© Brigitte van der Zanden daily commuters higher educationalcolleges, andaround43000 It hasmorethan50hospitals, 22universitiesand have oneormoreborders withanothercountry. EMR hostsaround150municipalities, 49ofwhich 1 January 2007 hasbeeninEupen,, since million inhabitantslivinginEMR.Theseatofthe to thequalityoflifeapproximatelyfour population, thusmakinganimportantcontribution partnership createsnewopportunitiesforthe ––Liège. Thiscross- 11 000km covers ageographicalareaofapproximately tackling cross-borderissues.TheEuroregion of LiègeandLimburghavejoinedforcesin community ofBelgium,andtheBelgianprovinces of theAachenRegion,German-speaking Zweckverband (specificadministrationunion) the DutchProvinceofLimburg,German Since 1976,thesouthernandcentralpartsof withdifferentlanguagesandcultures. brought togetherfivepartnerregionsinthree status in1991.For thepast35years,EMRhas Union; itwascreatedin1976andachievedlegal the oldestcross-borderregionsinEuropean The -RhineEuroregion(EMR)isoneof General overview Meuse- Euroregion 2 aroundthecitycorridorofAachen– (1). (1). relative to three different health-care systems. relative tothree differenthealth-care systems. etc., mustdealwiththeabove-mentioned changes (public) health-careprofessionals, organizations, in EMR,wherenotonlythe population,butalsothe more onpublichealth.This isespeciallyimportant broader. Thereisaclearneedandwishtofocus that theconceptofhealthcarehasbecomemuch approach andgreaterpatientautonomymeans comprehensive people-centeredpublichealth (health technology),thegrowingneedfora increasingly sophisticatedmedicaltechnology health inequalities,environmentalchallenges, patients. For example, populationageing, care activities,health-careprofessionalsand fundamentally differentapproachtohealth- rapidly: socialtrendsareenforcinga The health-caresectorinEMRischanging under whichthesecompaniesfunctiondiffer. insurance companies,althoughtheconditions health-care systemsofalltheregionsinvolve but alsowithinthecountries.For example,the systems, notonlyacrossthedifferentcountries, ’ publichealthstructuresandhealth-care There are,however, widedifferencesbetweenthe their healthstatuseshavemanysimilarities. history (forexample,inrelationtomining)and The regionsinEMRshareapartlycommon Old Bridge,Maastricht Regarding the topic of health, EMR has delegated through a collaboration programme, entitled action to achieve its objectives in this area to “Crossing in health”, which uses the the euPrevent | EMR Foundation (2). EuPrevent approaches of two frameworks: Positive health initiates, supports, stimulates and facilitates (3) and Health in All Policies (4,5). One of the cross-border cooperation between professionals aims of this programme is to collect and compare and organizations working to promote and data at the euregional level for use by both preserve the health of the population. It brings health-care professionals and policy-makers. An together partners from the different countries in example of this is the overview of life expectancy EMR to work on these challenges and create in EMR provided in Fig. 1 (2). opportunities for the population (2). This is done

Fig 1. Life expectancy in EMR, 2014

90

85

80 Male Female Life Expectancy (y) 75 Total Düren Walloon Belgium Euskirchen Zuid Limburg The Provincie de Liége Stadsregion Zweckverband Aachen Provincie Limburg (NL) Provincie Limburg (BE) North Rhime-Westphalia

Source: euPrevent, 2018 (2)

Another result of EMR collaboration in public system so far has been on dementia and health, executed through euPrevent (2), is a depression in the elderly. One of its concrete support system aimed at helping communities results is the creation of online assessment to become “senior friendly”, that is, to focus on tools that enable communities to examine being care friendly, carer friendly and inclusion their (euregional) collaboration on dementia or friendly, allowing senior citizens to continue to depression. These tools, which can be used by live normal lives from both an economic and everyone free of charge, can be found on the a social perspective. The focus of the support euPrevent website (2).

Meuse-Rhine Euroregion Strengths

EMR’s strengths include: 99 a wealth of experience in and knowledge about how authorities, patient organizations, university to make best use of three different (public) health- departments related to health care, and governments, care systems, including patient accessibility to all among others; services in the Euroregion; 99 the ability to transform abstract and more theoretical 99 a broad euregional network of health-care providers, topics into practical implications for (public) health health-care insurance companies, public health care in EMR.

Aspirations

EMR is aiming to: 99 improve the quality of life of EMR citizens by ensuring 99 extend the extent of EMR’s service as a test zone for (public) health care without borders; a wide range of cross-border policies and activities 99 deal with practical problems related to the changing related to public health care; demography, technology, life patterns and health- 99 direct more attention to (public) health-care economy care systems, as well as health inequality and patient in the broad sense, including innovations in the fields autonomy; of technology and marketing.

Challenges

These are: 99 differences in legislation, (public) health-care systems 99 shortages of health-care professionals; and structures across the Euroregion; 99 low health status in some parts of EMR. 99 differences in governmental responsibilities concerning (public) health care and topics related to health care;

Potential areas of collaboration

The Euroregion is interested in working with other regions on topics related to: 99 environmental health; 99 cross-border cooperation related to public health; 99 Health in All Policies (4,5); 99 cross-border cooperation on citizen empowerment, 99 changing demography, technology, life patterns health care and cultural innovation. and public health-care systems, as well as health inequality and patient autonomy;

Meuse-Rhine Euroregion Working groups

EMR is interested in participating in working groups on: 99 the Sustainable Development Goals (SDGs) (6)/ equity; 99 environment; 99 participatory approaches/resilience; 99 the all-of-government approach/intersectoral action.

People active in the Regions for Health Network (RHN)

Political focal point Technical focal points Marleen van Rijnsbergen Michael Dejozé Political Representative EMR Director, Euregio Meuse-Rhine (EMR) Executive of the Province of Limburg, Netherlands , Belgium [email protected] michaeldejoze@-mr.eu

Brigitte Van der Zanden Director, euPrevent Heerlen, Netherlands [email protected]

References

1. Euregio Maas-Rhein | Maas-Rijn | Meuse-Rhin [website]. Eupen: Euregio Maas-Rhein | Maas-Rijn | Meuse-Rhin; 2018 (http://euregio-mr.info/euregio-mr-de/wer-wir-sind/organisation/, accessed 26 April 2018). 2. euPrevent | EMR [website]. Heerlen: euPrevent | EMR; 2018 (www.euprevent.eu/tools/, accessed 26 April 2018). 3. Institute for Positive Health [website]. Utrecht: Institute for Positive Health; 2017 (https://iph.nl/, accessed 26 April 2018). 4. WHO, Ministry of Social Affairs and Health of . The 8th Global Conference on Health Promotion, , Finland, 10–14 June 2013. The Helsinki Statement on Health in All Policies. Copenhagen: WHO Regional Office for ; 2013 (http://www.who.int/healthpromotion/conferences/8gchp/en/, accessed 17 April 2018). 5. Leppo K, Ollila E, Peňa S, Wismar M, Cook S, editors. Health in All Policies. Seizing opportunities, implementing policies. Helsinki: Ministry of Social Affairs and Health; 2013 (http://www.euro.who.int/__data/assets/pdf_ file/0007/188809/Health-in-All-Policies-final.pdf, accessed 17 April 2018). 6. Sustainable Development Goals. In: Sustainable Development Knowledge Platform [website]. New York: United Nations; 2018 (https://sustainabledevelopment.un.org/sdgs, accessed 21 February 2018).

Meuse-Rhine Euroregion

© World Health Organization 2018