Sustainable societies The European Partnership for improving

health, equity and wellbeing

Caroline Costongs, Managing Director

AUSTRIA Austrian Health Promotion Foundation

BELGIUM Flemish Institute for Health Promotion and Disease

Prevention

BELGIUM Erasmus university Collage, Health Department

BELGIUM Ghent University, Public Health Department

CZECH REPUBLIC National Institute of Public Health

CZECH REPUBLIC Olomouc Region

DENMARK Danish Health and Medicines Authority

ENGLAND Department of Health

Kent & Medway NHS

North of England EU Health Office

FRANCE National Institute for Prevention and Health Education

(INPES)

GERMANY Federal Centre for Health Education (BZgA)

GREECE: Institute of Preventive Medicine, Environmental &

Occupational Health Prolepsis

GREECE: Society for the Development of Children

FINLAND: National Institute for Health and Welfare

Finnish Society for Social and Health – SOSTE

HUNGARY Hungarian National Institute for Health Development

(OEFI)

ITALY Veneto Region

ITALY Tuscany Region

LATVIA Riga City Council

IRELAND Institute of Public Health

NETHERLANDS Dutch Institute for Health Care Improvement CBO

RIVM: Netherlands Institute for Public Health and

the Environment

50 members & partners across EU

NORWAY Norwegian Directorate of Health

POLAND National Institute of Hygiene –

Public Health Research Institute

SCOTLAND NHS Health Scotland

SLOVENIA National Institute of Public Health

SPAIN Ministerio de Sanidad y Consumo

Universidad de La Laguna

SPAIN Public Health Agency Cataluña

SWEDEN National Public Health Agency

SWEDEN Stockholm County Council

SWITZERLAND Global Health Equity Foundation

WALES Public Health Wales

IRELAND Institute of Public Health

MONTENEGRO Institute of Public Health

ROMANIA Ministry of Health

SWEDEN Swedish Association of Local

Authorities and Regions SALAR

SWEDEN Region Vastra Goteland

EuroHealthNetThe European Partnership for Improving

Health, Equity and Wellbeing

PHASE

The European Platform for Action on Health & Social Equity

HPEHealth Promotion Europe

The European Network

for Health Promotion

CIRI

The European Centre for Innovation,

Research & Implementation in

Health & Well-being

The EuroHealthNet Office, Executive Board and General Council

Sustainable Development Goals 2030

Social Determinants of Health

Health inequalities are

persistent &

rooted in unfair and

unequal socio-economic

circumstances.

Determinants have a

cumulative impact across

the life-course.

.

SDH at city level - Brussels

St Jans Molenbeek…

… compared with…

Woluwe-Saint-Pierre

DRIVERS to reduce health inequalities

January 2015

Investment for health equity & sustainable societies

• Conditions during early childhood are particularly important in

determining future health.

• Focusing solely on most disadvantaged will not be sufficient. +

Risk of “poor services for poor people”

• Need investment across the social gradient, proportionate to the

levels of disadvantage (proportionate universalism)

• Investments needed on the root causes, such as poverty, long-

term unemployment, and inequalities in access to education.

• Case for cost-effective impacts can be made.

Sustainable Development Goals 2030

Ecological Determinants of Health

14

What is healthy and sustainable living?

What is not healthy and sustainable today?

2015 Unsustainable Lifestyle Trends

Average EU lifestyle impacts

Food: Meat & dairy - 24% of all food impacts

(emissions & material use)

Housing: Heating/cooling, water use, appliance

& electronics use - 40% of total energy

Mobility & Tourism: Air travel (9% increase) & car ownership

(35% increase) since „90s.

Health & Well-being: Lifestyle health impacts - obesity

(increased intake of sugars), heart disease

(fatty foods and smoking) & cancers

(exposure hazardous chemicals)

Material footprint

per year

2050

2011

16

What if current challenges were overcome?

