How can European health systems support investment in and the implementation of population health strategies?

Key messages

Policy issue and associated policy challenges

• Population health is influenced by a variety of factors, many of which require action outside the health system.
• The health and socioeconomic costs of the key contributors to poor health in Europe are substantial. Many of these health problems are avoidable.
• There is a growing body of information not only on the effectiveness but also on the cost–effectiveness of population health interventions.
• Policy measures to help promote investment in effective interventions need to focus on improving both the quality and use of evidence across multiple sectors.

Policy options

• One option to strengthen the evidence base might be to expand the remit of existing regulatory bodies that assess the cost–effectiveness of health care technologies.
• A second option in parts of Europe where capacity for evaluation is limited might be to adapt existing information to the local context to make the case for investment.
• Various institutional arrangements, including the possibility of a standalone ministry for population health, might help to facilitate coordination and secure funding for action; other related options include joint budgets or monetary transfers between sectors.

Facilitating implementation

• When new assessments are conducted, these might begin by focusing on interventions likely to be highly effective, cost-effective and noncontroversial. This can help new institutions to establish their presence and credibility.
• Improving communication between researchers and policy-makers across sectors can help facilitate change; knowledge brokers might provide a link between different groups.
• Increasing awareness of the health, non-health and economic effects of interventions can help to reduce resistance to action outside the health sector. Health impact assessment may have a role to play in this process.
• Mechanisms to monitor the implementation process across sectors might Investing in and implementing population health strategies also help facilitate change; setting explicit measurable targets on population health objectives might provide further incentives for stakeholders across sectors to take action.