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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
While there may be consensus on the broader issues of the core objectives of the health care system, expectations differ between EU countries, and European national policy-makers. This book seeks firstly to assess the impact of the enlargement process and then to analyse the challenges that lie ahead in the field of health and health policy.
This volume, published in the context of the Finnish Presidency of the European Union (EU), aims to highlight how and why the health dimension can and should be taken into account across all government sectors. Particular emphasis is placed on the unique mandate and obligation of the EU to protect health in all its policies. The topic is explored from the perspectives of available methods and different levels of policy-making, and examples are included from specific policy areas and health issues.
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.
People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.
What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).
"The joint WHO and UN-HABITAT report, Hidden cities: unmasking and overcoming health inequities in urban settings, is being released at a turning point in human history. For the first time ever, the majority of the world's population is living in cities, and this proportion continues to grow. Putting this into numbers, in 1990 fewer than 4 in 10 people lived in urban areas. In 2010, more than half live in cities, and by 2050 this proportion will grow to 7 out of every 10 people. The number of urban residents is growing by nearly 60 million every year. This demographic transition from rural to urban, or urbanization, has far-reaching consequences. Urbanization has been associated with overall shifts in the economy, away from agriculture-based activities and towards mass industry, technology and service. High urban densities have reduced transaction costs, made public spending on infrastructure and services more economically viable, and facilitated generation and diffusion of knowledge, all of which have fuelled economic growth"--Page ix.
This forward-looking resource recasts the concept of healthy cities as not only a safe, pleasant, and green built environment, but also one that creates and sustains health by addressing social, economic, and political conditions. It describes collaborations between city planning and public health creating a contemporary concept of urban governance—a democratically-informed process that embraces values like equity. Models, critiques, and global examples illustrate institutional change, community input, targeted assessment, and other means of addressing longstanding sources of urban health challenges. In these ambitious pages, healthy cities are rooted firmly in the worldwide movement toward balanced and sustainable urbanization, developed not to disguise or displace entrenched health and social problems, but to encourage and foster solutions. Included in the coverage: Towards healthy urban governance in the century of the city“/li> Healthy cities emerge: Toronto, Ottawa, Copenhagen The role of policy coalitions in understanding community participation in healthy cities projects Health impact assessment at the local level The logic of method for evaluating healthy cities Plus: extended reports on healthy cities and communities in North and Latin America, Africa, Europe, Asia, Oceania, and the Middle East Healthy Cities will interest and inspire community leaders, activists, politicians, and entrepreneurs working to improve health and well-being at the local level, as well as public health and urban development scholars and professionals.
The mythical 'demographic timebomb' can be defused through policies that reduce inequalities between and within generations.