Food: 500 kg/a, mostly vegetarian

Housing: 20 m2/person in zero net energy

Energy: 1000 kWh via wind and solar

Household goods: efficient, different and sufficient

Mobility & Tourism: 10 000 km/a in other means, no car

Health & well-being: improved health, well-being

8 tonne kg lifestyle (total resource use)

Vision of Sustainable Lifestyles in 2050

Bernd, Germany55,1t

Kirsti, Finland38,7t

Iria, Spain24,8t

Understanding citizen diversity

Péter, Hungary

8,8t

18

Factors influencing behaviour

Underlying socio-economic factors

INHERIT: Health Promotion & Sustainable Societies

Equitable society

Social Inclusion

Environment

Green economy

Technological

Innovation

Health and

wellbeing

INHERIT (2016-2019) - Purpose

• Lifestyle and behaviour affect health as well as the environment

• The lower an individual‟s SES, the more limited is his or her scope for

individual choice, contributing to health inequalities

INHERIT will identify policies and interventions which:

1) adapt living and societal conditions,

2) encourage more healthy and environmentally sustainable

behaviours,

3) catalyse the development of new and innovative policies,

interventions and/or products that can contribute to ensuring that

healthy and sustainable lives become the easy and attractive

‘default’ option for all.

Stable societies and good governance…

New economic and political realities

• Junckers 10 Political Guidelines (jobs, economic growth)

• European Fund for Strategic Investments (€ 315 billion for 2015-2017)

"Bigger on big things & smaller on small things”

• Reduce administrative burden to business development (REFIT)

• Health influence is weaker in EU Institutions

• Council Trio: inclusive, smart and sustainable growth, jobs and competitiveness

remain the top priority over the next eighteen months

Rethink our strategies, adapt and innovate

The EU Semester

Annual Growth Survey

End of Year

National Reform

Programmes

April

Country Specific Recommendations

JuneNational Action

Rest of the Year

Analysis of 2015 CSRs: focus on austerity

HEALTH • Strong focus on financial sustainability and cost-effectiveness • Primary care strengthening, accessibility and quality in few CSRs (5)• No CSRs on investing in preventative services or in health promotion

SOCIAL• Only 6 CSRs on poverty. CSRs from 11 countries mention some investment in

children and families• 7 countries received CSRs to increase retirement age, even though healthy

life expectancy in that country is lower

ENVIRONMENT• Environmental sustainability CSRs are lacking

Investing in Children: breaking the cycle of disadvantage

Active Inclusion of people excluded from the labour market

Strengthening Social Services of General Interest

Long-Term Care in ageing societies

Confronting Homelessness

Investing in Health

Making good use of Structural Funds –

The European Social Fund

The Social Investment Package (2013)

EU & SDGs

EU2020 review

New Migration

policy

LabourMobility Package

Social Pillar

AAA

TTIP

Work-Life Balance

Sustainable Development Goals 2030

• Sub-national role for EU advocacy (inform realities) & SDG implementation is vital

• “Beyond GDP debate” - redefine the current economic paradigm to take into consideration the

environment, quality of life, health and well-being and to balance growth, profits and

consumption

• Linking health, wellbeing, social equity and environmental sustainability as aims for whole-of-

governance (i.e. Wales Act!!)

• Multifaceted approaches from behavioural campaigns to legal frameworks including taxation,

subsidies and other financial incentives. - beware of “green-washing” and confusing high

number of eco-labels & health-labels

• Technical innovation to achieve 8 tonnes & social innovation (m-health) – beware of (1) equity

impacts and (2) rebound effect.

• Green economy & jobs / new business models (shift from ownership to services),

complementary currencies (time bank)

• Emerging small-scale initiatives are important signposts and test-beds for large-scale

sustainable solutions. - up-scaling and mainstreaming is not always easy.

Promising trends for implementing SDGs

Thank you!

c.costongs@eurohealthnet.eu

www.eurohealthnet.eu