Bucciardini Raffaella, Zetterquist Pi, Rotko Tuulia, Putatti Vania, Mattioli Benedetta, De Castro Paola, Napolitani Federica, Giammarioli Anna Maria, Kumar Bernadette N, Nordström Charlott, Plantz Christina, Zarneh Yvette Shajanian, Olsson Gabriella, Ahrne Malin, Kilpeläinen Katri, Lopez-Acuña Daniel, Vantarakis Apostolos, Marra Michele, Nessi Cecilia, Costa Giuseppe
Istituto Superiore Di Sanità, Rome, Italy.
Public Health Agency of Sweden, Stockholm, Sweden.
Arch Public Health. 2023 May 11;81(1):89. doi: 10.1186/s13690-023-01086-3.
Health inequalities within and between Member States of the European Union are widely recognized as a public health problem as they determine a significant share of potentially avoidable mortality and morbidity. After years of growing awareness and increasing action taken, a large gap still exists across Europe in terms of policy responses and governance. With the aim to contribute to achieve greater equity in health outcomes, in 2018 a new Joint Action, JAHEE, (Joint Action Health Equity Europe) was funded by the third EU Health Programme, with the main goal of strengthening cooperation between participating countries and of implementing concrete actions to reduce health inequalities. The partnership led by Italy counted 24 countries, conducting actions in five policy domains: monitoring, governance, healthy living environments, health systems and migration, following a three-step implementation approach. Firstly, specific Policy Frameworks for Action (PFA) collecting the available evidence on what practice should be done in each domain were developed. Second, different Country Assessments (CAs) were completed to check the country's adherence to the recommended practice in each domain. The gap between the expected policy response (PFA) and the present policy response (CA) guided the choice of concrete actions to be implemented in JAHEE, many of which are continuing even after the end of JA. Final recommendations based on the best results achieved during JAHEE were elaborated and agreed jointly with the representatives of the involved Ministries of Health. The JAHEE initiative represented an important opportunity for the participating countries to work jointly, and the results show that almost all have increased their level of action and strengthened their capacities to address health inequalities.
欧盟成员国国内及成员国之间的健康不平等被广泛视为一个公共卫生问题，因为它们在很大程度上导致了潜在可避免的死亡率和发病率。经过多年的意识提高和行动增加，欧洲在政策应对和治理方面仍存在巨大差距。为了促进在健康结果方面实现更大公平，2018年，一项新的联合行动——欧洲健康公平联合行动（JAHEE）由欧盟第三个健康计划资助，其主要目标是加强参与国之间的合作，并实施具体行动以减少健康不平等。由意大利牵头的合作伙伴关系有24个国家参与，按照三步实施方法在五个政策领域开展行动：监测、治理、健康生活环境、卫生系统和移民。首先，制定了具体的行动政策框架（PFA），收集了每个领域应采取何种做法的现有证据。其次，完成了不同的国家评估（CA），以检查各国在每个领域对推荐做法的遵守情况。预期政策应对（PFA）与当前政策应对（CA）之间的差距指导了JAHEE中要实施的具体行动的选择，其中许多行动在联合行动结束后仍在继续。基于JAHEE期间取得的最佳成果制定了最终建议，并与相关卫生部的代表共同商定。JAHEE倡议为参与国提供了一个共同合作的重要机会，结果表明几乎所有国家都提高了行动水平，并加强了应对健康不平等的能力。
