Learning from others: Comprehensive health equity strategies in Europe
In this short paper, Haber and Wong present the national health equity strategies of 14 European countries, hoping to encourage the development of a comprehensive health equity strategy for Canada. The authors claim that while Canada has contributed to awareness of the concept of social determinants of health (SDOH), its policies have largely failed to address the unequal distribution of health and its social determinants. They also claim that a national strategy is needed, both symbolically and strategically, to encourage all levels of government to make health disparities a priority.
The national strategies differ in significant ways: some focus solely on health inequalities, while others blend health equity with other goals; some are driven by central government, while others are driven by the department of health.
In Sweden, the Public Health Objectives Bill (2003) requires all departments to take responsibility for 11 objectives aimed at creating equitable social conditions for the entire population. Norway’s Ministry of Health coordinates health equity policy development with politicians and bureaucrats from six other ministries. England has health and well-being boards that coordinate, through local authorities, the integrated work of health, social services, and tackling health inequalities. Scotland has recently given local authorities more autonomy to frame and implement strategies to align with community values and needs.
The paper also describes two European-wide initiatives: the European Charter for Health Equity (2011), and the European Portal for Action on Health Inequalities (2011). The portal provides a sharing space for information, policies and best practices on SDOH and health in all policies.
According to Haber and Wong, an effective national health equity strategy should include
- a focus on the social determinants of health
- thoughtful selection of targets and evaluation steps
- mechanisms to steer and coordinate policy within and beyond government
- strong linkages between policy and programs at the national and local levels
- coordination among government policy actors outside of health
Use this resource to:
- Advocate for a national health equity strategy in Canada
- Learn how national, provincial and local health initiatives can be coordinated through a national policy
- Investigate the success factors and options for policy designed to reduce the social inequities that cause health disparities
Haber, R. & Wong, E. (2013). Learning from others: Comprehensive health equity strategies in Europe. Toronto, ON: Wellesley Institute.