Abstract
The effects of health inequalities within and between European countries are widely recognized, and reducing health inequalities is on the agenda of many countries. Despite an increasing concern and awareness on health inequalities, a wide gap exists in Europe in terms of political response.
Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love. Healthy urban development has a great potential to reduce health inequalities. Healthy living environments can only be created if sectors other than the health sector are involved.
Health in all policies (HiAP) is an approach promoted by WHO since the Ottawa Charta (1986). It acknowledges the need for an integrated approach to health involving different policy fields. The reduction of health inequalities is one core aim. Including HiAP is a smart - and feasible - policy choice and one concrete measure it to use prospective Health Impact Assessment focusing on equity.
Working with other government sectors requires an understanding of different mandates and goals, and may involve crossing administrative and budgetary barriers between sectors. Different policy actors and professional disciplines have their own languages and approaches to the problems and opportunities in societal development. For this reason, HiAP needs to promote an understanding of the language, goals and working methods across government sectors. Municipal governments need to build trusting and collaborative relationships both between internal sector silos, and across stakeholders within society.
The municipal context offers comprehensive entry points for action. Municipalities seek to provide education throughout the life course, create appropriate conditions for housing as well as for physical activity and healthy eating. Municipalities can also promote the creation of a stable ecosystem. Moreover, a focus on municipalities addresses the local political context, local political regulations and urban or rural planning and development, which are important contributions to improving living conditions.
There is valid information on health, health inequalities and its determinants available, but the information is not automatically transformed to concrete policy actions and measures. Besides knowledge, policy implementation requires many other elements to be effective: political will and commitment, collaboration, resources and governance.
This session presents current findings and actions in the frame of the EU Joint Action Health Equity Europe (JAHEE). The first contribution includes an analysis of specific governance aspects for healthy living environments that are being addressed in JAHEE: How is the process from needs to decision-making to actions done by the participating 13 countries? After that, 4 examples from the Netherlands, Italy and Spain will describe their needs, governance and tools while implementing local health equity policies in their own context.
Key messages
The local level is the place where many determinants of health can be shaped and where Health and Equity in all Policies can be realized in an innovative way. There are many existing examples for tools and governance for local health equity policies that can be transferred to other places.
Collaboration among community members, local health service providers, and researchers in an Urban research center in Harlem, New York