EU Action

The European Health Union

The European Semester

The European Pillar of Social Rights

EU Child Guarantee

EU4Health

EU Joint Actions

EU funded research initiatives

On this page we dive into European action on health inequalities. What are the initiatives, programmes and projects address health inequalities and the socioeconomic determinants of health?
Pandemics, climate change, and growing inequalities pose growing threats to our health. Those challenges cross borders, so transnational collaboration is needed to address them effectively. European countries have collaborated in the field of health for many years, and since the 1992 Maastricht Treaty, the European Union has had responsibilities in the field of health.

To find out more about Council consultations and Presidency outputs addressing health inequalities visit the EU Institutions page.

 

The European Health Union

European Commission (EC) President Ursula von der Leyen announced an initiative for a new ‘European Health Union’ (EHU) in the State of the Union address in September 2020. The initiative to build strong EHU came about as the COVID-19 pandemic crisis has shown critical limitations of current structures, services, and approaches to health at the EU level.

In November 2020, the EC proposed a number of initiatives focused on crisis preparedness and response measures.By February 2021, the EC had proposed initial measures to strengthen cooperation and coordination between European Member States towards a European Health Union.

One of the flagship initiatives under the European Health Union Umbrella is Europe’s Beating Cancer Plan - a political commitment to ‘turn the tide against cancer’.  It focuses on:

  1. Prevention
  2. Early Detection
  3. Diagnosis and Treatments
  4. Improving quality of life for cancer patients and survivors.

Preventing cancer is interlinked with reducing health inequalities through actions on the determinants of health. In addition, the plan includes some specific measures to measure and reduce health inequalities – particularly between countries.

 

The European Semester

The European Semester is the EU’s annual cycle of economic and social policy coordination. In particular, it concerns reforms and legislation related to public expenditure, employment, education, and social- and health-care. Because it influences the socioeconomic determinants of health ands health care reforms, it is an important tool to address health inequalities.

The process

The process starts in November of each year with an assessment of the economic and social context of every Member State. It concludes by July with the adoption by the Council of the EU of a set of country specific recommendations. Over the following year, recommendations are addressed by the Member States which will present National Reform Programmes on the progress.

How the Semester process has evolved

The semester was first created in 2010 as a mechanism to address fiscal and budgetary issues. However, it has slowly but steadily incorporated principles of health and social equity within its priorities over the past decade.  This is also linked to the introduction of the European Pillar of Social Rights. In 2019, the European Commission President Ursula von der Leyen’s Political Guidelines committed the Commission to integrate the UN Sustainable Development Goals (SDGs) into the European Semester. This represents a unique opportunity to put people and their health at the centre of economic policy.

COVID-19 and the Resilience and Recovery Facility (RRF)

In 2020, in response to the COVID-19 crisis, the European Semester has been tied to the implementation of a revamped EU structural reform service – the EU Resilience and Recovery Facility (RRF) worth a total of 672.5 million euro. The aim of the EU RFF is:

  • to help states to address pre-existing challenges identified in the context of the European Semester (especially the 2019 and 2020 cycles)
  • to achieve the EU’s policy objectives, especially the green and digital transitions in view of the recovery from this crisis.
EuroHealthNet and the European Semester

EuroHealthNet produces annual in-depth analyses of the European Semester and health for health agencies and people involved in the Semester process.

Find all of EuroHealthNet's Semester analyses here.

illustration of the European Semester process and relivance to health inequalities
The European Semester: Country-specific recommendations in May and June; Autumn package and annual growth survey in November; country reports in February; and national programmes in March and April.

 

 

The European Pillar of Social Rights

The European Pillar of Social Rights (‘EPSR’ or ‘social pillar’) is a (non-binding) commitment among Member States to address social challenges and guarantee social rights. It covers areas that affect health such as:

  • education
  • employment
  • working conditions
  • housing.

The Pillar consists of 20 principles, structured around three categories:

  1. equal opportunities and access to the labour market
  2. fair working conditions and
  3. social protection and inclusion.

