Future of EU Social Policy, 21 October 2004 European Public Health Alliance The social aspects of health Tamsin Rose, General Secretary, EPHA EPHA is a network of 100 non governmental and not-for- profit organisations across Europe working on health and health-related issues. Our mission is to improve the health of European citizens and to increase their participation in EU policy-making.

Future of EU Social Policy, 21 October 2004 WHO identifies the determinants of health  Social Gradient  Stress  Early life  Social exclusion  Work  Unemployment  Social Support  Addiction  Food  Transport

Future of EU Social Policy, 21 October 2004 A recipe for good health  Be rich  Pick your parents well  Get educated  Live in supportive, safe communities  Live in quality housing  Avoid stressful low-paid manual work  Don’t lose your job Roy Romanow, Commissioner, Commission on the Future of Health Care

Future of EU Social Policy, 21 October 2004 Poverty is the largest single determinant of ill health Poverty Ill health income socio-economic status living conditions education Lower life expectancy High infant mortality Poor reproductive health Higher rates of infectious diseases Higher rates of drug, alcohol and tobacco use Higher rates of depression, suicide, violence and exposure to environmental hazards

Future of EU Social Policy, 21 October 2004 The social gradient and health  Health includes quality of social and emotional experiences not just experience of disease and disability.  Poverty, limited education and poor health interact and reinforce each other. Greatest impact on children who take these physical, psychological and social issues into adulthood and across generations.  Goal must be to raise overall prosperity with a focus on marginalised and disadvantaged groups.

Future of EU Social Policy, 21 October 2004 Needs of specific groups  Urban poor and unemployed may lack access to, or not make appropriate use of, health services because they lack resources and knowledge and are often marginalized.  Homeless major impact in terms of overall mortality, prevalence of chronic respiratory diseases, and alcohol and drug dependence.  Ethnic minorities, migrants and refugees: Their needs often receive far less attention, and they cannot always be reached through the usual health and welfare channels.  Women : poverty, family responsibilities as carers and social inequity impact on their health

Future of EU Social Policy, 21 October 2004 Addressing barriers to health  Government policies need to aim at reducing the overall burden of disadvantage. This needs to link health policies with initiatives on employment, income maintenance and social welfare, housing and education.  Emphasis on empowering individuals to make lifestyle choices and changes in their lives. Welfare policies need to provide not only safety nets but springboards to offset earlier disadvantage.

Future of EU Social Policy, 21 October 2004 European Public Health Alliance Rue d'Arlon B-1000 Brussels Belgium Tel : Fax :