During the past decade, the case – both moral and economic – for tackling inequalities in health within and between EU countries has built formidably. EU public health action programmes have supported work to identify evidence and develop strategies/specific measures to do so.
The European Commission's 2009 “Solidarity in health” paper goes some way towards putting together the complex mix of policy and practice needed to address the problems effectively.
Successive EU presidencies have demonstrated growing government recognition of the extent of the problem, an important precursor to finding solutions, with the current Spanish presidency actively encouraging practical steps, particularly to measure and understand needs.
This matter extends beyond health systems, though the need to systematically reorient them towards disease prevention and health/wellbeing promotion is a vital part of the solution, not least as a crucial response to the major economic and social crises expected as priorities for the Europe 2020 strategy are being set.
The EU institutions have a fundamental part to play. The EU's commendable aspiration in the Lisbon treaty to “promote [ … ] the wellbeing of its peoples” needs to be converted into action addressing social, economic and environmental determinants: the “causes of the causes” of poor health. Only then can we begin to tackle the problem.
