]
• Greece: Institute of Preventive Medicine Environmental and Occupational Health (PROLEPSIS)[32]
• Hungary: National Public Health Center [33]
• Ireland: Institute of Public Health in Ireland (IPH)[34]
• Italy: National Institute of Public Health (ISS)[35]
• Italy: Federsanita ANCI[36]
• Italy: Piedmont Regional Health Promotion Documentation Center (DoRS)[37]
• Italy: Regional Healthcare and Social Affairs Agency of Puglia [38]
• Italy: Veneto Region[39]
• Italy: Tuscany Region[40]
• Latvia: The Centre for Disease Prevention and Control (CDPC) of Latvia [41]
• Latvia: Riga City Council Department of Welfare [42]
• Luxembourg: Luxembourg Institute of Health [43]
• Luxembourg: Luxembourg Institute of Socio-Economic Research [44]
• Netherlands: National Institute for Public Health and the Environment (RIVM) [45]
• Netherlands: Pharos Dutch centre of expertise on health disparities [46]
• Norway: Norwegian Directorate of Health [47]
• Poland: National Institute of Public Health - National Institute of Hygiene [48]
• Portugal: National Institute of Health Doutor Ricardo Jorge [49]
• Scotland: NHS Health Scotland [50]
• Slovakia: Ministry of Health of the Slovak Republic, Section of Health [51]
• Slovenia: National Institute of Public Health (NIJZ) [52]
• Spain: University of La Laguna [53]
• Spain: Ministry of Health, Consumer Affairs and Social Welfare [54]
• Sweden: Region Stockholm [55]
• Sweden: Public Health Agency of Sweden [56]
• Sweden: Public Health Committee - Region Västra Götaland [57]
• Wales: Public Health Wales [58]

RESEARCH is EuroHealthNet’s research-oriented platform. It aims to promote evidence-based approaches to health and wellbeing across all groups in society. Associate Members include leading centres of research and public health who are committed to improving the uptake of evidence in policy making processes.

• Belgium: Université catholique de Louvain, Institute of Health and Society [59]
• Denmark: Roskilde University [60]
• England: Blackburn with Darwen Borough Council, Public Health Department [61]
• England: Newcastle University, Institute of Health and Society [62]
• England: University of Brighton, School of Health Sciences [63]
• Italy: Venice's Community Social Cooperative Company [64]
• Netherlands: Netherlands Institute of Mental Health and Addiction (Trimbos Institute) [65]
• Netherlands: Radboud University Medical Center [66]
• North Macedonia: Institute of Public Health of the Republic of North Macedonia [67]
• Norway: Norwegian University of Science and Technology, Faculty of Social Sciences and Technology Management [68]
• Norway: Oslo Metropolitan University [69]
• Portugal: University Institute of Lisbon, Centre for Psychological Research and Social Intervention [70]
• Spain: University of La Laguna [71]
• Sweden: Swedish Association of Local Authorities and Regions (SALAR) [72]

POLICY is EuroHealthNet’s advocacy and policy-oriented platform and brings together organisations willing to work on addressing the wider determinants of health.

• England: The Health Foundation[73]
• Netherlands: Dutch Association of Mental Health and Addiction Care (GGZ Nederlands)[74]
• Netherlands: FNO zorg voor kansen[75]
• Sweden: Swedish Association of Local Authorities and Regions (SALAR) [72]

PRACTICE is EuroHealthNet's platform to help build capacities for the design and implementation of strategies and interventions to improve health, address the social determinants of health and reduce health inequalities.

• England: The Health Foundation[76]
• France: Appic-Santé[77]
• Italy: Association Pianoterra [78]
• Netherlands: Radboud University Medical Center[79]
• Portugal: Nossa Senhora do Bom Sucesso Foundation[80]

The EuroHealthNet partnership invites ministerial and governmental bodies to participate in a limited, non-voting capacity.

• Belgium: Federal Public Service - Health, Food Chain Safety and Environment [81]
• Lithuania:Ministry of Health (Lithuania) [82]
• Malta: Public Health Regulation Department [83]
• Romania: Ministry of Health [84]
• United Kingdom: Department of Health [85]

• Social determinants of health
• Health promotion
• Health equity
• Sustainable development

• http://eurohealthnet.eu/
• http://healthyageing.eu
• http://www.health-inequalities.eu/
• http://inherit.eu
• http://eurohealthnet-magazine.eu