Ministers help progress on health equity – but will their aims survive the cuts?

Although frustrated by the volcanic ash cloud that wrecked its showpiece event in Madrid in spring, Spain has presided over useful steps forward in building high level action to tackle health inequities at EU level.

Under the Spanish EU Presidency leadership, Health ministers  have now agreed to back and help implement measures set out by the European Commission last year.

Amid the standard text of their formal Conclusions are some interesting points which offer encouragement, despite worrying social and welfare predications for the continent.

Noting that “the framework for public health has changed” is a gentle step towards reorienting treatment systems towards prevention.

Overdue recognition that “an approach based on equity in health may enhance the efficiency of different policies and contribute to EU goals of fostering economic development while maintaining social cohesion” suggests that the catchy but clumsy  “health is wealth” slogan is being more carefully defined, at least for public health.

It is another sign that having social, research and health policy makers work closer together can pay dividends – an added value of EU co-operation.

So the invitation for member states to “obtain a regular overview of the health impact of their main policies, with special emphasis on obtaining information related to social determinants of health” – and gather the proper data – is potentially important, if it is taken up. That remains a big if, given almost inevitable cutbacks amid budget deficit reduction plans.

In the UK, for example, a threat hangs over the renowned longitudinal study of birth cohorts providing almost unique data for generations.

No data analysis, no reliable overview is the all too common obstacle.

The focus on women and children is also welcome given increasing and emerging evidence, not least from EuroHealthNet’s Gradient project co-funded by the EU research programme, that investment in early years has greatest potential impact from various perspectives.

The Europe wide initiative that new WHO Director General Zsusanna Jacob has commissioned Sir Michael Marmot to carry out now has some clear guidance from at least 27 of its health ministers about the directions where their concerns, needs and instincts lie.

The challenge will be to convince their colleagues in the finance ministries to wield their axes in ways that do not slash and burn whatever limited progress is made through the good intentions of the Commission’s plans and the good ideas locally in many of their states.

The full Council Conclusions are available here. More information about the Gradient project is available here.

EuroHealthNet members can see full reporting of Council processes in the regular Health Highlights online newsletter, available if you join us.

[Photo: “European Flag” by rockcohen, available under a Creative Commons License]