Periodic Reporting for period 2 - EURO-HEALTHY (Shaping EUROpean policies to promote HEALTH equitY)
Reporting period: 2016-07-01 to 2017-12-31
Evaluating population health and health inequalities represents challenges. Although knowledge has advanced considerably with respect to the key driving forces likely to influence health and well-being and the methods used to assess them, there is still a lack of comparable measures that can afford a holistic understanding of population health with multiple determinants involved and can be applied to different geographical levels, while accounting for future scenarios.
The main objective of EURO-HEALTHY was to build tools that contribute to the advancement of knowledge of policies that have the greatest potential to enhance health and health equity across European regions, with particular focus on the Lisbon and Turin case studies. Thus, the project developed innovative tools based on the Population Health Index (PHI) whose goals are to: i) evaluate and monitor overall health, ii) evaluate the interactions between health and multiple dimensions at different geographical levels, iii) foresee and discuss the impact of multilevel policies on population health and geographical health inequalities, iv) provide a basis for multilevel policy dialogue on health and health equity.
The project provides a comprehensive picture of health and well-being across multiple dimensions and geographical levels. Its findings emphasise how crucial it is to understand the causes of geographical health inequalities and to secure opportunities to address them. The information gathered is of the utmost importance, particularly for policymakers and mainly at regional levels, to support their decision-making regarding those policies with the highest potential to improve health equity in Europe and to further monitor the impact of the policies of today and for the future. The knowledge and evidence on population health variations across EU regions provided by the PHI can inform a better allocation of Structural Funds and maximise opportunities for reducing regional inequalities for the period 2014-2020.
The PHI findings demonstrate a high degree of variation in the geographical distribution of health determinants and health outcomes, emphasising that inequalities still persist across Europe: Northern regions stand out with the highest levels of health when compared with the Southern and Eastern regions that continue to show lower population health scores. The identified inequalities refer to environmental, social, economic, and lifestyle/behavioural patterns. The data can be found in the Atlas of Population Health in the European Union, available on the website. The project’s overall conclusions are that:
• Monitoring, reporting, and evaluating health determinants and health outcomes are absolutely necessary elements in the efforts to reduce health inequalities.
• The Population Health Index (PHI) is a useful tool for more evidence-based policymaking.
• The socio-technical approach combining multi-criteria methods and participatory processes is crucial when designing population health measures that consider the views of stakeholders and experts as well as reflect scientific evidence and reliable data.
• Web-Delphi processes have proven to be an inclusive and effective way to collect information from a significant number of geographically dispersed experts and stakeholders.
• The evaluation of health policies should be carried out in light of theoretically sound scenarios and assisted by powerful graphs that can show the extent to which possible futures play a key role in the analysis of policies in order to make local stakeholders interact and align towards a policy agenda.
• The start of action in equity requires building solid evidence and information bases at the sub-national level. Developing solid indicators and identifying suitable data sources for new concepts such as health equity and population health is essential to make progress.
The main objective of EURO-HEALTHY was to build tools that contribute to the advancement of knowledge of policies that have the greatest potential to enhance health and health equity across European regions, with particular focus on the Lisbon and Turin case studies. Thus, the project developed innovative tools based on the Population Health Index (PHI) whose goals are to: i) evaluate and monitor overall health, ii) evaluate the interactions between health and multiple dimensions at different geographical levels, iii) foresee and discuss the impact of multilevel policies on population health and geographical health inequalities, iv) provide a basis for multilevel policy dialogue on health and health equity.
The project provides a comprehensive picture of health and well-being across multiple dimensions and geographical levels. Its findings emphasise how crucial it is to understand the causes of geographical health inequalities and to secure opportunities to address them. The information gathered is of the utmost importance, particularly for policymakers and mainly at regional levels, to support their decision-making regarding those policies with the highest potential to improve health equity in Europe and to further monitor the impact of the policies of today and for the future. The knowledge and evidence on population health variations across EU regions provided by the PHI can inform a better allocation of Structural Funds and maximise opportunities for reducing regional inequalities for the period 2014-2020.
The PHI findings demonstrate a high degree of variation in the geographical distribution of health determinants and health outcomes, emphasising that inequalities still persist across Europe: Northern regions stand out with the highest levels of health when compared with the Southern and Eastern regions that continue to show lower population health scores. The identified inequalities refer to environmental, social, economic, and lifestyle/behavioural patterns. The data can be found in the Atlas of Population Health in the European Union, available on the website. The project’s overall conclusions are that:
• Monitoring, reporting, and evaluating health determinants and health outcomes are absolutely necessary elements in the efforts to reduce health inequalities.
• The Population Health Index (PHI) is a useful tool for more evidence-based policymaking.
• The socio-technical approach combining multi-criteria methods and participatory processes is crucial when designing population health measures that consider the views of stakeholders and experts as well as reflect scientific evidence and reliable data.
• Web-Delphi processes have proven to be an inclusive and effective way to collect information from a significant number of geographically dispersed experts and stakeholders.