An accompanying ‘Social Scoreboard’ measures progress and trends. It also allows for cross-country comparison. The scoreboard includes indicators on things like

  • formal childcare
  • at-risk-of-poverty or social exclusion rate
  • self-reported unmet need for medical care.

Because many of the principles in the Pillar cover the social determinants of health, it plays an important role in addressing health inequalities.

In addition, principle 16 specifically addresses health. It states that: everyone has the right to timely access to affordable, preventive and curative health care of good quality.

The social pillar was introduced in 2017 and an action plan will be launched in March 2021. The social pillar has now also been integrated into the semester process.

Read EuroHealthNet’s Factsheet on the European Pillar of Social Rights for more information.

Illustration of the 3 areas of the socail pillar and impact on health and health equity

EU Child Guarantee

The Political Guidelines of the European Commission President Ursula von der Leyen announced the adoption of a Child Guarantee. The goal is to ensure that every child in Europe at risk of poverty or social exclusion (‘children in need’) has access to the most basic of rights like health care and education.

More specifically, the objective is to ensure access to the services that are essential for development and well-being, in particular

  • early childhood education and care
  • health care
  • education
  • nutrition
  • housing
  • participation in cultural and leisure activities.

The European Commission, following it's Communication ‘A Strong Social Europe for Just Transitions’, will adopt a proposal for a Council Recommendation on a Child Guarantee in 2021.

EU4Health

In 2020, the EU’s response to the lessons learned from COVID-19 came through the EU4Health funding programme for 2021-2027. This ambitious programme is meant to build resilient health systems through, amongst others, reducing health inequalities. This will include

  • disease prevention and health promotion in an ageing population,
  • digital transformation of health systems
  • access to health care for vulnerable groups.

It aims to:

  • boost EU’s preparedness for major cross border health threats;
  • strengthen health systems so that they can face epidemics as well as long-term challenges;
  • make medicines and medical devices available and affordable
  • advocate the prudent and efficient use of antimicrobials
  • promote medical and pharmaceutical innovation and greener manufacturing.

Other EU action including programmes, such as the European Social Fund Plus (ESF+) and Horizon Europe will provide additional investments in the health sector to complement EU4Health. For more information about EU4 health and European funding, financing and budgets for health inequalities, visit the EU funding page.

 

EU Joint Action

A Joint Action is a collaborative action co-funded by EU Member States and the Commission on priority health issues. Some of them work on health inequalities and underlying social determinants of health, such as the ones listed below. The Joint Actions below are examples that EuroHealthNet was part of. You can find more EU Health Programme projects here.

 

Joint Action on Health Equity Europe (JAHEE)

The Joint action on Health Equity Europe (JAHEE)JAHEE Logo represents an important opportunity for Member States to work jointly to address health inequalities and achieve greater equity in health outcomes across all groups in society, in all participating countries and in Europe at large. It runs from 2018-2021 The general objective of JAHEE is to

  • improve health and well-being of  European citizens
  • achieve greater equity in health outcomes across all groups in society in all participants countries and in Europe at large.

In addition JAHEE will also include a specific focus on both vulnerable groups and migrants The Joint action covers:

  • Integrating action on Health Inequalities into national policy
  • How to monitor Health Inequalities
  • Healthy Living environments
  • Migration and health
  • Improving access to health and social services for those left behind
  • Health and Equity in All Policies – Governance

An overview of key outcomes from the JAHEE project can be found in this article.

To find out more, visit jahee.iss.it

Structure of the joint action on health inequalities

 

Other EU funded initiatives and European action on health inequalities

In addition to EU action on policies, the EU also fosters research, innovation and collaboration at the European level through its Framework Programme (FP) for Research and Innovation, which span 7 years. The current Framework Programme is called Horizon Europe, spanning the period of 2021 – 2027. The FPs provide funding for a variety of projects in the field of health equity. In addition, the European Parliament has offered a number of tenders for projects to address health equity. The projects listed below are examples that EuroHealthNet was part of. You can find more EU-funded research and innovation projects here.

Find more projects in the our health equity resource database.

Other EU-funded research and innovation initiatives addressing health inequalities can be found via this list of databases.

 

EuroHealthNet is co-funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union nor the granting authority can be held responsible for them.

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