On the occasion of two major recent reports reviewing trends and progress on health inequalities in Europe – by the European Commission and the WHO Regional Office for Europe – the European Public Health Alliance (EPHA) and its partners are calling for urgent and concerted action among all relevant actors to close the huge, persistent and growing health divide between the richest and the poorest in our societies. Despite this issue being high on political agendas for the last 10 years, only meagre progress has been achieved and in many cases the inequalities have been growing, partly due to the consequences of deliberate political actions in response to the economic crisis.
Gaps in life expectancy for both men and women narrowed over the last decade mainly due to a decline in infant mortality – but there still remains a significant difference between how long people live and how much of their years lived are spent in health (healthy life expectancy). In fact, the latest figures show that there are twice as many years lost due to ill health or premature death in low- and middle-income countries than in high-income countries in Europe.
“Why must anyone suffer only because he or she was born and has lived on the ‘wrong’ side of Europe?,” questioned Joanne Vincenten, Secretary General of the European Child Safety Alliance. “Increasing inequalities in living conditions are seen everywhere, even in more affluent societies. Take the example of Belgium where Medicins du Monde reports the alarming fact that today, in the 21st century, only 6% of Roma children living in Brussels, the capital of Europe, are vaccinated. And from our own work, injury and accidents for children already create the greatest inequity for children’s health and the growing economic divide likely means it will get worse,” added Ms Vincenten.
Both reports on health inequalities come timely to carry on key messages from EPHA’s 4th Annual Conference “Brave New World: inclusive growth and well-being or vested interests and lost generation?” which highlighted that “European decision-makers have – so far – failed to ensure that people living in Europe, their health and well-being are sufficiently protected and promoted, and that good and democratic economic governance is the tool to address it.”
This call from the public health community, social actors and ordinary people, is in stark contrast in their urgency to lack of sufficient attention to these issues in the State of the European Union address given by the President Barroso on the on 11 September – just months after the Citizens’ Summit, for the first time in the 60 years since creation of the EU, managed to channel Europeans’ voices and concerns into concrete, urgent demands directed to EU leaders, including Mr Barroso. Unsurprisingly therefore, serious questions are raised about the ability of the current political leadership in the EU to listen to and tackle the issues at the foremost of the minds of people living in Europe, and the consequent erosion of trust in Europe, its institutions and leadership.
“In the aftermath of the crisis, public spending on health services has reduced significantly in member states. Reductions in the availability and affordability of healthcare have gendered consequences, because women use these services to a higher extent than men. In addition, they may affect the gendered division of paid an unpaid labour to the disadvantage of women, whereby women are forced to cover for the lack of services. This trend has impacts not only in terms of health and health inequalities, but also on long term trends in relation to gender equality and well-being,” said Cécile Gréboval, Secretary General of the European Women’s Lobby.
Since the onset of the financial and subsequent economic crisis, a quake of dreadful social and health consequences has shaken European societies putting our fundamental rights and values into question, rights such as access to healthcare services and medicines or our right to water and sanitation, not to mention the impact on suicides, mental health, families and children and the dignity of those who are being pushed into poverty, exclusion and inability to participate in democratic processes affecting their living conditions. As a recent study (4) suggests, the views and preferences of rich Europeans are more likely to be reflected and fought for by political parties than those of poorer citizens.
“If we want to be serious and break up this stagnation in progress on closing the unjustified and preventable gap in health status between our richest and our poorest members of society, this is the moment to strike. The current economic situation should be an opportunity for change and bold visions, not inactivity and more of the same game,” said EPHA Secretary-General Monika Kosińska. “We know what the root causes that bring about health inequalities are and we must demand the leadership and commitment from our political decision-makers to transform nice words into hard actions, good governance and inclusive economic progress.We know the problem, the causes and the solutions – the real question is the political failure to do what’s needed,” Kosińska concluded.