• The evaluation of health policies should be carried out in light of theoretically sound scenarios and assisted by powerful graphs that can show the extent to which possible futures play a key role in the analysis of policies in order to make local stakeholders interact and align towards a policy agenda.
• The start of action in equity requires building solid evidence and information bases at the sub-national level. Developing solid indicators and identifying suitable data sources for new concepts such as health equity and population health is essential to make progress.
The PHI is a landmark achievement and the flagship of the project. A multi- and trans-disciplinary approach was applied to enable the appraisal and comparison of population health and inequalities in multiple dimensions, within and across European countries, in 269 NUTS 2 level regions, and ten selected metropolitan areas (Athens, Barcelona, Berlin, Brussels, Lisbon, London, Paris, Prague, Stockholm, Turin), including 540 municipalities and two case studies (Lisbon and Turin). This measure evaluates population health over a wide range of areas of concern (10), dimensions (17), and indicators (39). In addition, the project:
• Involved 96 stakeholders and 56 experts in progressive fashion, actively engaging them in multiple research activities related with the process of constructing the PHI and scenarios of evaluating policies in the two case studies.
• Developed an open access user-friendly WebGIS platform to provide a snapshot of of EU population health over multiple dimensions and geographical scales (http://healthyregionseurope.uc.pt).
• Collected data for 80 indicators at 3 geographical levels: national (countries), regional (NUTS 2) and metropolitan (municipalities) that is available via the online platform eurohealthydata (https://eurohealthydata.uc.pt)
• Built population health scenarios for 2030, useful to reflect upon the future of population health inequalities in Europe and inform the assessment of policies with impact on health;
• Evaluated the potential of policies to improve overall health and reduce health inequalities (e.g. strengthening social cohesion, promoting quality of work and investing in better physical and built environments).
Detailed information on the main results is given on the EURO-HEALTHY website, including 8 videos summarising the work performed in the project.
• Involved 96 stakeholders and 56 experts in progressive fashion, actively engaging them in multiple research activities related with the process of constructing the PHI and scenarios of evaluating policies in the two case studies.
• Developed an open access user-friendly WebGIS platform to provide a snapshot of of EU population health over multiple dimensions and geographical scales (http://healthyregionseurope.uc.pt).
• Collected data for 80 indicators at 3 geographical levels: national (countries), regional (NUTS 2) and metropolitan (municipalities) that is available via the online platform eurohealthydata (https://eurohealthydata.uc.pt)
• Built population health scenarios for 2030, useful to reflect upon the future of population health inequalities in Europe and inform the assessment of policies with impact on health;
• Evaluated the potential of policies to improve overall health and reduce health inequalities (e.g. strengthening social cohesion, promoting quality of work and investing in better physical and built environments).
Detailed information on the main results is given on the EURO-HEALTHY website, including 8 videos summarising the work performed in the project.
EURO-HEALTHY presents a ground-breaking concept with respect to the multi- and trans- disciplinary approach and methods used to appraise population health in Europe. The socio-economic impact of the project is represented by the following points:
Science-into-action: The project has delivered a tool (PHI) which is not only totally scientifically robust but also simple and user-friendly. The PHI demonstrates a fundamental capacity to serve different stakeholders and actors with the direct support needed to understand, conceptualise, and ultimately to help them to take action and address the determinants of health inequality in Europe.
Knowledge-transfer between scientists and decision-makers: Population health improvement requires actions on multiple determinants, and therefore such actions must be sustained by a collective effort bridging the gap between research and policy and involving stakeholders whose actions and decisions potentially affect population health.
Value of solidarity and concern for social justice: The project activities have contributed to the processes which emphasise sharing, bringing European countries together, and learning from each other as to how to improve in diverse areas to ultimately enhance overall population health and health equity. Having broad-ranging data about different countries, regions and metropolitan areas, collected and utilised in one measure (PHI), facilitates that joint learning process, encourages conversation and dialog, and supports identification of relevant partners with similar problems to tackle the problem via joint efforts (setting up learning networks).
Please check our website for the full version of the Final Report.
Science-into-action: The project has delivered a tool (PHI) which is not only totally scientifically robust but also simple and user-friendly. The PHI demonstrates a fundamental capacity to serve different stakeholders and actors with the direct support needed to understand, conceptualise, and ultimately to help them to take action and address the determinants of health inequality in Europe.
Knowledge-transfer between scientists and decision-makers: Population health improvement requires actions on multiple determinants, and therefore such actions must be sustained by a collective effort bridging the gap between research and policy and involving stakeholders whose actions and decisions potentially affect population health.
Value of solidarity and concern for social justice: The project activities have contributed to the processes which emphasise sharing, bringing European countries together, and learning from each other as to how to improve in diverse areas to ultimately enhance overall population health and health equity. Having broad-ranging data about different countries, regions and metropolitan areas, collected and utilised in one measure (PHI), facilitates that joint learning process, encourages conversation and dialog, and supports identification of relevant partners with similar problems to tackle the problem via joint efforts (setting up learning networks).
Please check our website for the full version of the Final Report.