A new joint project between Østfold and The North Denmark Region is focusing on the increasing health inequalities in the Baltic Sea Region.

The project, called DIALOG, is a follow-up of the HEPRO project (2005-2008).

The main strategy of the project is to focus on wider policy actions addressing the socio-economic determinants of health and targeting more specific vulnerable and disadvantaged groups. This two-pronged approach is proposed by the WHO’s work on obesity, where they highlight the need for small-scale interventions to be supported by overarching strategy and policy interventions.

-  Over the past decades, there has been an improvement of the overall health in Europe; however, despite the overall improvements in health indicators, health inequalities within and between the EU countries have continued to exist and in many cases have widened. This highlights that, although overall health is improving, the health of those from higher socio-economic groupings is improving at a faster rate, therefore widening the health gap, says Project Director Arvid Wangberg.

There exist large amounts of knowledge and data on health inequality, describing the existence and problems of inequalities and where they are found. It is also known that health inequalities are not just caused by bio-medical factors, but also reflect structural inequalities in the distribution of wealth.

-  Health inequalities are a consequence of socio-economic determinants. Therefore, the solutions are found not only on the level of the individual but also on the structural and political level, says Wangberg.

The Baltic Sea region faces the challenges of ensuring economic growth and development, i.e. expressed as a need for increasing the workforce.

-  There is a need for expanding the existing workforce, meaning finding solutions to include the presently marginalised groups in the society and in the workforce, as well as on a more structural level preventing that more become marginalised. This can in the long term contribute to ensuring a more sustainable regional and economic development, says the project manager.

Findings from the EUROHEPRO survey illustrate the inequality issue. Asking people with chronic diseases, the perceived restrictions in their daily life and work increase with age, but in the eastern countries of the Baltic region, the perception of restrictions is significantly higher.

-  This has a direct effect on their involvement in the local community and maybe also on their involvement in the workforce, says Wangberg.

The Dialog project is currently in a preparation phase, but will be initiated in the spring of 2009 subject to political approval.