EPHO4: Health Promotion including action to address social determinants and health inequity

The purpose of this essential public health operation (EPHO) is to promote population health and well-being by addressing inequalities and the broader social and environmental determinants. Supportive environments need to be created and community assets strengthened to empower individuals and populations to have healthier lifestyles and behaviours across life course. Multisectoral action is needed to create healthy environments and to reduce inequalities and risk factors in social and environmental determinants of health.

A recent self-assessment of public health services in 41 of the 53 countries in the WHO European Region found that:

• There are examples of some very progressive and strategic approaches in the WHO European Region to health inequality, found in the United Kingdom and Nordic countries.
• Health inequalities are not routinely considered while developing health promotion strategies. Inclusion of equity in legislation and policy-making is reported by only half of European Union countries.
• Despite many individual activities, health promotion is overall underdeveloped in the Region, particularly for noncommunicable diseases and lifestyle risk factors.
• Capacity needs to be built in the areas of formulating strategies, and implementation and monitoring in order to strengthen overall responses. Countries in Central Asia and Eastern Europe especially lack such capacity.

As a result, a recommendation was made to strengthen and develop integrated cross–sector health promotion policy and services. These should address inequality and the wider determinants of health and should be especially orientated towards reducing non-communicable diseases and promoting well-being. Capacity should be built for formulating and implementing strategies in these areas.

Maternal and newborn health

WHO/Europe’swork includes the Effective perinatal care training package and the Beyond the numbers methodology that help countries in developing national policies and guidelines for better quality of maternal care. WHO is most active in the countries with the greatest need, particularly in the Balkan region and the Commonwealth of Independent States.

Child and adolescent health

WHO/Europe has developed a systemic approach to address adolescent health called the ‘Five S’ that helps countries strengthen their response to adolescent health. The implementation of WHO early childhood development programmes and cross-sector approaches such as Schools for health in Europe also helps to improve the survival, growth and development of young children.

Healthy ageing

WHO/Europe has adopted the Active ageing policy framework for policy-makers, which is based on a multisectoral approach to health for the elderly.

Tobacco control

Under the aegis of the WHO Framework Convention on Tobacco Control (WHO FCTC), WHO/Europe is successfully promoting the six tobacco control policy intervention areas through the MPOWER framework.

Alcohol use

WHO/Europe works closely with the European Commission on the European Information System on Alcohol and Health. It uses the European Alcohol Action Plan 2012to guide countries in drafting or renewing national alcohol policies to reduce the harmful use of alcohol, for example through increasing taxation and decreasing access to alcohol products.

Illicit drugs

WHO/Europe supports countries in providing effective treatment programmes for drug users. Support is provided in technical advice on harm reduction measures and opioid substitution therapy.

Violence and injury prevention

WHO/Europe helps countries build capacity for policies to prevent injuries and promoting safety. WHO’s TEACH-VIP is a comprehensive injury prevention and control curriculum that assists in policy development and capacity building.

Transport and health

The countries in the WHO European Region have been committed to pursuing healthy and sustainable transport since 1999, when the Charter on Transport, Environment and Health was adopted at the Third Ministerial Conference on Environment and Health. WHO/Europe supports countries in defining and managing healthy mobility policies, and promoting healthy and sustainable transport through a “health in all policies” approach. It helps countries make health and environmental considerations a more explicit criterion for decision making on transport.

HEPA Europe network

WHO/Europe supports Member States in creating environments supportive of physical activity through the HEPA Europe network (theEuropean network for the promotion of health-enhancing physical activity).

Nutrition, physical activity and obesity

WHO/Europe works with Member States in the development, implementation and evaluation of policies to promote healthy diets and to prevent overweight and obesity.