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.
