Impact Outlook • ‘While people across Europe are living longer than ever before, differences in status between people in higher economic groups and those in lower economic groups are not declining’

• ‘Health is an enabler of social and economic participation in daily life, the ‘motor’ behind our economies and a key determinant of a person’s wellbeing, happiness and satisfaction’

Helping to deliver wellbeing to the masses Caroline Costongs, Managing Director at EuroHealthNet explains how the partnership’s work as a knowledge broker between health and social systems is vital if health inequalities within Europe are to be eradicated

Can you please share a little about the background to EuroHealthNet? of their lives. In addition, health inequalities cost EU governments dearly: as growing numbers of people suffer from one or more EuroHealthNet was set up in 2002 after originally being the European chronic conditions, the high costs of treatment are increasing Network for Healthy Promotion Agencies (ENHPA), established in pressure on the financial sustainability of health and social systems 1996. The majority of member agencies are still the same – national institutes and regional health authorities. EuroHealthNet What are some of the priority actions you will be promoting through is now the leading European Partnership for improving health, equity your engagement with the Employment and Social Innovation (EaSI) and wellbeing. We aim to reduce health inequalities within and financing instrument? between member states. Health systems cannot in and of themselves reduce health Do you feel the long-term health prospects of EU citizens have inequalities, but they can lead efforts to improve awareness about improved in the last 20 years, or do you feel the socioeconomic them and lead on action. In addition, access to health services and challenges currently faced are greater than ever? the quality of the services provided are important determinants of health. It is therefore crucial that all professionals working in This is an interesting question. While people across Europe are health systems, whether as health administrations, as physicians, living longer than ever, differences in health status between people nurses, public health or professionals have an in higher economic groups and those in lower economic groups understanding of health inequalities and the skills – corresponding to are not declining. In addition, many of the life-years that people are their profession and duties within health systems – to act on them. gaining are not being spent in good health, particularly amongst lower socioeconomic groups. However, too often health systems are reduced to healthcare systems, which focus primarily on the management and treatment of disease. Studies using data from a wide range of European countries have Their role in promoting health, preventing disease and providing shown that smoking, excessive alcohol consumption, lack of physical general support to people with health needs or disabilities, which exercise and obesity are all more common in lower socioeconomic includes working with other sectors and actors to achieve this, is often groups in most European countries. They also suffer more from overlooked and severely undervalued. This is why our priority actions problems, which is linked to a lack of control over life towards health systems include network development, capacity circumstances, and content and conditions of work. Socioeconomic building, policy monitoring and elaboration, effective communication gradients in health, or the systematic correlation between health and building the evidence base. At the same time, EuroHealthNet status and socioeconomic status, exist in all EU Member States. acts as a knowledge broker between the health and social systems. Given the increasing levels of income and wealth inequalities, it is likely these gradients are becoming steeper in many EU countries. EuroHealthNet has invested much effort in building capacities throughout the partnership to implement priority actions on the Growing levels of health inequalities reflect that our market ground in countries and regions. This includes using EU-level tools, economies are not delivering wellbeing in a fair and effective manner. such as the Social Investment Package, as incentives to work on the This can be improved. Health is an enabler of social and economic social determinants for health, the European Semester to link-up participation in daily life, the ‘motor’ behind our economies and a key with national health reform planning, and promoting the use of determinant of a person’s wellbeing, happiness and satisfaction. In Structural and Investment Funds towards improving health, equity EU surveys, people systematically value health above all other aspects and wellbeing objectives.

96 www.impact.pub Caroline Costongs is Managing Director at EuroHealthNet. She Contact details has been working in Public Health policy and practice for over 25 Caroline Costongs years, especially in the field of health inequalities, EU health and Managing Director of social inclusion policies, and regional development, EuroHealthNet healthy ageing, health promotion, sustainable development and capacity building for Health in All Policies (HiAP). T: + 32 2 235 03 20 E: [email protected] W: www.eurohealthnet.eu

EuroHealthNet EUROPEAN PARTNERSHIP FOR IMPROVING HEALTH, EQUITY & WELLBEING

We produce documents and analyses on the key issues, develop actively disseminated findings to a broad range of stakeholders. capacity building sessions for our members, organise targeted country visits to reinforce capacity, knowledge and feedback on the most Are there any key topics or disciplines you would like to see a stronger relevant topics, and liaise with key stakeholders and decision-makers. focus on in terms of research in the near future?

Could you talk about the Seventh Framework-funded DRIVERS project? Evidence-based, led and guided approaches must remain fundamental for health promotion, with a fairer and greater The aim of DRIVERS (2012-2015) was to identify and fill knowledge proportion of research and implementation resources allocated gaps about factors that drive the three key social determinants of to building and using that knowledge. But a focus on the familiar health inequalities and the impact they have on avoidable health determinants of health alone is not enough; we must continuously inequalities. These are: (1) update our understanding early childhood development, of the ‘causes of the causes’. (2) employment and working Our rapidly changing world conditions (3) social protection requires us to be more dynamic, measures. In addition, the innovative and responsive than project aimed to analyse the ever before. This calls for insights methods used to assess these into, for example: effects, so that they can be l The relationship between improved or new methods states, people and corporations, developed, in order to better as well as worldwide capital flows determine the differential and their consequences outcomes of policies and l The concept of the ‘risk programmes on health equity. society’ and its impact over Finally, DRIVERS researched people’s life course the best ways to advocate for l The digitalisation of human health equity policies, starting life and the influence of new from scientific evidence. media on children and young people in particular DRIVERS has brought together existing knowledge An increase in health inequalities is a major concern for EuroHealthNet It is essential to engage with and tested theories about how such public health drivers; different influences across the life course affect health inequalities superficial responses do not suffice. Providing information, raising using systematic reviews, meta‐analysis and comparative data awareness, empowering individuals, and building the skills and analysis across EU member states. We assessed existing research capacities to anticipate and respond to such developments from methodologies and developed more effective ones to determine a health equity perspective is of utmost importance. the differential outcomes of actions to tackle health inequalities using longitudinal data sets. Various methodologies have been A broad public health research agenda is needed to provide implemented in case studies across Europe, to supplement and shed evidence and support the development of a meaningful public further light on the research findings. We also developed a set of discourse around international sustainability processes, such as the overarching principles and more detailed practical recommendations Agenda2030 and the 17 Sustainable Development Goals (SDGs). for policy and practice, ranging from individual-level interventions to European level policies, to reduce health inequalities and improve We need multi and interdisciplinary research to provide new health equity. insights and evidence on how Health in All Policy approaches and intersectoral work can contribute to implement the SDGs. DRIVERS has actively sought out the involvement of a range of stakeholders, so as to benefit from citizens’, practitioners’ and civil To find out more about drivers and EuroHealthNet, visit society perspectives. We have published numerous academic articles EuroHealthNet.eu and public reports, organised several workshops and final events, and

www.impact.pub 97