Sophie Arie

The United Kingdom is using its term as president of the European Union to urge the region to focus on reducing the difference in the health of rich and poor people.

"Almost all important health problems, and major causes of premature death across Europe such as heart disease and cancer, are more common among people with lower levels of education and income," said the UK secretary of state for health, Patricia Hewitt, who hosted an EU summit in London this week called "Tackling health inequalities—governing for health."

"Narrowing this health gap, and making good health a reality for everyone, is essential if we are to create a Europe of social justice as well as prosperity," she said.

At the conference, which was attended by delegates from 25 European countries and international health experts, Marko Kyprianou, the EU commissioner for health and consumer protection, warned of the need to break a vicious cycle: "In many countries the gap in incomes between rich and poor has widened. With growing inequalities in wealth have come growing inequalities in health. And in turn, inequalities in population health contribute to widening disparities in wealth."

Two reports published at the summit provided the most up to date figures on health inequality across Europe and highlighted the fact that relative health inequality has increased dramatically in some European countries in recent decades, despite overall improvements in public health. In many cases this appears to be the effect of globalisation, which has increased income gaps and is changing cultural habits.

"In several eastern European countries inequalities have increased enormously in the past decade," said Johan Mackenbach, a professor in the department of public health at the Erasmus University Medical Centre, Rotterdam, and author of one of the reports.

In Estonia in 1989, for example, people from upper socioeconomic groups could expect to live around seven years longer than people from disadvantaged groups. In 2000 the gap had increased to 13 years.

People in higher socioeconomic groups are living longer, in part because of a focus on fitness and healthy eating. People in lower socioeconomic groups generally continue to smoke, eat badly, and take less exercise. Other factors, such as housing, environment, and work conditions, also contribute.

A second report showed that although countries such as the Czech Republic, Latvia, and Lithuania have adopted the World Health Organization’s advised target of reducing health inequality indices by 25% by 2010, other countries have more specific goals. The Netherlands, for example, aims to reduce mortality differences between the sexes and between groups with different educational backgrounds by 20% by 2015. British policy is even more specific, with special attention on smoking, teenage pregnancy, and child obesity, as well as heart disease and stroke.

Commissioner Kyprianou said new thinking across all sections of government—from finance to education and labour, as well as health departments—was needed to tackle the problem. He urged European countries to develop innovative policies by studying the solutions and trends emerging in different countries.

To help the economies of Europe’s poorest areas deal with large economic disparities a massive investment of EU structural funds has been proposed over the next seven years, he said. From 2007 these funds can be used not only for health infrastructure but also for community based health improvement and preventive action to reduce health inequalities.

Health Inequalities: Europe in Profile, by Professor Mackenbach, and Health Inequalities: A Challenge for Europe, by Ken Judge, can be found at www.dh.gov.uk/eupresidency2005.