title: Addressing health inequalities by using Structural Funds. A question of opportunities.
abstract: Making up a third of the EU budget, Structural and Investment Funds can provide important opportunities for investing in policies that tackle inequalities in health. This article looks back and forward at the 2007-2013 and 2014-2020 financial periods in an attempt to inform the development of health equity as a strand of policy intervention under regional development. It combines evidence from health projects funded through Structural Funds and a document analyses that locates interventions for health equity under the new regulations. The map of opportunities has changed considerably since the last programming period, creating more visibility for vulnerable groups, social determinants of health and health systems sustainability. As the current programming period is progressing, this paper contributes to maximizing this potential but also identifying challenges and implementation gaps for prospective health system engagement in pursuing health equity as part of Structural Funds projects. The austerity measures and their impact on public spending, building political support for investments as well as the difficulties around pursuing health gains as an objective of other policy areas are some of the challenges to overcome. European Structural and Investment Funds could be a window of opportunity that triggers engagement for health equity if sectors adopt a transformative approach and overcome barriers, cooperate for common goals and make better use of the availability of these resources.
authors.affiliation: Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: oana.neagu@maastrichtuniversity.nl.
authors.forename: Oana Maria
authors.initials: OM
authors.lastname: Neagu
authors.affiliation: Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: kai.michelsen@maastrichtuniversity.nl.
authors.forename: Kai
authors.initials: K
authors.lastname: Michelsen
authors.affiliation: HealthCluster Net, Hoofdweg 146 II, 1057 DB Amsterdam, The Netherlands. Electronic address: jonathan@healthclusternet.eu.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Watson
authors.affiliation: Management Centre Innsbruck, Universitätsstraße 15, 6020 Innsbruck, Austria. Electronic address: barrie@dowdeswell.entadsl.com.
authors.forename: Barrie
authors.initials: B
authors.lastname: Dowdeswell
authors.affiliation: Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. Electronic address: helmut.brand@maastrichtuniversity.nl.
authors.forename: Helmut
authors.initials: H
authors.lastname: Brand
mesh_terms: D002017:Budgets; D003695:Delivery of Health Care; D004467:Economics; D005376:Financial Management; D006078:Government Programs; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D011446:Prospective Studies; D011640:Public Policy; D035862:Vulnerable Populations
keywords: Cohesion policy; Health; Health equity; Health inequalities; Structural and Investment Funds