On 23 January, the ’Equity Action’ Final Conference was hosted by the European Commission, marking the end of the Joint Action on Health Inequalities and expressing hope and determination that this will the beginning of further coordinated action at all levels.
Equity Action aims to reduce health inequalities by helping to improve policies at national and regional level and involving the contribution of stakeholders. It is jointly funded by the EU Health Programme, 15 EU Member States and Norway, and involves 25 partner organisations, 30 regions and numerous stakeholders.
The purpose of this final meeting was to showcase the results of the Joint Action on Health Inequalities ‘Equity Action’ and to consider opportunities and priorities for action.
The conference agenda included a video message by European Health Commissioner, Tonio Borg who emphasised that health inequalities were now an integral part of European policy making and economic governance processes. However, he also cautioned that ’a lot more has to be done’.
In his key opening speech, Professor Michael Marmot, UCL Institute of Health Equity presented some of the findings of the report his consortium produced for the European Commission, ’’Health inequalities in the EU’’’, released in December 2013.
He stated that, although overall health was improving across Europe, the status quo of avoidable health inequalities was not good in many countries where child poverty, unemployment and low education were reflected in steep social gradients. The latter could be overcome by doing what some Member States were already practising, including, inter alia, investments in education, quality jobs, early life years, parenting and family support, and well functioning social support systems. It was crucial to improve both health for everybody and to reduce health inequalities in order to narrow the social gradient. Some countries, such as Sweden already do this quite well, and Marmot cited the city of Malmö as one example, at city level of a locality, that had achieved a lot and had demonstrated real political commitment by economic and health actors.
He identified three groups of countries, 1) those who had intensified their policy response to health inequalities in recent years - amongst others, this included Denmark, the UK and Norway -, 2) those where the policy response had remained at the same level - including Germany - and 3) those where policy action had decreased, which included wealthy countries like the Netherlands, but also Greece. In this respect Marmot stated that financial difficulties represented an even more urgent reason to invest in health saying that it was vital to recognise that avoidable health inequalities are wrong not only because of economic considerations but because they are a matter of social justice.
But Marmot also expressed much optimism and excitement, stating that health inequalities had developed from a ’dirty secret’ that nobody wanted to know about to an item that now stands firmly on the European policy agenda. He said that no matter where individual countries stood with regard to their policy response, it was important for all of them to ’ do something, do more and do it better! ’.
In her speech, which echoed Marmot’s sentiments, EPHA President Peggy Maguire stressed the importance of policies aiming to tackle health inequalities being structural and implemented in all policy areas. For this to happen, strong and innovative leadership is needed, which also has to be engaged with the most disadvantaged groups they intend to serve. This is why the NGO sector is essential; it is the only voice that connects both actors.
Maguire criticised the dominant top-down approach, a sentiment which was also reflected in the public health discourse and which it was agreed required urgent change. Those involved in policy making must begin considering people as agents of change instead of being merely targets of their policies. This idea will also will be reflected in the EPHA election manifesto for the European Parliament elections in May, which will request that newly elected MEPs adopt a broader understanding of health.
She added that enough research has been conducted on health inequalities; the solution entailed taking a multidisciplinary approach to health and involving our most disadvantaged communities in the policy making process. NGOs are their first link, and they play a crucial role in making their voices heard, even when this is not always easy.
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