Health is the key social and economic component of modern nation states. In Europe, there is still existing inequality and differentiation in public health conditions across the national and social spectrum. WHO office in Europe has pioneered the Health 21 and Health for All programs that charter the course to eliminate this disparity and create a unified service structure where health facilities and services are weaved into the social and economic fabric.Health as a fundamental rightWHO considers health as a primary social and democratic right. Any inequality in health conditions and access to related services create different socio-economic groups within a country.
These groups affect the rate of development, growth and progress at different levels, causing regression in the overall development plan of the country (Whitehead and Dahlgren, 2006). The existing inequality in health systems is systematic, socially produced and unfair. It is result of years of inequitable and skewed government policies that have led to lower standard of health services in economically weaker sections of society. Further, the higher rates of morbidity and mortality suffered by people at lower economic straddles contravene the principle of equity and social justice. However, these conditions are not biologically and socially determined and by planned intervention, they can be corrected and improved to create a healthy and robust social structure (Raphael, 2001).With the purpose of creating an equitable health system, European governments are presented with following action items that bring the marginalized and peripheral sections in the mainstream development scenario. The action items are (Whitehead and Dahlgren, 2006):1. Focus on poverty group-this is the target approach that aims at distributing health services among people who are found lacking access to these services.
2. Closing down the health divide: Health policies to identify the existing gap between worst served and best served social groups and then try to narrow down the divide by raising the standard of worst serve group to the level of best served.3. Reducing overall social inequality: This is the universal policy approach which aims to create an equitable system of health services, facilities and social welfare for the entire population (WHO, 2002).
4. Consideration of social determinants of health inequities: This principles includes the broader factors that cast long term affect on health conditions, such as difference in social opportunities, living standards, and workplace atmosphere and lifestyle.5. Targeting gender inequality in health services. In conformation of the fact that women lack access to health welfare system more than men, the policy intervention must extend the reach of health care system to women.
Improving health facilities for women can directly reduce the existing rate of infant mortality and morbidity (Whitehead and Dahlgren, 2006).Public Health Policy and Healthy Public PolicyWhose approach on the issue of equitable health includes both public health policy and healthy public policy. The former is a granular level approach, whereas later constitutes macro level intervention polices to create a large scale health based infrastructural system, which at present is hallmark of developed urban areas. A study of metropolitan systems around the world, shows requirement of a sustainable design of urban health planning which encompasses the challenges of urban pollution, work lifestyle, ageing problem, transport, physical inactivity and life style diseases, degrading local health environment and limited access to health services (Healthy Cities, 2003).These activities require top level policy change and intervention, with both planning and implementation facilitated by government authorities.
These interventions include1. Economic growth: Economic growth is an important determinant of social health, especially in the long term perspective. With improved income and financial conditions, the population gets betters access to good health services. Policy changes can drive economic growth by creating more employment opportunities, creating conditions of entrepreneurship, promoting trade, export and import services, and industrial activity. However, while driving the economic growth, the government policy should ensure even distribution of its benefits (Raphael, 2001).2.
Improved environmental health system: Under the programs of WHO and UNDP, many city communities have invested in creating a generally healthy civic system. This includes replacement of diesel engine vehicles by CNG operative model, recycling of municipal waste, energy conservation, industrial water treatment strategies and tree plantation (Healthy Cities, 2003).3. Improving civic health system: There are a number of policies advocated to improve civic health systems. These include, expanding the network of hospitals, encouraging nonprofit health organizations, ensuring safe work environment to eliminate workplace health hazards, promoting education and knowledge on nutrition and lifestyle, and closing down the poverty gap.