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Driving forward health equity – the role of accountability, policy coherence, social participation and empowerment

This resource is available in English and Polish only.

As part of the World Health Organization (WHO) European Health Equity Status Report initiative, this summary report presents the findings of a scientific expert review on the lack of progress in health equity in the region, despite significant investment to address individual determinants. Presenting their results in four related reports, the review panel found that accountability, policy coherence, social participation and empowerment were key drivers of health equity. In other words, when these drivers were present, there was greater action to reduce health inequities.

Corporate influence

The report considers the increasing effect of corporations on progress towards health equity, and discusses the importance of these key drivers in mitigating negative effects of the “commercial determinants of health.” The authors give equal attention to the idea that integrated governance is essential for policies that are coherent across levels of government and different sectors.

Throughout this work, accountability, policy coherence, social participation and empowerment are conceptualized as related and even synergistic “common goods.” This means that when accountability is ensured, when policy is aligned and coherent across governments and across sectors, when society is well represented and participates in decision-making and policy processes and when communities are empowered, human rights principles are at play.

As a result, there are multiple benefits (outlined in Table 1 on p. 7 of the summary report), and there is an overall positive effect on health equity. 

The following advice is given to those working in public health and policy:

  • Value the knowledge and experience of communities.
  • Make the most out of “empowering spaces” (e.g., community gatherings).
  • Stop using “stigmatizing narratives of disadvantage.”

Note that the WHO Regional Office for Europe has published three additional reports related to this summary:

Use these resources to:

  • reflect on the applicability of accountability, policy coherence, social participation and empowerment as drivers for health equity action in the Canadian context;
  • consider the multiple benefits of these key drivers; and
  • discuss, with your public health colleagues, how to better value the knowledge and experiences of communities, make the most of “empowering spaces”, and change stigmatizing narratives.


WHO Regional Office for Europe. (2019). Driving Forward Health Equity – the Role of Accountability, Policy Coherence, Social Participation and Empowerment. Copenhagen (Denmark): WHO Regional Office for Europe.

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Tags: Community engagement, Healthy public policy, Key concepts, Public Health Organization, Link

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