“Our equity policies will improve everybody’s health and accelerate the levelling-up rate of those who were behind – and we know that these kinds of policy frameworks work,” said Chris Brown, Head of the WHO European Office for Investment for Health and Development.
The Office hosted a meeting in Venice to begin work on the second report of the European Health Equity Status initiative (HESRi2), due out in 2025. Scientific experts and senior health policy leads from 12 European countries looked at how to capture and interpret data to deliver more impactful, solution-oriented policies on diverse issues facing the WHO European Region.
Together they considered wide-ranging topics including young people’s mental health, inequities among the ageing population, migration into and within the Region, unmet needs, and inequalities in the transition to a green economy – all through a health equity lens.
Over the last 5 years, since the publication of the first HESRi report, the Region has experienced unprecedented shocks, including the COVID-19 pandemic. Today, policy-makers and the public alike want to foster societies with better quality of life and more security amid new and ongoing challenges. Countries are seeking ways to address conflict, climate change, fiscal instability, and distrust in science and institutions, all in an increasingly ageing, digitalized, socially fragmented and polarized global context.
Building equal societies
Since its launch in 2019, HESRi has been groundbreaking in terms of modelling the impacts of affordable investment in a basket of policies. It has demonstrated that such investments can reduce inequities in health among adults within 4 years – the typical lifespan of a governance cycle.
Chris explained, “We want to ensure that local and national authorities are inspired to level up health and well-being by implementing policies that deliver equity, and also by designing policies that reduce existing inequities.”
Where the first HESRi report looked for indicators of health inequity, HESRi2 aims to build a more nuanced picture, not only by including new indicators, but also through innovative modelling techniques for positive return on investments for health equity.
“We want to develop models that answer specific policy questions,” continued Chris, who noted that the second HESRi report will provide a raft of opportunities, ideas and designs for countries to apply to their own specific context. She added that HESRi2 will highlight where benefits and savings can be created through desirable social outcomes as well as cashable solutions.
“Going forward, we are developing a strong communication and advocacy strategy to engage communities, politicians, professional associations and ministers from across governments in order to nurture knowledge exchange and build collaboration between groups. This was a strong theme that came out of this meeting,” Chris emphasized.
New approaches
Radu Plămădeală, Head of the Directorate for the Coordination of Public Policies and European Integration at the Ministry of Health of the Republic of Moldova, was one of the participants at the meeting. He highlighted the benefits of learning from other countries and using innovations to model equity returns that can produce benefits across many sectors of society.
Radu noted an additional benefit of HESRi participation: support in adapting policies on, for example, ageing well for all, and youth mental health and inclusion. “Thank you for helping us to develop our strategies by inviting us to observe the results achieved elsewhere and adapting these strategies to suit our own situation,” he said.
Radu continued by pointing out the challenge of youth migration and poor well-being in the Republic of Moldova due to low wages, lack of opportunities, and general social and economic insecurities. Meanwhile, the Government wants to grow the economy while renewing the social contract by pursuing policies on gender equality, decent work, secure housing, healthy ageing, and high-trust health- and social-care systems.
Denmark, Finland, Italy, Kyrgyzstan, Lithuania, the Republic of Moldova, Romania, Slovenia, Spain and the United Kingdom are part of a new country-learning exchange group to further the work on HESRi2. They requested that work on HESRi2 include qualitative data around issues of governance for health equity, innovations in building trust and social cohesion, and solutions to societal and political polarization.
A further request from the country partners was to include how commercial factors impact health equity. Rasmus Baagland, Senior Adviser to the Danish Health Authority, pointed out, “Adolescents are very influenced by the commercial determinants of health, and it would be interesting to address the links between equity and commercial determinants, for example, alcohol, tobacco and social media.”
A shared mission
HESRi has become a key tool in monitoring progress in 5 areas that act as enabling conditions for advancing the equity agenda in the Region. As well as highlighting backsliding or improvements in equity since 2019, HESRi2 will focus on progress made on 3 policy priorities:
- equitable ageing in ageing societies;
- tackling the inequities in mental health and well-being among young people aged 18 to 28; and
- closing gaps in health equity between different places within countries.
It will highlight reasons for successes or failures, as well as solutions for accelerating progress.
The new report will model how different investments in equity-transformative policies and approaches not only improve lives and well-being, but also contribute to producing trusting, prosperous and sustainable public systems, societies and economies – a priority in the new European Strategy for Health and Well-being, and the second European Programme of Work.
At the latest session of the WHO Regional Committee for Europe (RC74), the Region’s 53 Member States affirmed their commitment to health for all, while recognizing that, despite improvements, health inequities persist. Ongoing effort and collaboration between countries are needed to close gaps in health opportunities and outcomes, which is critical for prosperous, healthy societies and economies.
Member States taking the floor over the 3 days of RC74 repeatedly stressed the need to design life-course and noncommunicable disease policies that prevent new, and mitigate existing, vulnerabilities. Innovations in public health, digital transformations and community engagement should be equity-proofed, they stressed.
The outcomes of HESRi2 will further equip countries with data-driven insights and innovative strategies to support policy actions that close health equity gaps, strengthening well-being and prosperity for all. To this end, the kick-off meeting represented a significant milestone in the shared mission to build a healthier, more equitable Europe.