Poverty and social exclusion in the WHO European Region: health systems respond [antikvár]

Much about poverty is obvious enough, particularly the relationship between poverty and ill health. So evident are the linksthat extreme poverty is listed in the International Classification of Diseases. Far more controversial are the answers to thefollowing questions: How is poverty caused? How can it be measured? How can it be tackled? What are the health status andaccess to health systems of people experiencing poverty and social exclusion, and how do they compare to people experiencinggreater wellbeing and inclusion in society? What can health systems do to meet the needs of people in poverty and thus ensurethe right to health for all? What can be done at cross-government levels (by the health sector together with others) to addresspoverty and social exclusion as determinants of health?These questions are at the centre of a longstanding European and worldwide debate. Today, in the context of the currentfinancial crisis and economic downturn, scaling up focus by all stakeholders on these issues is critical.The past decade began with an unprecedented global commitment to tackle poverty. This was embodied by the MillenniumDeclaration, endorsed by 189 nation, which led to the creation of the eight Millennium Development Goals (MDGs) addressingmultidimensional poverty. At the regional level, United Nations agencies work to support national governments to reinforceactions in these areas. In the WHO European Region, in 2001 and 2002, the WHO Regional Committee for Europe passedresolutions EUR7RC51/R6 and EUR/RC52/R7, calling for increased action on the links between poverty and health. Theseresolutions emphasized the need for a rights-based approach to tackling the impacts of poverty on health. They stressed that allEuropean Member States are affected by poverty, albeit to different degrees, and urged governments to formulate and furtherdevelop actions to combat the harmful effects of poverty on health.One of the actions resolution EUR/RC52/R7 required of WHO was to continue the process of developing, analysing anddisseminating knowledge on the relationship between poverty and health, including through the use of case study researchmethodology. The resolution specified that the WHO European Office for Investment for Health and Development, in Venice,was to have a key role in supporting follow-up. The Venice Office - set up by WHO with the cooperation of the Italian Ministryof Health and the Veneto Region of Italy - supports European Member States in addressing the socioeconomic determinants ofhealth and reducing health inequities. As adverse daily living conditions and related health inequities disproportionately affectpopulations experiencing poverty and social exclusion, the follow-up to resolution EUR/RC52/R7, the work of the WHOCommission on Social Determinants of Health and the more recent World Health Assembly resolution WHA62.14on reducinghealth inequities through action on the social determinants of health, have become an important part of its activities.I hope that this publication, through both its development and its dissemination to a wider European audience, contributes toa further scaling-up of research and action to address the impact of poverty on health. Reducing health inequities across thesocial gradient, with proportionate attention to the most vulnerable populations, is of great importance in the new Europeanhealth policy, which is one of my priorities as Regional Director at the WHO Regional Office for Europe. The policy willpromote regional values and aims for health, provide a coherent and integrated framework and roadmap for health action, andspecify ways in which health systems can be strengthened and the wider determinants of health and health inequities can betackled. The release of this publication supports the Regional Office's collective efforts towards the MDGs and uptake of thefindings of the WHO Commission on Social Determinants of Health. It also synergizes with 2010 as the European Year forCombating Poverty and Social Exclusion, as well as with the follow-up to the 2009 European Commission communicationSolidarity in health: reducing health inequalities in the European Union.