INEQUALITIES IN HEALTH: CHALLENGES AND OPPORTUNITIES IN EUROPE

Abstract

Today’s public health challenges are complex and link with living conditions and lifestyles of people. Our goal must be better health and well-being which is equitable and sustainable. It is clear that the disease burden affects populations unequally as a result of a complex interaction of socio-environmental determinants and the structure and function of health systems. The mechanisms are becoming better understood thanks to public health research.

Oral health is a vitally important part of general health. This Conference focuses on the oral disease burden in Europe, the well-documented inequalities in the way it is experienced by different population groups and the necessary responses by health systems and by public health intervention. Thus, solutions to tackling this significant component of NCDs are greatly welcome.

Overall we are doing well. Europeans continue to live longer and healthier lives than ever before; the differences in life expectancy and mortality between countries are diminishing; and premature mortality is decreasing. Meanwhile, oral diseases and related poor quality of life persist in Europe even in countries with advanced oral health care and high public expenditures for oral health.

Profound challenges remain in Europe. The absolute differences in oral health status between countries are substantial, and within-country inequities remain. Unfortunately, there remain political, structural and professional obstacles in eliminating or reducing the key social determinants of oral health and in implementation of effective preventive programmes.

We must absolutely rise to the challenge of unhealthy lifestyles. For example, if current rates of intake of sugars, tobacco use, and excessive alcohol consumption do not decline substantially our opportunities in preventing non- communicable diseases could be lost. This applies to oral health as well.

(Eliminate) We must truly “leave no-one behind”. Policies that influence the social determinants help explain the health inequities that we see and the new forms of health vulnerability which affect particularly those whose health is already lagging.

We must integrate and coordinate our responses to all of the determinants of health. Within the WHO European Region since 2012 we have established Health2020: a single health policy framework to guide our work. We have a variety of supporting strategies and action plans in place. The work carried out by our recently revitalised Oral Health Programme is consistent to the WHO Health2020 policy; this programme is part of the Division of Noncommunicable Diseases and Promoting Health through the Life-course. The concern for oral health is now incorporated into the “Action Plan for the prevention and control of noncommunicable diseases in the WHO European Region” which was just confirmed a few days ago by the Member States at the 2016 Meeting of the Regional Committee.

Today the United Nations 2030 Agenda for Sustainable Development, and the Sustainable Development Goals (SDGs), together with Health 2020, give us an opportunity to establish a coalition for health to ensure that “no-one is left behind” in pursuing health and well-being for all.

We need to secure good governance for health; policy coherence at regional, national and sub-national levels. and whole-of-government and whole-of-society efforts involving all stakeholders. National ownership, political commitment, the assessment of needs and robust planning combined with effective delivery are fundamental. The WHO document “Oral Health Surveys – Basic Methods” is most instrumental to the assessment of population needs, surveillance of oral health, and continuous evaluation and planning adequate delivery of services.

Promoting intersectoral work amongst diverse actors is one of the key challenges. This requires the strengthening of accountability for health across the whole of government and society, as well as the implementation of Health in All Policies (HiAP).

For oral health as for all health, we need strong and effective public health services to fight against health problems and to help us respond to needs. A focus on moving “upstream” towards health promotion and integrated disease prevention is most essential and we need people centred health services that work together.

11.30 – 12.15. Member’s presentations Saturday 1st October 2016.