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HOW TO REDUCE HEALTH 
INEQUALITIES? 
Results of 4 EU funded projects 
Edited by Johan Mackenbach
Developing Methodologies to Reduce Inequalities in the Determinants of Health 
The health inequalities impact of 
natural ...
Beneficial impacts of policies: findings 
• Policies that promote financial security for the 
worst off boost their employ...
Improved mental health 
demetriq.eu 
Source: Reeves, Stuckler et al, 2014 
• Introduction of 
National Minimum 
Wage impro...
Policy messages 
• Some social welfare and labour market reforms 
have had adverse effects, falling most heavily on 
the m...
demetriq.eu
www.demetriq.eu
Reducing health inequalities by 
improving work and employment 
conditions 
Johannes Siegrist 
Senior Professor of Work St...
The life course approach of DRIVERS 
Early 
childhood 
Health 
Equity 
Working 
conditions 
Social 
Protection
Social gradient of health-adverse 
work stress across Europe 
Level of national labour market 
integration and work stress...
Epidemiological evidence 
• Work stress is associated with elevated risks of depression, 
CHD, and disability in employed ...
Policy recommendations 
• Improve monitoring of health-adverse working conditions and 
the provision of occupational healt...
www.health-gradient.eu
Smoking inequalities: 
learning from natural experiments 
Anton Kunst 
Department of Public Health 
AMC / University of Am...
Key finding 1: 
In 2013, socioeconomic disadvantage was intimately related to 
smoking initiation across all Europe
Key finding 2: 
Despite strong developments in tobacco control since 2000, 
inequalities in smoking cessation have not dim...
Key finding 3: 
Specific tobacco control measures do reduce smoking 
in all groups, though not more in lower groups 
• The...
Key message: 
We need new strategies to stop this addictive, toxic, 
commercial product affecting disadvantaged people 
• ...
www.silne.ensp.org
More info 
www.sophie-project.eu 
@sophieproject 
info@sophie-project.eu 
Play video
www.sophie-project.eu
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How to reduce health inequalities? Results of 4 EU funded projects: DEMETRIQ, DRIVERS, SILNE and SOPHIE.

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How to reduce health inequalities? Recommendations to government ministers from four EU-funded projects: DEMETRIQ, DRIVERS, SILNE and SOPHIE, by Margaret Whitehead, United Kingdom; Johannes Siegrist, Germany; Anton Kunst, The Netherlands; Carme Borrell, Spain. Presented at the 7th European Public Health Conference: "Mind the gap: Reducing inequalities in health and health care". Glasgow, 20th to 22nd November 2014.

Published in: Healthcare
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How to reduce health inequalities? Results of 4 EU funded projects: DEMETRIQ, DRIVERS, SILNE and SOPHIE.

  1. 1. HOW TO REDUCE HEALTH INEQUALITIES? Results of 4 EU funded projects Edited by Johan Mackenbach
  2. 2. Developing Methodologies to Reduce Inequalities in the Determinants of Health The health inequalities impact of natural policy experiments Margaret Whitehead University of Liverpool, UK demetriq.eu Demetriq received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 278511
  3. 3. Beneficial impacts of policies: findings • Policies that promote financial security for the worst off boost their employment chances • Better job security reduces adverse effects of recession • Smart public investments in health and social protection return up to 3 Euros for each 1 Euro of spending • Fairer pay reduces mental health inequalities demetriq.eu
  4. 4. Improved mental health demetriq.eu Source: Reeves, Stuckler et al, 2014 • Introduction of National Minimum Wage improves GHQ scores • People felt significantly less under financial stress
  5. 5. Policy messages • Some social welfare and labour market reforms have had adverse effects, falling most heavily on the most disadvantaged • Governments have real policy options to deal with recession while protecting the worst off • Changes in national policies need to be assessed for their impact on the health and wellbeing of different socioeconomic groups in society demetriq.eu
  6. 6. demetriq.eu
  7. 7. www.demetriq.eu
  8. 8. Reducing health inequalities by improving work and employment conditions Johannes Siegrist Senior Professor of Work Stress Research, University of Düsseldorf, Germany DRIVERS is co-ordinated by EuroHealthNet and has received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n°278350
  9. 9. The life course approach of DRIVERS Early childhood Health Equity Working conditions Social Protection
  10. 10. Social gradient of health-adverse work stress across Europe Level of national labour market integration and work stress score Source: Wahrendorf M et al. (2013) European Sociological Review 29:792-802. Wahrendorf M, Siegrist J. (2014) BMC Public Health 14:849.
  11. 11. Epidemiological evidence • Work stress is associated with elevated risks of depression, CHD, and disability in employed populations across Europe (OR varying between 1.3 and 2.0). • Work stress is a mediator in the relationship of socioeconomic position (SEP) with health. • SEP moderates the effect of work stress on health: stronger effects among lower SEP groups.
  12. 12. Policy recommendations • Improve monitoring of health-adverse working conditions and the provision of occupational health services, especially among lower SEP groups. • Promote health equity by tackling structural determinants of the work-related burden of disease. • Prioritise social and labour policies that strengthen sustainable employment in national budgets, particularly in contexts of neoliberal policies and strong fiscal austerity measures.
  13. 13. www.health-gradient.eu
  14. 14. Smoking inequalities: learning from natural experiments Anton Kunst Department of Public Health AMC / University of Amsterdam
  15. 15. Key finding 1: In 2013, socioeconomic disadvantage was intimately related to smoking initiation across all Europe
  16. 16. Key finding 2: Despite strong developments in tobacco control since 2000, inequalities in smoking cessation have not diminished
  17. 17. Key finding 3: Specific tobacco control measures do reduce smoking in all groups, though not more in lower groups • The ‘equity impact’ tobacco tax is mostly positive, though variable • The ‘equity impact’ of smoking cessation services is variable but often negative
  18. 18. Key message: We need new strategies to stop this addictive, toxic, commercial product affecting disadvantaged people • Stronger supply-side policies (product composition, sales, advertisement) • Equity-oriented demand-side programs (focus on disadvantaged youth)
  19. 19. www.silne.ensp.org
  20. 20. More info www.sophie-project.eu @sophieproject info@sophie-project.eu Play video
  21. 21. www.sophie-project.eu

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