Tackling socioeconomic inequalities in health: analysis of European experiences.
Effective strategies must be developed to reduce socioeconomic inequalities in health. Most efforts take place in isolation, and only the UK experience has been discussed widely in international published work. We therefore analysed policy developments on health inequalities in different European countries between 1990 and 2001. We noted that countries are in widely different phases of awareness of, and willingness to take action on, inequalities in health. We identified innovative approaches in five main areas: policy steering mechanisms; labour market and working conditions; consumption and health-related behaviour; health care; and territorial approaches. National advisory committees in the UK, the Netherlands, and Sweden have proposed comprehensive strategies to reduce health inequalities. Variations between these packages suggest that policymaking in this area still is largely intuitive and would benefit from incorporation of more rigorous evidence-based approaches. Further international exchanges of experiences with development, implementation, and evaluation of policies and interventions to reduce health inequalities can help to enhance learning speed.
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR, Rotterdam, Netherlands. j.mackenbach@erasmusmc.nl
Johan P
JP
Mackenbach
Martijntje J
MJ
Bakker
D003431:Cross-Cultural Comparison; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods / Q000592:standards*; D005060:Europe; D006291:Health Policy; D006292:Health Priorities; D006302:Health Services Research / Q000379:methods; D006801:Humans; D011050:Policy Making; D011634:Public Health; D011787:Quality of Health Care / Q000592:standards*; D012959:Socioeconomic Factors