The Role of Cohesion Policy Funds in Decreasing the Health Gaps Measured by the EURO-HEALTHY Population Health Index

Abstract

Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to analyze to what extent the planned investments for 2014-2020 are addressing the regional health gaps, in light of the population health index (PHI), a multidimensional measure developed by the EURO-HEALTHY project. The operational programs of all regions were analyzed, namely, the CP planned investments by field of intervention. Analysis of variance was performed to examine whether the regional scores in the PHI dimensions were statistically different across regions with different levels of development (measured by gross domestic product (GDP)). Results show that 98% of regions with worse performances on the PHI are less developed regions. Overall, all regions present planned investments in intervention fields linked to dimensions appraised within the PHI (e.g., employment, income, education, pollution). Yet, more needs to be done to focus regional investments in health determinants where regions still lag behind. The PHI has the potential to inform future CP restructuring, providing evidence to extend the current eligibility criteria to other dimensions beyond the GDP.

“East” in Europe—Health Dimension through the Lens of the UK Daily Mail and Statistical Facts

“…In general, however, EU countries in Eastern Europe rank lower in the index (with the exception of the Czech Republic), with Romania and Bulgaria ranking the lowest, and there are more disparities within the country (50–70%) [ 61 ] (p. 55). This corresponds with further research by Santana et al (2020) where counties’ level of development and GDP is highly related to Population Health Index (the mean difference between LD and MD European regions is the highest in healthcare performance, housing conditions and waste management) [ 62 ] (p. 10), as well as “LD regions present significantly worse population health scores in all dimensions of health determinants, compared with those presented by MD regions” [ 62 ] (p. 14).…”

Trends of amenable deaths due to healthcare within the European Union countries. Exploring the association with the economic crisis and education

“…According to the literature, education is among the most relevant determinants and prominent in shaping health outcomes because it relates more directly to knowledge and skills than other socioeconomic indicators ( Laaksonen et al, 2005 ; Popham & Iannelli, 2021 ; Sauerberg, 2021 ; Witkam et al, 2021 ). In a study designed to appraise population health in a wide range of health domains in Europe, education was considered the second most relevant dimension, confirming what is widely stated in the literature ( Santana, Freitas, Costa, et al, 2020 ).…”

“…According to Smeyers and Depaepe (2006) , school dropout is not the problem itself but an indication and origin of fundamental inequities. As a multi-faceted and complex problem, it is caused by a cumulative process of disengagement, resulting from personal, social, economic, geographical, educational or family-related reasons ( OECD, 2012 ); therefore it requires the identification of causal links and an holistic answer to the problem that often goes beyond health and includes a range of health determinants outside the healthcare sector ( De Witte et al, 2013 ; Santana, Freitas, Costa, et al, 2020 ).…”

“…The NUTS 2 level, commonly referred to as regions, was formulated by the European Commission for the application of regional policies that might positively contribute to tackle health determinants ( Santana, Freitas, Costa, et al, 2020 ). Therefore, the NUTS 2 level is fundamental to better understanding of the challenges and opportunities of each region within the EU ( Becker et al, 2010 ; Santana, Freitas, Costa, et al, 2020 ).…”

Realization of the EU's Cohesion Policy in Health Care in the Visegrad Group Countries in the Perspective 2014-2020

“…There is wide evidence that low income and low socioeconomic status are connected with poor health outcomes, particularly with respect to high mortality (12). By allocating funds to the regions where development is lagging behind, CP could act as a major driver of health equity (13).…”