Health inequities as a challenge to the social policies of European governments

Health inequities are defined as systematic differences in health that can be avoided by appropriate policy intervention, and for this reason are considered unfair and unjust. Health inequities are not solely related to access to health care services; they are caused by the unequal distribution of these determinants of health, including power, income, goods and services, poor and unequal living conditions, and the differences in healthdamaging behaviours that these wider determinants produce. They are defined as systematic differences in health that can be avoided by appropriate policy intervention and that are therefore deemed to be unfair and unjust. To be able to devise effective action, we first need to understand the causes of these inequities in health. Health inequities are not solely related to access to health care services; there are many determinants related to living and working conditions, as well as the overall macro-policies prevailing in a country or region. The differences in social and economic development are reflected in health inequities that can be seen both between and within countries. Furthermore, evidence shows that even in the more affluent countries health inequities are seen in all parts of Europe. In the WHO European Region the gap in life expectancy between countries is 17 years for men and 12 years for women. Inequities in health are caused by the unequal distribution of these determinants of health, including power, income, goods and services, poor and unequal living conditions, and the differences in health-damaging behaviours that these wider determinants produce. The experiences of various countries indicates that in order to narrow the health inequities countries have to improve living conditions including the provision of comprehensive welfare systems, and high-quality education and health services. The Strategy Health 2020 developed and approved by the WHO European Region countries is focusing on reducing inequities in health, which are key strategic objectives of endorsed by the 53 Member States. It emphasizes the need to strengthen population-based prevention on the social determinants of health. Also, in 2009 the European Commission developed European Union (EU) Health Strategy Programme titled “Solidarity in health: reducing health inequalities in the European Union”.