European Union and SDHs
The EU and its Member States identify addressing the considerable health inequalities as one of the most important challenges in public health. The examples in EU show differences in life expectancy, mortality rates for cardiovascular diseases and cancer, health behavior (e.g. diet and obesity) and other long-term health problems. EU institutions, bodies and agencies have supported actions to reduce health inequalities though various policies, programmes, initiatives and instruments.1
The emphasis on HiAP emerged during the Finnish presidency in 2006. However, already Article 168 of the TFEU states that “A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.”2
By highlighting the importance of SDHs as root causes of health inequity, the 2008 final report by the Commission on the Social Determinants of Health and more recent European reports have encouraged EU to further broadening the agenda to affect SDHs.
Sources:
- Scholz, N. 2020. Addressing health inequalities in the European Union. European Parliamentary Research Service. European Union. Available from https://www.europarl.europa.eu/RegData/etudes/IDAN/2020/646182/EPRS_IDA(2020)646182_EN.pdf
- EUR-lex 2008. Treaty establishing the European Community (Nice consolidated version) – Part Three: Community policies – Title XIII: Public health – Article 152 – Article 129 – EC Treaty (Maastricht consolidated version) – Article 129 – EEC Treaty. Available from https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:12002E152:EN:HTML
More:
European Commission 2013. Commission staff working document. Report on health inequalities in the European Union. Available from https://ec.europa.eu/health/sites/default/files/social_determinants/docs/report_healthinequalities_swd_2013_328_en.pdf
Finland’s Presidency of the EU – results Unofficial translation – subject to changes. Available from http://www.proyectos.cchs.csic.es/euroconstitution/library/historic%20documents/Constitution/Finland%20Presidency%20results%2015.12.2006.pdf
Huijts, T., Stornes, P., Eikemo, T.A. & Bambra, C. 2017. The social and behavioural determinants of health in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. European Journal of Public Health, Volume 27, Pages 55–62. https://doi.org/10.1093/eurpub/ckw231
Regional office for Europe (WHO) 2014. Review of social determinants and the health divide in the WHO European Region. Final report. Available from https://www.euro.who.int/en/publications/abstracts/review-of-social-determinants-and-the-health-divide-in-the-who-european-region.-final-report
Secretary of State for Foreign and Commonwealth Affairs 2006. PROSPECTS FOR THE EUROPEAN UNION IN 2006. The Finnish Presidency, July to December 2006. Available from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/272327/6896.pdf
SDHs in Sweden
Despite significant improvements in health, inequities continue across and among countries in the WHO European Region, including Sweden. In Sweden, as regions are close to their people and have the capacity and abilities to establish efficient public health policies, they play a critical role in tackling health inequities.1
Lundberd (2018) states that while public health in Sweden is generally good, gaps in circumstances, opportunities, and health persist. The Swedish government formed a national Commission for Health Equity in 2015. In itself, the Commission’s work constitutes a new step toward greater health equity in Sweden. If the Government’s goal is to be met, a succession of deliberate reforms and improvements in services and programs across various sectors will be required, rather than a single or two dramatic acts. Patience and long-term efforts will be required.2
Continued efforts to reduce health inequalities must address broader inequalities, including efforts to strengthen individuals’ own opportunities to act and generate resources, as well as the public sector’s capacity to provide resources at different stages of life or in situations where individuals’ own resources are insufficient. Such attempts to establish more equitable circumstances and opportunities for people from diverse socioeconomic strata and groups must be consistent, patient, and unwavering.2
Source:
- WHO Regional Office for Europe 2014. Tackling health inequities: from concepts to practice. The experience of Västra Götaland. Available from https://www.euro.who.int/__data/assets/pdf_file/0004/256783/Tackling-health-inequities-from-concepts-to-practice-The-experience-of-Vastra-Gotaland.pdf
- Lundberg, O. 2018. The next step towards more equity in health in Sweden: how can we close the gap in a generation? Scandinavian Journal of Public Health. 46: 19-27. https://doi.org/10.1177/1403494818765702
More:
Marmot, M. 2014. Making social determinants of health real in one Swedish city. Socialmedicinsk tidskrift. 5: 433–437.