John YfantopoulosProfessor of Social Policy & Health Economics University of Athens

Impact of Socio-Economic Science and Humanities - an example: Health and inequality Athens 26-27th February 2014

Platon Hippocrates Aristotle's

Aristotle 384-322: On equity and equalityThe first page of Ethics Nicomchia in Latin 1566 Edition

Directorate-General for Employment, Social Affairs and Equal Opportunities Unit Major Health Inequalities between and within Member StatesEU Communication October 2009 Solidarity in health: reducing health inequalities in the EU14-year difference in life expectancy for men and 8 year gap for women between EU Member States

Regional Inequalities in Greece Men Life Expectancy Men Range 5.7 yearsMin= 71,92 Max=77,62

Regional Inequalities in Greece Women Life Expectancy WomenRange= 3.88 Min = 77.88Max = 81.76

Health Inequalities Gini Coefficients EU-SILC 2005

Health Inequalities Gini Coefficients EU-SILC 2009

Example 3: Self perceived Health Inequalities EU-SILC 2010 and 2005

Data Sources

Data Sources

Self-rated healthEuropean Union Statistics on Income and Living Conditions (EU-SILC)How is your health in general? Is it:Very good/Good/Fair/Bad/Very bad

European Social Survey (ESS) How is your health in general?European Health Interview Survey (EHIS)How is your health in general? Is it:Very good/Good/Fair/Bad/Very bad

Survey of Health, Ageing and Retirement in Europe (SHARE)Would you say your health is:Excellent/Very good/Good/Fair/Poor

Methodology

Measures of Dispersion

Company NameDepartment Name

Derivation from the Mean

Mean

Company NameDepartment Name

Company Name

Cumulative share of people from lowest to highest Health

100%

Line of Equality (45 degree)

100%

Lorenz Curve

A

B

Cumulative Health in %

CONCEPTUAL FRAMEWORK

The Conceptual Framework of EU

Health Impact Analysis

Definition proposed by Louise Saint Pierre (from Canada )"The assessment of impact on health is a structured and collaborative approach that, using different tools and methods, mobilizes the knowledge of public health and other types of relevant knowledge, to estimate the potential effects of a project or a policy on the health of the population"", and the distribution of those effects within it, to provide information useful to policy makers."

The Dutch ApproachMultilevel Local National International A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. The HIA is a flexible method, which is well suited to study, and examine broad policy objectives as well as concrete policy intentions. The application of the method is multi-level: local, national and international.

Health Impact Analysis There is a mixed picture of the HIAs across different countries.France, Belgium, Latvia, and Greece there is little known or happening at a national levelItaly and Hungary it is known by experts in public healthEmerging use of HIAs in Basque Country, Portugal, and Spain particularly in regional settings

Well established processes

Scotland, Wales, England, Ireland, Wales, Norway and SwedenThere are methodological or process requirements on how assessment should be carried out.Well Established Health Impact Analysis

Well Developed Bodies of HIASweden has undertaken HIAs and has been part of the project the effectiveness of health impact assessment. Scope and limitations of supporting decision-making in Europe. Ireland has an extensive range of expertise in HIA, have annual training, produced a number of publications and support and undertake a number of HIAs. England, there is a range of expertise and a number of HIAs have been undertaken,

Health Impact Analysis in Portugal In Portugal, there are links with some academic institutions like: the Institute of Hygiene and Tropical Medicine the Lisbon Faculty of Medicine and the National Health Institute Doutor Ricardo Jorge (INSA) and the Directorate-General for Health (DGH), which are under the Ministry of Healths direct responsibility.

HIA in ITALY In Italy epidemiologists and public health professionals are well aware of HIA and have tried to introduce it within the frame and regulation of Environmental Impact Assessment and Strategic Impact Assessment. Moreover a recent project on the Health in All Policies (HiAP) Strategy has put together experts from different fields (social sciences, economic sciences, technical engineering sciences and epidemiology and public health) to scrutinize the impact on health of different categories of policies

Health Impact Analysis in ITALY 2013 Italian review on Equity in HealthsubmittedInternational benchmarking

Implications

Evidence Cost AnalysisBarriers:(who is gaining?)Actions in time of crisis

THANKS FOR YOURATTENTION EMAIL; yfantopoulos@gmail.com

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