Reducing Health Inequalities for Children Living in Europe

Dorota Sienkiewicz

EPHA

EUPHA 3rd Conference

Integrated Public Health

11 November 2010, Amsterdam

Introduction

“Inequalities are a matter of life and death, of health and sickness, of well-being and misery” (The Marmot Review, 2010)

“Poverty makes us sick and ill; sickness and illness make us poor” (Flemish Minister of Health, BE EU Presidency Health Inequalities conference)

“Social injustice is killing people on a grand scale” (WHO 2008)

“It is unreasonable to expect people to change their behaviour when the environment discourages such change” (Schmid, 1995)

“What if social inequalities caused health inequalities are intrinsic characteristic of human societies? What if this is just the way it is because of natural selection, biology, or the survival of the fittest, you name it… Should we quietly step back and accept the status quo?” (BE EU Presidency Health Inequalities conference)

Introduction

“These serious health inequalities do not arise by chance, and they cannot be attributed simply to genetic makeup, ‘bad’, unhealthy behaviour, or difficulties in access to medical care, important as those factors may be. Social and economic differences in health status reflect and are caused by, social and economic inequalities in society” (The Marmot Review, 2010) (add political inequalities?)

Children and Health

“the generation of children born at the turn of the 21st century could be the first to have a lower health and life expectancy than their parents” (Kickbusch, 2007)

The moral test for our societies is not how well they care about their most well-off, but how well they care about their most vulnerable, voiceless and disengaged. => see the EU2020 strategy…

Political recognition

WHO CSDH (2005-2008)

WHO Euro Review 2012?

EC Communication: Solidarity in Health

Trio EU Presidency

But: focus on Health Inequalities and Children?

So why nothing has been done so far?

Rejection? Figures not believed in? Lack of capacity and know

how? Unimportant voters? Economic growth better for

everyone?

Short-term vision? Politicians are only

politicians? Hidden poverty under-

rated? Poverty has a female face?

Children , poverty, social inequalities

Of the 80 million (17%) Europeans living in poverty (below 60% average income), 19 million children live under threat of poverty – it is one child out of five

Poor conditions in which children are born, grow up, learn and play diminish physical, mental and social chances for them to live optimal lives

Poverty makes us sick, and sickness makes us poor – circle of intergenerational poverty

Children , poverty, social inequalities – how linked?

Poverty and jobless, low educated and working poor households

Poverty and exposure to environmental hazards Poverty and access to health services and primary

healthcare Poverty and malnutrition Poverty and risk and unhealthy behaviours Poverty and mental health Poverty and housing and deprived neighborhoods

Children as a vulnerable group

Poor nutrition

Traffic injuries and accidents in the home

Poisoning

Second-hand tobacco smoke

Sedentary lifestyle

Advertising and marketing to children

Having a child – a risk of poverty esp. numerous families

All children vs. sub-groups

CC HH II LL DD RR EE NN

What could be done at EU level

EP Written Declaration on Children’s Health Inequalities

1 million citizens initiative

EC Communication on Children’s Health Inequalities

EU Action Plan on Children’s Health Inequalities

Children’s health, children in poverty (incl. relative) as indicators for measuring the progress

EY on Children’s Health Inequalities

Civil Society Thematic Platform or Coalition

MS encouraged, supported, funded

CS encouraged, supported, funded

What could be done at EU level

To a great extent addressing children’s health inequalities means addressing them through their families, mothers, social protection, employment, education

Eg. Maternity Leave Directive

Six Recommendations where to fit in Children’s Health Inequalities (after WHO CSDH 2008)

Give every child the best start in life (early child development)

Enable all children, young people, and adults to maximise their capabilities and have control over their lives

Create fair employment and good work for all

Ensure a healthy standard of living for all

Create and develop healthy and sustainable places and communities

Strengthen the role and impact of ill-health prevention

By any means, movement is urgently needed

from all across Europe

If we want to avoid having instead of the current vision for Europe 2020 or 2030, a situation of Europe in 1931, the US and Japan in 1937

In 2030 the population of productive age will be either too old, too sick, too unskilled or prematurely dead

There will be none left to achieve “economic, green, inclusive growth”; there will be no “highly competitive” Europe

On an optimistic note…

This crisis should be used as an opportunity, re-frame Investing is cost-effective 20-80 pay-offs with initiatives aimed at children (compared

to 80-20 adult) Innovative, creative, intergenerational, socially healing and

purifying, funny, robust, hand-in-hand with EU values, and…

They/we all will love you for that!

Thank you for your attention and invite you to a discussion!

For more information please see www.epha.org or contact Dorota

Sienkiewicz at d.sienkiewicz@epha.org