It is only when health is absent when we realise how central it is to everything else. Besides taking measures to slow down the spread of the virus and treating those in need, the EU and its member states must make an effort to improve the overall health of the European population, or risk worsening the unwanted long-term impacts of the pandemic.
We are living amid bad news and unsettling fear. The coronavirus crisis has spread across the globe. The figures of confirmed cases and deaths and the images emerging, especially from Italy, Spain and New York, of what may await the rest of us provide a strong incentive to do everything we can to contain the pandemic, ‘flatten the curve’ and reduce the burden on healthcare systems. Every life lost is one too many.
Simultaneously, the exceptional measures implemented across the EU and beyond are already bringing unwanted consequences. Quarantines and lockdowns, closed borders, reduced travel and limited movement of people, goods and services, disruptions to supply chains and economic slowdown are expected to have devastating economic implications. Businesses will suffer. Jobs will be lost. The safety nets for the most vulnerable in society are becoming even weaker. On top of all this, the social distancing measures and continued isolation of families and individuals may lead to further unwanted consequences, like increased mental disorders, depression, obesity or domestic violence.
The crisis reveals the problems with the existing system
While the situation in Europe is likely to deteriorate further, the coronavirus crisis is already revealing systemic problems in our present social and economic models. It has taken a pandemic to demonstrate that health is the basis for sustainable prosperity. It will be up to both the EU and its member states to take this lesson to heart and translate it into action.
A new, different approach to health will be a precondition for addressing the COVID-19 crisis and managing its economic and social repercussions. Beyond preventing the spread of the disease in order to reduce the burden on healthcare systems and treating those in need, we will also need to see enhanced efforts to improve the overall health of the European population. This means prioritising and integrating health promotion and disease prevention in policymaking and authorities’ communications. If policymakers fail to take comprehensive measures to create a better, healthier society, the unwanted long-term impacts of the pandemic will only worsen.
Health matters, prevention matters
The coronavirus crisis is a wake-up call that health matters. While the immediate focus is on containing the pandemic and treating patients, as it should be, the crisis provides a dramatic reminder of the importance of healthy populations.
The people most vulnerable to COVID-19 appear to be those with pre-existing conditions and weak immune systems, often the elderly, as well as smokers because of the higher risk of transmission of the disease and/or possible lung-related conditions. Over 30% of Europeans over 15 years old have a chronic disease, and two-thirds of those close to the retirement age have a minimum of two chronic conditions. A fifth of Europeans smokes daily. While the severely affected corona patients are not limited to these groups, just a fraction of these people needing healthcare all at once could collapse our healthcare systems.
The Europeans’ state of health should provide a serious point of reflection for European leaders. For years health experts have warned about these numbers and the growing prevalence of chronic diseases. Non-communicable – that is, non-infectious – diseases (i.e. heart and respiratory diseases, mental disorders, cancers, diabetes) cause around 86% of deaths and 77% of disease burden in Europe. However, what is ignored too often is that at least 80% of cases with heart disease, diabetes and strokes and 40% of cancers could be prevented. Air pollution, for example, causes respiratory diseases and leads to an estimated 400,000 to 790,000 premature deaths annually, just in Europe.
This matters: around 10% of EU GDP is currently spent on healthcare annually, and up to 80% of this is spent on treating patients with non-communicable diseases that are, to a large extent, preventable. Moreover, the economic losses related to lower employment rates and productivity are often not considered. As the EU member states have focused primarily on treating patients, only 3% of health spending has been directed to health promotion and disease prevention.
With the EU heading towards a recession, it is time for a fundamentally different approach. We must ensure, systematically, that our healthcare systems don’t become unnecessarily overburdened. We must be smarter with public spending and prioritise health promotion and disease prevention across societies. Healthy populations are the foundation of a functioning society and economy.
What must happen now?
The EU member states must work closely together to prevent the further spread of COVID-19 and treat those in need. At the same time, the EU and member state authorities should strive to improve people’s overall health, wherever and whenever possible. There are already worrying signals that stress and mental illnesses may be on the rise due to the crisis, and should be addressed. The need to improve people’s immune systems and address the underlying risk factors for preventable diseases, like unhealthy lifestyles (including unhealthy diets, smoking, excessive consumption of alcohol, physical inactivity), is as important as ever.
While acknowledging the severe constraints under which healthcare systems and public administrations currently operate, governments should continue to encourage people to live as healthy as possible under the circumstances. This could range from providing guidance on healthy diets and quitting smoking, ensuring access to healthy food and encouraging exercise. The aim should be to help people adopt healthier habits, which could last beyond the pandemic. It is also vital to support people’s mental health. When of added value to the member states, the EU should provide guidance and raise awareness across the continent on good practices in enhancing people’s well-being.
Moreover, it is essential to study the link between air pollution and the spread of the coronavirus. Regions with higher levels of air pollution seem to have higher COVID-19 mortality rates. While this could be explained by a prevalence of a greater number of people with air pollution-related health conditions (e.g. respiratory diseases), researchers are also investigating the hypothesis that fine particle pollution may carry the virus via air. Additional research is needed on this. However, even in the absence of further evidence, there is already a strong imperative to swiftly reduce air pollution levels, especially in places where containment efforts have not yet contributed to bringing them down.
Towards healthier societies
We need a lasting change to how we treat and value health if we are to reduce our vulnerabilities in the face of pandemics like COVID-19. The EU and its member states must make a greater effort to inject health considerations in all policies, to achieve healthier populations. Success will depend on cross-sectoral and society-wide collaboration and strong political leadership which, so far, has been lacking.
As a short-term measure with long-term implications, the European Commission should propose, and member states agree to, a new Multiannual Financial Framework for 2021-27 which clearly recognises health as a driver for a stronger economy. The new proposal should do more to promote health and disease prevention across policies. Two of the Commission’s upcoming initiatives, which should be supported by an updated MFF, and which will land in the hands of member states at some point, provide a more specific case in point.
In its upcoming Farm to Fork strategy, the Commission should propose to stop subsidising and supporting the production and consumption of agricultural products that are known to be harmful to people’s health, as well as the climate and environment. As a result, we should see across the EU a consistent promotion of healthy plant-based diets, which are instrumental in protecting people against preventable diseases and can contribute to reducing local air pollution, thus bringing additional health benefits.
Moreover, the ongoing crisis makes the Commission’s work on its Zero Pollution strategy even more relevant and timely. The current drastic reduction in air pollution due to the reduced traffic and industrial production across quarantined Europe and beyond, and the related temporary health benefits, bring to light the hidden health costs of our existing economic model. It is essential that European leaders finally recognise the enormous burden that our emissions-heavy economic model creates on people’s health. It is time to move from declarations to actions to reduce air pollution, and step up efforts to improve air quality and reduce emissions from transport, power and industrial plants, agriculture (i.e. livestock) and wood-burning permanently.
As the EU and its member states take measures to contain the pandemic, they should recognise the value in improving people’s overall health and the environment that shapes their health. Healthy populations and healthy environments are not simply ‘nice-to-haves’ that should be reconsidered only once this crisis is over. The need for health promotion, disease prevention, and injecting health considerations across all policies has never been as vital and urgent as now. This will be key to address not only the ongoing health crisis but also the inevitable economic crisis.
Annika Hedberg is Head of the Sustainable Prosperity for Europe’s programme.
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