14 October 2011
Stakeholder alignment in the European Union and beyond
One of the key priorities of the Spanish Presidency of the European Union (EU) in 2010, “Innovation in Public Health: monitoring social determinants of health and reduction of inequalities in health”, was coordinated by the Government of Spain in collaboration with the European Commission and WHO. The promulgation of this strategy followed the identification of health equity and social determinants of health as a priority, with monitoring as a key first step, by the Spanish Ministry of Health in 2007. During its EU Presidency, Spain advanced the issues of monitoring social determinants at the national, EU, and global levels and of considering the role of the EU in contributing to the reduction of global health inequities. One result was the report “Moving Forward Equity in Health: Monitoring Social Determinants of Health and the Reduction of Health Inequalities”, which reviewed existing work and outlined key priorities for further progress in this area. The other main outcome at the EU level — the conclusions on “Equity and Health in all Policies” — was approved by the EU Employment, Social Policy, Health and Consumer Affairs Council of Ministers. At the national level, the Spanish EU presidency triggered the development of a national strategy for health equity based on deliberations by the National Commission for the Reduction of Social Inequalities in Health, which was convened for this purpose. The main strategic themes are:
- to develop health equity information systems to guide public policies;
- to promote and develop knowledge and tools for intersectoral work, advancing towards the concept of “Health and Equity in All Policies”;
- to promote policies aimed at ensuring equity during childhood and youth and a good start in life for all children, regardless of their parents’ circumstances;
- to develop a plan for political visibility of the National Strategy on Health Equity and Social Determinants of Health.
These main themes have been implemented at subnational level (through autonomous communities), with ongoing training on how to integrate a focus on social determinants and health equity into health strategies, programmes, and activities. additional efforts towards health equity have focused on Roma, Spain’s largest ethnic minority, who experience a disproportionate burden of ill health. These efforts have involved engagement with Roma civil society at national and local levels.