Intervening to reduce inequalities in infections in Europe - PubMed (original) (raw)

Intervening to reduce inequalities in infections in Europe

Jan C Semenza et al. Am J Public Health. 2008 May.

Abstract

The European Centre for Disease Prevention and Control was founded in response to newly emerging infections such as severe acute respiratory syndrome and avian influenza. However, Europe faces other communicable disease challenges that have proven to be remarkably resilient to public health interventions. We present examples of communicable diseases with inequitable distribution among those with poor educational attainment, low income, or other socioeconomic factors in every European country. Because these findings are incompatible with social justice and fairness, we examine strategic interventions targeting upstream causes of communicable disease transmission keeping in mind 10 indispensable public health functions essential to reach marginalized groups. These interventions have to be tailored to the socio-political context and rely on community-based decision-making and intersectorial collaboration.

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FIGURE 1—

Comprehensive approach to intervening on inequalities in infections. Note. Structural determinants (e.g., political context, income, education) frame intermediary determinants (e.g., housing, occupational conditions) and give rise to social stratification. This process leads to different vulnerabilities and exposures between the better- or worse-off socioeconomic groups, which manifest as health inequities. These inequalities in turn have differential consequences and exacerbate social stratification. Interventions are designed to target the 10 essential public health functions that are fundamental and indispensable to public health.

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