Foundation euPrevent, Het Overloon 2, Heerlen, 6411TE, The Netherlands.
Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. box 616, Maastricht, 6200 MD, The Netherlands.
BMC Public Health. 2024 Mar 8;24(1):746. doi: 10.1186/s12889-024-18175-9.
The sudden emergence of COVID-19 in 2020 demonstrated that Europe was not prepared for a public health crisis like this pandemic. In the European Union, matters of health have remained primarily under the jurisdiction of individual Member States. However, certain events, such as the Kohll-Decker ruling on free mobility of health services and the COVID-19 pandemic, compelled the EU to address health matters in border regions. This study examines how EU policies address public health in border regions. To that end, we have drawn from border studies, a field that provides insight into the fluidity and complexity of borders in everyday life. Besides that we used constructivist policy studies as a lens for the analysis of EU policy documents.
A policy discourse analysis was conducted to explore how European policy addresses the development of a transnational, European public health in border regions. Key European policy documents published between 2002 and 2027 were analysed to understand how policies are constructed and problems are framed. The analysis was guided by research questions and the theoretical approach.
The analysis reveals that, while having limited competences in the field of health care, the EU is slowly developing a rationale and a knowledge base to increase its competences in health care. It also shows that in the field of public health, the EU argues for addressing health determinants and promoting healthy lifestyles, though it does not address health promotion in border regions. The EU's authority in public health in border regions revolves primarily around addressing physical, biological and chemical threats rather than social health problems.
Though the EU has carefully developed a transnational perspective on health care, the EU has not developed any authority with respect to transnational public health. Though public health and health promotion in border regions have been confronted with specific challenges, neither specific Member States nor the EU have a transnational collaborative perspective that does justice to the characteristics of border regions. When it comes to public health in border regions, there is no European mindset as yet.
2020 年 COVID-19 的突然出现表明，欧洲对这场大流行这样的公共卫生危机毫无准备。在欧盟，卫生事务主要仍由各成员国管辖。然而，某些事件，如科勒-德克尔关于卫生服务自由流动的裁决和 COVID-19 大流行，迫使欧盟在边境地区处理卫生问题。本研究探讨了欧盟政策如何解决边境地区的公共卫生问题。为此，我们借鉴了边境研究，该领域提供了对日常生活中边界流动性和复杂性的深入了解。此外，我们还将建构主义政策研究作为分析欧盟政策文件的视角。
进行了政策话语分析，以探讨欧洲政策如何在边境地区发展跨国的、欧洲公共卫生。分析了 2002 年至 2027 年期间发布的关键欧盟政策文件，以了解政策是如何构建和问题是如何框架的。分析由研究问题和理论方法指导。
分析表明，尽管在医疗保健领域的权限有限，欧盟正在缓慢发展一个合理的理由和知识库，以增加其在医疗保健领域的权限。它还表明，在公共卫生领域，欧盟主张解决健康决定因素和促进健康生活方式，尽管它没有解决边境地区的健康促进问题。欧盟在边境地区公共卫生方面的权威主要围绕应对物理、生物和化学威胁，而不是社会健康问题。
尽管欧盟已经谨慎地发展了跨国医疗保健视角，但欧盟在跨国公共卫生方面没有任何权威。尽管边境地区的公共卫生和健康促进面临着具体挑战，但无论是特定成员国还是欧盟，都没有一个公正对待边境地区特点的跨国合作视角。就边境地区的公共卫生而言，目前还没有欧洲思维。
