Arnaud Senn
Health Inequalities: an EU perspective Rare Disease Day Brussels, 28 February 2011
Arnaud Senn, DG Employment, Social Affairs & Equal Opportunities
Major Health Inequalities between and within Member States DG Sanco-DG Employment Communication October 2009 « Solidarity in health: reducing health inequalities in the EU”
14-year difference in life expectancy for men and 8 year gap for women between EU Member States 2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
2
Health inequalities on the EU agenda • Health Inequalities: EC Communication in October 2009 • Strong commitment of Committee of the Regions, European Economic and Social Committee and EU Parliament • Social Protection Committee / Official opinion 18 May 2010 highlighted: – The importance of reducing health inequalities for social protection and social inclusion – The importance of the Social Gradient – The close connection between this subject and other major challenges, esp. Poverty issues, Active Ageing.
Health inequalities, on the EU agenda: EU 2020 Strategy • 3 Priorities – Smart growth – Sustainable growth – Inclusive growth: high employment & Social and territorial Cohesion
• 5 Headline targets – 75% of population 20-64 employed – 3% of GDP in R&D – 20/20/20 climate energy targets (incl. Increase to 30% of emissions reduction if the conditions are right) – < 10% school leavers / 40% of younger gener. Tertiary degree – Poverty: taking 20 million people out of poverty-Social exclusion
Ongoing work on health systems at EU level
• Ongoing work on the impact of the financial crisis on society and also on health systems • Ongoing work on long-term care and its financial impact on social protection systems • Improving health care efficiency and efficiency of medical expenditure in a context of budget constraints • In this context, focusing on underprivileged groups hit by health inequalities is even more important and profitable.
Ongoing political debate at national level • Current context of budget cuts in most Member States • Sir Marmot’s Review: – A clear and strong social gradient identified in most health inequalities areas – Action against health inequalities requires action across all the social determinants of health – Proportionate Universalism: «actions must be universal but with a scale and intensity that is proportionate to the level of disadvantage»
Communication on Health Inequalities • Taking stock of the situation • Identifying key issues to address • Defining the contribution of EU policies to the reduction of health inequalities • Focusing on precise follow-up actions
Determinants of health inequalities: Dahlgren and Whitehead’s Rainbow
Causes of Health Inequalities
2-Mar-11
Living conditions
Services
basic needs, warmth, food, water, housing, environmental quality
healthcare, education, social protection
Work and working conditions
Health related behaviours
job quality, health and safety at work
life skills, smoking, alcohol, exercise
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
9
Priorities of the Communications • Improving the data and knowledge base, especially indicators • Building commitment across society • Meeting the needs of vulnerable groups • Developping the contribution of all EU policies: exemple of PROGRESS funding
Exemple of PROGRESS Funding • Focusing on health inequalities in a social and professional context • Applications from field stakeholders of the Member States • Learning more on health inequalities and facilitating exchange of best practices • Liaising health and other related subjects: health is not only a health professionals’ matter.
Vulnerable groups and age groups clearly identified • Vulnerable groups: poor people, some migrants or ethnic minorities (eg:Roma), unemployed people. • Vulnerable age-groups: – Children: Child health is determining for (future) adult health. – Women: women live longer but are more likely to spend the late stage of their lives in bad health conditions – Elderly people who are, in average, more subject to poverty in most of the EU Member States. Elderly people are also more likely to require long-term care.
2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
12
Related issues: Three Common objectives for health care and long-term care To promote accessible, high-quality and sustainable healthcare and long-term care by ensuring: • access (incl. financial and geo.) for all to adequate health and long-term care and that the need for care does not lead to poverty and financial dependency; • quality in health and long-term care and by adapting care, including developing preventive care, to the changing needs and preferences of society and individuals; • that adequate and high quality health and long-term care remains affordable and financially sustainable 2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
13
Thank you for your attention
2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
14
Arnaud Senn, DG Employment, Social Affairs & Equal Opportunities
Major Health Inequalities between and within Member States DG Sanco-DG Employment Communication October 2009 « Solidarity in health: reducing health inequalities in the EU”
14-year difference in life expectancy for men and 8 year gap for women between EU Member States 2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
2
Health inequalities on the EU agenda • Health Inequalities: EC Communication in October 2009 • Strong commitment of Committee of the Regions, European Economic and Social Committee and EU Parliament • Social Protection Committee / Official opinion 18 May 2010 highlighted: – The importance of reducing health inequalities for social protection and social inclusion – The importance of the Social Gradient – The close connection between this subject and other major challenges, esp. Poverty issues, Active Ageing.
Health inequalities, on the EU agenda: EU 2020 Strategy • 3 Priorities – Smart growth – Sustainable growth – Inclusive growth: high employment & Social and territorial Cohesion
• 5 Headline targets – 75% of population 20-64 employed – 3% of GDP in R&D – 20/20/20 climate energy targets (incl. Increase to 30% of emissions reduction if the conditions are right) – < 10% school leavers / 40% of younger gener. Tertiary degree – Poverty: taking 20 million people out of poverty-Social exclusion
Ongoing work on health systems at EU level
• Ongoing work on the impact of the financial crisis on society and also on health systems • Ongoing work on long-term care and its financial impact on social protection systems • Improving health care efficiency and efficiency of medical expenditure in a context of budget constraints • In this context, focusing on underprivileged groups hit by health inequalities is even more important and profitable.
Ongoing political debate at national level • Current context of budget cuts in most Member States • Sir Marmot’s Review: – A clear and strong social gradient identified in most health inequalities areas – Action against health inequalities requires action across all the social determinants of health – Proportionate Universalism: «actions must be universal but with a scale and intensity that is proportionate to the level of disadvantage»
Communication on Health Inequalities • Taking stock of the situation • Identifying key issues to address • Defining the contribution of EU policies to the reduction of health inequalities • Focusing on precise follow-up actions
Determinants of health inequalities: Dahlgren and Whitehead’s Rainbow
Causes of Health Inequalities
2-Mar-11
Living conditions
Services
basic needs, warmth, food, water, housing, environmental quality
healthcare, education, social protection
Work and working conditions
Health related behaviours
job quality, health and safety at work
life skills, smoking, alcohol, exercise
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
9
Priorities of the Communications • Improving the data and knowledge base, especially indicators • Building commitment across society • Meeting the needs of vulnerable groups • Developping the contribution of all EU policies: exemple of PROGRESS funding
Exemple of PROGRESS Funding • Focusing on health inequalities in a social and professional context • Applications from field stakeholders of the Member States • Learning more on health inequalities and facilitating exchange of best practices • Liaising health and other related subjects: health is not only a health professionals’ matter.
Vulnerable groups and age groups clearly identified • Vulnerable groups: poor people, some migrants or ethnic minorities (eg:Roma), unemployed people. • Vulnerable age-groups: – Children: Child health is determining for (future) adult health. – Women: women live longer but are more likely to spend the late stage of their lives in bad health conditions – Elderly people who are, in average, more subject to poverty in most of the EU Member States. Elderly people are also more likely to require long-term care.
2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
12
Related issues: Three Common objectives for health care and long-term care To promote accessible, high-quality and sustainable healthcare and long-term care by ensuring: • access (incl. financial and geo.) for all to adequate health and long-term care and that the need for care does not lead to poverty and financial dependency; • quality in health and long-term care and by adapting care, including developing preventive care, to the changing needs and preferences of society and individuals; • that adequate and high quality health and long-term care remains affordable and financially sustainable 2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
13
Thank you for your attention
2-Mar-11
Directorate-General for Employment, Social Affairs and Equal Opportunities ─ Unit
14
