EPHA workshop: Reducing Health Inequalities for Children Living in Europe

Since virtually every aspect of human development is defined very early in life - during pregnancy and in early childhood - this period has a life-long impact on many aspects of health and well-being which continues through to adolescence and adulthood. From a public health perspective, the poor health of children born and growing up in poverty is preventable as long as comprehensive and cohesive public policies are in place. Not only is investment in early child development crucial, but maintaining early health equality gains requires a sustained commitment to all children and adolescents, which also includes education and subsequently entering the job market. Poverty during adolescence worsens opportunities for future quality of life, behaviours, employment and income.

To what extent are EU and national policies and strategies child-friendly? How well are children’s voices heard (and taken into account) concerning where they grow up, live, play and learn, and how well is their physical, sexual and mental health taken care of? Not only are children often passive victims of policies that impact on health, but they are also more likely to be exposed to poverty and exclusion than the average population – transport policies, environmental policies, public health measures on tobacco and alcohol, food advertising, green spaces and urban planning, education policy, sexual and reproductive health and rights as well as economic, migration and other policies further upstream all have a profound impact on the health of children living in Europe.

The objective was to identify the main health challenges faced by children and adolescents and to determine the best way forward for an adequate European approach towards children and health inequalities. This involves a meaningful and concerted engagement of policy-makers, public health community, researchers, civil society and children themselves, in order to prevent and mitigate the impact of health inequalities on all children living in Europe.

The workshop was intended for public health practitioners, educators, scientists, policy-makers and all others interested in children’s health in the framework of EU health inequalities. They were invited to actively participate, discuss and exchange their expertise. It aimed to explore the complex relations between child-related social determinants of health, in particular child poverty, and health inequalities. Another aim was to identify those policies that have the best impact on reducing children’s health inequalities, and to determine whether an EU-wide strategy would prove useful.

Three presentations on the issue were delivered:

 The introductory presentation "Reducing health inequalities for children living in Europe" by EPHA’s Dorota Sienkiewicz set up the scene for health inequalities; social, economic and political determinants of such a situation; inequalities in relation to children’s health; different children’s groups and their vulnerabilities; EU and WHO regulations and legislations and possible currents of interventions.

 A group of particularly vulnerable children in the EU - Roma children - were discussed in the presentation, "Poverty and health inequalities among Roma in Macedonia, and in particular among children" by Nesime Salioska of Roma SOS). She stated that Roma children face multiple discrimination and poverty, which tremendously impact on their cognitive development, physical and mental health. Roma children are insufficiently integrated with health and child protection services, and they experience low immunisation, hunger and malnutrition. It was recommended to collect data on Roma children’s health, take preventive measures targeted directly at them and their families, as well as the environments they live in.

 An example of good practice from the city of Gdansk in Poland on "Interdisciplinary approach to health promotion" was presented by Marek Jankowski of EPHA member the Polish Society for Health Programs in which two children-focused, parent-targeting programmes were discussed - "Healthy life for your child" and "My way to health". A number of innovative, interactive and multi-disciplinary solutions towards reducing children’s health inequalities - starting in the early years of development, at school and in families - were presented for consideration. Most importantly, the programmes were developed by actors from civil society in collaboration (financial and political) with local authorities, which is still a rather pioneering way of working together in CEE countries.

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