The Norwegian Directorate of Health’s expert panel – social inequality in health:
Principles of action to tackle social inequality in health
A small document presenting Action principles to tackle social inequalities in health from a Norwegian interdisciplinary expert group of scientist within the field.
The document is both in Norwegian and English.
You will find the English part by scrolling down the document.
http://www.helsedirektoratet.no/vp/multimedia/archive/00093/_Handlingsprinsipper_93669a.pdf
The foreword by the Director General of Health explains the context of the document:
“The Norwegian Directorate of Health occupies a position in the interface between policy and science. Our goal is to translate the knowledge and advice of specialists into action. There are few areas where this is as important, and as difficult, as that of social inequality in health. In 2005 the Directorate adopted an action plan against social inequality in health, «The Challenge of the Gradient», and one of its main measures was to appoint a panel of experts in the field. The panel consisted of nine researchers from a variety of disciplines and institutions who had studied social inequality in health from a variety of different angles. The first challenge we gave the panel was to draw up a set of principles of action as a basis for a policy to reduce such inequalities. This publication presents the result.
The discussions between the experts on the panel took place in, and between, four meetings in 2005, and the principles were adopted in their final form at a meeting on 24 November 2005. The following month the Minister of Health and Care Services initiated a process that resulted in a white paper entitled National strategy to reduce social inequalities in health (Report No. 20 (2006–2007) to the Storting). The process was guided by the Principles of Action, and the final strategy was based largely on the panel’s recommendations. Thus the Principles of Action have already influenced national policy. By publishing them the Directorate hopes they will be used profitably at other decision-making levels and in other forums.
At an international level the Principles of Action are not unique. One of the forerunners was The Concepts and Principles for Equity and Health by the British expert Margaret Whitehead, which was published by the World Health Organization in 1992. What does appear to be unique about the present set of principles is that they are the result of consensus among the experts on the panel. When nine researchers from different institutions and with different disciplinary approaches manage to agree on a set of policy recommendations, we feel it is worth listening to them.
Bjørn-Inge Larsen
Directorate of Health”
Principles of action to tackle social inequality in health
· 1. It is a defined goal to reduce social inequality in health. This must be achieved without any deterioration of the average level of health or the health of the higher socioeconomic groups. The targets for reducing inequality must be quantified, and time limits must be defined for milestones.
· 2. Policies adopted to reduce social inequality in health must be knowledge based. The situation must be monitored, policies and measures must be evaluated, and health impact assessments must be carried out for important decisions made within and outside the health service. If existing knowledge is inadequate, measures should be initiated that are expected to have a positive effect and that are very unlikely to have negative consequences.
These kinds of measures must be evaluated especially thoroughly
· 3. Strategies to reduce social inequality in health are anchored in “the gradient”. This means giving priority to universally oriented population strategies. It may also be necessary to initiate special, target-oriented measures aimed at disadvantaged groups
· 4. To achieve the objective of reducing social inequality in health, in the short term and in the long term, direct measures aimed at specific health problems should be combined with indirect measures aimed at minimizing the structural causes of health problems.
· 5. Strategies to reduce social inequality in health should to be comprehensive and coordinated. This means combining a number of different public health perspectives and coordinating measures across social sectors and administrative levels.
· 6. A policy to reduce social inequality in health means attaching importance to reducing unfortunate social consequences of disease and impaired health, such as loss of work, especially in occupational groups with lower socioeconomic status.
From: Tone. P. Torgersen Seniorrådgiver/Senior Adviser Helsedirektoratet/Norwegian Directorate for Health
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