Impact Outlook • ‘Research demonstrates that health equity is not only a matter of social justice, but also a prerequisite for the achievement of smart, sustainable and inclusive growth’ • ‘In Europe, we lack such coordinated vision on a broad and inter-disciplinary health research and health information systems. Current systems do not always provide fast, high-quality and fully comparable information’ Re-balancing health inequality Having worked in public health policy and practice for over 25 years, Caroline Costongs, Managing Director of EuroHealthNet, understands the need for dynamic, flexible and responsive health research, particularly if we are to bridge the socio-economic health divide in Europe Can you please share a little about the background to EuroHealthNet – The fundamental need to address social equity factors at EU levels what were the drivers for the partnership being set up and what are the remains clear, essential and constant. The capacities of public and civil key goals? society bodies are still limited, which highlights ever more strongly the need for multi-agency, international support for building resilience. EuroHealthNet was set up in 2002 after originally being the European EuroHealthNet continues to support members in the implementation Network for Health Promotion Agencies (ENHPA), established in of priority actions in countries and regions. Our efforts include, among 1996. The majority of member agencies are still the same – national others, developing research activities together, exchange effective public health institutes and regional health authorities. EuroHealthNet strategies and promoting the use of EU Structural and Investment Funds is now the leading European Partnership for improving health, equity towards improving health, equity and wellbeing objectives. and wellbeing. We aim to reduce health inequalities within and between member states. Specifically, our work resulted in the further development of healthy ageing strategies in Slovenia and in Italian regions; a widely appreciated Research demonstrates that health equity is not only a matter of social analysis of the EU Semester (and Country-Specific Recommendations) justice, but also a prerequisite for the achievement of smart, sustainable, with a health equity focus on retirement, children and families, and and inclusive growth. With our activities, we generate, identify, and health systems; successful efforts of evidence being brought into policy promote approaches to tackle health and social inequalities that influence environments at EU and national level; increased capacity and awareness the wellbeing of European citizens and their ability to contribute to a on relevant EU processes by health authorities; and many strengthened more sustainable Europe. partnerships to tackle health inequalities from different policy angles. The various aspects of our work – network development, policy In general terms, what are some of the main challenges facing those monitoring and learning, effective communication, capacity building, in public health research? What would you like to see European providing evidence – offer an innovative way to foster change in relevant Governments doing to address issues? policies and legislation. EuroHealthNet acts as a knowledge broker between health, social, and other sectors and makes sure the public We are now living in a rapidly changing world. This requires us to be health community actively engages with EU priorities. more dynamic, flexible and responsive than ever before. We need a vision of the kind of research and information we require, in order to meet our For instance, we undertake country visits and facilitate exchanges new challenges such as climate change, increasing economic inequalities, with member states’ authorities in order to raise awareness on global conflict, and demographic changes including migration & ageing. the EU Semester and ensure that health promotion and disease How can we capture these changes with public health research and prevention play a stronger role in the pursuit of social, employment and within existing Health Information Systems? economic objectives. In Europe, we lack such coordinated vision on a broad and inter- Could you expand on some of the biggest challenges EuroHealthNet disciplinary health research and health information systems. Current faces, specifically in terms of levelling up the social gradient in health? systems do not always provide, fast, high-quality and fully comparable What actions has EuroHealthNet taken to develop a more integrated information. We also need to make sure that there is a social gradient health system? perspective included, to ensure different socio-economic groups are www.impact.pub 73 CAROLINE COSTONGS is Managing Director at EuroHealthNet. She has been working in public health policy and practice for over 25 years, especially in the field of health inequalities, EU health and social inclusion policies, health equity and regional development, healthy ageing, health promotion, sustainable development and capacity building for Health in All Policies (HiAP). reached and benefit from evidence-based interventions. Potential ambition is to stimulate greater collaboration between the health, technological advances in the use of data should not further exclude the environment and other sectors to implement shared solutions. The most vulnerable in society, including refugees, prisoners, and homeless research will demonstrate how effective inter-sectoral work can take people, who are often invisible in official data. place, identify barriers and success factors to cooperation, and the role of political and economic context and public awareness. From European governments we need a sustained investment in public health research using new technologies and ways to link data from LIVING Initiatives: Examples of practices could include ‘Place Standard different sectors that offer great potential for understanding health Scotland’, which is a tool developed by the Scottish Government, NHS (inequalities) and its determinants and provide the crucial data needed to Health Scotland and Architecture and Design Scotland that is framed develop improved policy for healthy and sustainable societies. around key questions that are central to the delivery of successful, sustainable places. The tool can be applied by the private sector Could you tell us a little about the Horizon 2020 Inherit project? (developers), the public sector and communities themselves. Practices could also include a nationwide behavioural change programme that was INHERIT stands for ‘Inter-sectoral Health and Environment Research implemented in Hungary to encourage families to reduce their carbon for Innovation.’ The overall aim of INHERIT is to define effective footprint, or a pilot project in Latvia to implement energy efficiency inter-sector policies, interventions and innovations that contribute measures in multi-family apartment buildings. to environmental sustainability while also promoting the health and wellbeing of European citizens, particularly those at the lower end of the CONSUMING Initiatives. This could involve subsidies or taxes on socio-economic gradient. specific foods or nutrients with the objective of shaping what people buy and influencing intake and health outcomes, like the Finnish A unique aspect of INHERIT is its focus on lifestyles and behaviours. tax on sweets, ice-cream, and soft drinks and the French tax on non- Lifestyles and behaviours are strongly influenced by existing socio- alcoholic beverages with added sugar and sweeteners. It may include economic and demographic trends in our society, while they also help the production of indigenous varieties of fresh fruits and vegetables or to determine these trends. INHERIT will investigate the links between other programmes to promote the consumption of healthier and more lifestyles and behaviours, environmental sustainability, health and health sustainably produced foods in deprived areas. equity, to identify entry points for action and levers for change. Lifestyles and behaviours are frequently locked into existing economic, political MOVING practices could include those that focus on recovering and social structures that limit scope for individual choice. The lower an public space for citizens and limiting the use of private cars in individual’s socio-economic position, the more limited his or her scope the city, for example as has been done successfully in the Basque for individual choice. INHERIT will explore this to identify opportunities country (Spain), Copenhagen, and New York. They may also include for policies, interventions and innovations that provide new chances for ‘walking bus’ initiatives, which encourage children to walk to school lifestyles and behaviour change that can lead to a triple win for individuals alone or with family members and can now be found in a number of and for society. countries worldwide. What tangible improvements does Horizon 2020 hope to achieve in the next four years? Contact details: The key motivation of the INHERIT consortium is to strengthen Caroline Costongs conviction and capacities within the health sector to encourage, support Managing Director of EuroHealthNet and drive public health, environmental science and other sectors, including industry, to jointly pursue the inter-related goals of improving T: + 32 2 235 03 20 E: [email protected] health equity and wellbeing, while ensuring environmentally sustainable E: [email protected] lives for all. W: www.eurohealthnet.eu INHERIT will support progress on the behavioural and lifestyle dimension of what has been described as society’s most pressing 21st century task: the increasingly articulated need to build public health EuroHealthNet EUROPEAN PARTNERSHIP FOR IMPROVING HEALTH, EQUITY & WELLBEING and wellbeing and greater equality on ecological principles. INHERIT’s 74 www.impact.pub.