National policies for reducing social inequalities in health in Europe

Abstract

Gaps in health between poor and rich countries, and between social groups within countries, are unacceptably large and may be widening. WHO has made the fi ght against inequities in health a priority in the European region, as part of the policy framework for health for all in the twenty-fi rst century (HEALTH21), aimed at allowing all people to participate in social and economic life. It proposes a number of concrete steps, in order to promote access to health and reduce inequalities in health status. Equity should be everybody's concern, because inequities in health are everybody's loss. They harm many people, operate on a socioeconomic gradient, and put a strain on economic development and social cohesion. Equity is not something that is achieved once for all. A three-pronged approach to action includes: provision to all people of a "decent minimum' ' of assets and resources for creating and maintaining health and living; targeted additional support for disadvantaged groups in ways that respect their dignity and human rights; and appropriate policies, actions, and investments to secure opportunities and support at all levels of society. Genuine progress can be achieved by:

•securing a champion and making action understood and attractive;

•identifying and acting on needs;

•working in partnership and at different levels - community, subnational, national, and international;

•mobilizing investment for health;

•building in accountability for health;

•agreeing on policy choices, and reallocating resources and responsibilities accordingly;

•learning and developing knowledge, and looking around and ahead.