| | Learning from EuroHealthNets Health Inequalities Projects that can contribute to Health Equity 2020 Ingrid Stegeman

2007 – 2010 EU Consortium that drew on the knowledge of its 24 partners to: 1.Contribute to our understanding of health inequalities 2.Identify and highlight potential solutions 3.Stimulate action to ensure progress for health equity – 2012 Develop capacities of public health sector to work more closely with other sectors to ensure that their policies and actions contribute to improved health and well-being, through: 1.Analysis of examples relating to Education, Urban Planning and Transport, Agriculture 2.Development and Implementation of a Capacity Building Training Programme (Achieving Win-Win for Health Equity).

Learning gained: Gold star: whole of government support, approaches and mandates for equity to ensure policies/plans translate into practice Data on health inequalities important political tool but too often lacking Still important need within health sector to raise awareness and build capacities to: -Ensure own-house in order: good quality health care/promotion in proportion to need and targeted to + involvement of specific user groups -Raise awareness about health inequalities -Foster collaborations with other sectors to optimize health across social gradient. DETERMINE: Menu for Capacity Building and Awareness Raising Actions: Policy development; Organisational development; Skill development; Partnership development and leadership; Awareness Raising and Advocacy; Development of the information and evidence base. Crossing Bridges: Negotiation skills + gathering and sharing information and evidence. Challenges: attributing health outcomes and justifying resources + changing health sector approaches.

GRADIENT What works to level-up the health gradient amongst children, young people and families in the EU? 1. Some countries better than others in generating conditions that lead to level gradients. 2. Improving Social Capital matters, particularly for disadvantaged families in communities with low social capital (through e.g. sport associations, parental involvement in schools) 3 GRADIENT Evaluation Framework – as a tool to help governments monitor the effects of universal policies on the health of people across the social gradient Addressing the strategic Determinants to Reduce health Inequity Via 1) Early childhood development, 2) Realising fair employment, and 3) Social protection - Identifying and filling key gaps in knowledge about policies about how these three social determinants lead to health inequalities. -Undertaking further research and assessing how outcomes can be applied to real life situations and stakeholders

co-beneficiaries; 16 EU MS, 22 Regions Tools: Trainings on HiA to improve the equity focus in cross-government policy making Regions: Development of a network (22 regions in 12 Member States) to: -Explore and support the role of regional and sub-national actors in tackling health inequalities -Develop knowledge of how to use structural funds for reducing health inequalities (Workshop in Spring Guidance Tool) Knowledge: Scientific experts to provide support and develop knowledge for action on health inequalities Stakeholders: Explore how to engage stakeholders in efforts to reduce health-inequalities

Learning gained: Good Practice: -Governance/Community Planning/Health and Well Being Groups/Action Plans HI to ensure (health + social) sectors work together to improve socio-economic conditions in deprived areas and services for relatively deprived groups (leveling-up). UK + Scandinavian countries and regions -Good/innovative practices to address risk factors and improve health/services for the most deprived. But: Initiatives coming from health promotion sector and actors: are measures hard enough to make a difference? How can other sectors be engaged? (Learning from effective approaches lies in their detail.) Greater application of prospective and post-facto health-impact assessments being reported, though on an ad-hoc basis. Yet: are outcomes taken into account and acted upon by non-health sectors? Measuring and attributing impact?

Structural Funding for Health Inequalities What kind of actions to address health inequalities should the heath- sector seek to get funded? How can the health sector claim funds for initiatives that clearly address the social determinants of health inequalities (e.g. unemployment, social capital, social inclusion, early child development programmes) but that are not necessarily their core business?

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