World Conference on Social Determinants of Health

Interview with Polish Minister of Health

11 August, 2011- Poland took over the presidency of the Council of the European Union on 1 July, 2011 and pledged to move forward on reducing health inequalities within the EU. We asked Dr Ewa Kopacz, Minister of Health of Poland, about the overall situation in Poland and the EU, about what she considers to be the most urgent policy priorities, and about her expectations of the World Conference on Social Determinants of Health.

Q: The Government of Poland has chosen the reduction of health inequalities to be one of its sectoral priorities during its presidency of the Council of the European Union. What is your overall assessment about the present state of health inequalities in the EU?

First, I would like to discuss the background to the differences in public health development across the EU, the primary cause of which is historical in nature. Following the establishment in 1952 of the European Coal and Steel Community with five members, the European Union has evolved through many stages and under many guises, some purely economic in nature. This has led to the present situation where health inequalities are very apparent, and they are evidenced by all major indicators of public health. These inequalities are particularly evident between the 15 original Member States (EU-15) and countries of the former Eastern Bloc (EU-12).

In 2008, there was a 14 years difference in male life expectancy between these two groups of countries. Furthermore, while the rate of premature mortality (death before 65 years of age) is in single digits in most countries of the EU-15, in many eastern areas of the EU only half of men live to the age of 65. Numerous other examples of disparities exist, as shown by successive studies, the most recent being the extensive 2008 HEMS study (see footnote below). In contrast to the economic progress seen in the new EU Member States, health gaps have not closed and, indeed, some of these differences are even widening.

The patterns and changes in the health status of the Polish population well represent the overall health situation for the EU-12 so let me quote a few examples.

Between 1960 and 1990, the health status of Poland's population was in decline and adult life expectancy decreased. After 1990, observed health indicators began to demonstrate some positive trends. By the end of the first decade of the 21st century, infectious diseases were well controlled and infant mortality was reduced to single digit level. Cardiovascular morbidity and mortality rates have decreased in adults, while lung cancer incidence in men has also declined by 30%. Between 1990 and 2008, the probability of premature mortality in Polish men and women declined by 10 and 5 percentage points, respectively. Life expectancy at birth increased in men and women by 5 and 4 years, respectively.

These are our successes in Poland, but we are still at the beginning of the road. In contrast to macroeconomic indicators, health gaps did not noticeably shrink during the first two decades of economic transformation, and the rate of improvement in health indicators has been too slow to reach the levels observed in western Europe. Urgent action is therefore required to tackle the impact of the current economic crisis. Continued improvements in public health are crucial for the building of human capital as well as the economic progress of any country.

Footnote: Zatonski W (eds.) et al. Closing the health gap in the European Union. Cancer Centre and Institute, Warsaw, 2008. Available from: