Health inequity a threat to core European values

Bad Hofgastein, Austria: New WHO report warns of polarising effects of health inequalities.

Christine Brown, World Health Organization | Photo credit: European Health Forum Gastein (EHFG)

By Brian Johnson

Brian Johnson is Managing Editor of The Parliament Magazine

04 Oct 2019

Participants at this year’s European Health Forum Gastein have been told that there are five key conditions that can make a difference to health inequity.

These include income insecurity, living conditions and health services. Other reasons include employment conditions and ‘social and human capital’.

During an interactive session on health inequalities, delegates were asked to vote on what they thought were the leading factors causing such inequality.

Some 36 percent voted for living conditions, 29 per cent went for income security and 18 per cent opted for social and human capital.

The in-session survey, while unscientific, was designed to encourage the audience to think about some of the issues discussed at the session which was sponsored by the World Health Organization’s Regional Office for Europe.

The event, on the opening day of the three-day heath policy conference in Austria, was told that the “polarizing” effects of major gaps in health and well-being currently existing across all countries in the WHO European region threaten the “very core” of values of solidarity and stability, upon which its prosperity and peace are built.


A senior WHO official presented the organisation’s recent work on health equity, which highlighted six macroeconomic policies that can help reduce health inequities.

Chris Brown, head of office at the WHO European Office for Investment for Health and Development, said the success of such action, however, depended on addressing the “essential conditions and drivers” of inequity.

These, she told the audience, include policy coherence, accountability, participation, and, “underlying them all”, empowerment.

She said the WHO European health equity status report shows that “we can change the narrative from ‘can’t do’ and ‘it is not my problem’ to saying “yes, it can be done and how it can be done.”

One example of inequality she cited are the current gaps in life expectancy between men and women in Europe. Life expectancy reduction for women adversely affected by inequality is between 2.3 years and seven years. But males who are similarly affected by poverty, poor health and economic hardship can expect to live up to 15.5 years less than those who are not affected.

She said, “This is a terrible social justice issue and we need to wake up because it’s happening now.

“What the report says is about real lives, not statistics, and about those who are left behind due to things like their living conditions.

“Some of the results of the study are quite shocking. They show, for instance, the scale of inequalities due to quality of housing.”

She asked, “How is it, for example, that we in the EU in the 21st century still have food insecurity and the existence of things like food banks?”

She added, “We have health inequality policies but they are not delivering results and are not helping those left behind.”

Further comment came from Dr Natasha Azzopardi-Muscat, president of the European Public Health Association.

She praised the WHO report as “full of surprises” saying it should be made available even in places like GP surgeries “because it pulls together very important information such as powerful data on housing. It shows what needs to be changed.”

She also asked, “But why should we care about health inequalities? We should care because it is about everyone. But unless we can get the public to sit up and get angry about health inequities and say this has to change, we will not see the necessary changes.”

Another speaker, Professor Fred Freundlich, of Mondragon University in Spain, advocated the concept of “shared ownership” in the workplace which, he said, can help address health inequality.

He told the packed audience, “Where I work in the Basque country in Spain there are many shared ownership companies. The region also has lower than average health inequalities.”

“That is why this matters. Shared ownership of business is not as some might think a strange concept. It is just a well-kept secret. The effect on health can be real and it can also help businesses who share ownership be more profitable. If we expand the trend we will be getting somewhere.”

“Without shared ownership of business it will be difficult to tackle the issue,” he cautioned.

The event, on the first of the three-day forum, heard that a “healthy dose of disruption” was needed to challenge the “misconceptions” that block progress for healthy, prosperous lives.

The health equality session, “why it matters and what we can do”, was also told that it is necessary to increase political engagement and “focus on solutions.”

Professor Johanna Hanefeld, of the London School of Hygiene and Tropical Medicine, also called for an inclusive dialogue with the public on why reducing health inequities matters for everyone in Europe.

He said civil society had a role in helping to tackle the issues addressed at the session.

The European Health Forum Gastein is an independent, non-partisan organisation, founded in 1998 which aims is to provide a platform for discussion on health policy in the EU and beyond.

Over 500 leading health experts and stakeholder are participating in the annual policy-focussed conference held in the Gastein Valley in the Austrian Alps. The three-day event concludes on Friday.