john yfantopoulos professor of social policy & health economics university of athens impact of...
TRANSCRIPT
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
THE HOLLY FATHERS
Platon Platon
Hippocrates Hippocrates
Aristotle's Aristotle's
Aristotle 384-322: On equity and equality
The 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 States
EU Communication October 2009 « Solidarity in health: reducing health inequalities in the EU”14-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 Women
Range= 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
Mean
Derivation from the Mean
Cumulative share of people from lowest to highest Health
100%
100%
A
B Cum
ulat
ive H
ealth
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 level
• Italy and Hungary it is known by experts in public health
• Emerging use of HIAs in Basque Country, Portugal, and Spain particularly in regional settings
• Well established processes
• Scotland, Wales, England, Ireland, Wales, Norway and Sweden
• There are methodological or process requirements on how assessment should be carried out.
Well Established Health Impact Analysis
Well Developed Bodies of HIA• Sweden 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 Health´s 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
Health Impact Analysis in ITALY
2013 Italian review on Equity in Healthsubmitted
International benchmarkingInternational benchmarking
Implications Implications Evidence Evidence
Cost AnalysisCost Analysis
Barriers:(who is gaining?)Barriers:(who is gaining?)
Actions Actions … in time of crisis… in time of crisis
