title: [Health and social inequality in Europe: changes of the basic conditions for municipal health services].
abstract: Good health is not distributed equally, neither in life conditions--including the individual ability to act--nor according to the supply grid. These interrelations, shown in several empirical investigations, assume more importance in view of the groving tendency to social polarisation in the countries of Europe, different in fact in the single countries, but clear in respect of tendency: social exclusion does not only mean to have less financial resources but also social disadvantages in other realms of living, especially in health. Migration, not only from East to West, but also inside and between the countries of the European Union and inside of Eastern Europe too, is only an especially dear expression that social problems have their origin in international problems and casualities, but become visible in local and regional structures and thus in the responsibility of the municipalities. Globalisation, Europe etc., terms mostly connected with positive connotations, have not only a positive side, but also another one, namely, the re-regionalisation of social problems especially in the municipalities. Normally the municipalities have to counterbalance and to regulate the negative consequences of these European--and moreover international--changes of the structures, although their financial means are declining. The municipal health service is integrated in this contradictory constellation. To prevent irrational social and/or political developments, the reasons and possible strategies of reform policy will have to be discussed carefully.
authors.affiliation: Evangelische Fachhochschule Rheinland-Westfalen-Lippe.
authors.forename: E U
authors.initials: EU
authors.lastname: Huster
mesh_terms: D003153:Community Health Services; D003695:Delivery of Health Care; D005060:Europe; D018166:Health Care Reform; D006801:Humans; D012959:Socioeconomic Factors