A Framework for Studying EU Health Policy through a Political Determinants of Health Lens: The Case of the European Health Union.

CONTEXT: The COVID-19 pandemic has highlighted how the European Union (EU) impacts national health systems and people's health. In November 2020, the European Commission launched the European Health Union (EHU) to better coordinate and maximise EU Member States' abilities to deal with cross-border health threats. This paper scrutinises the early institutionalisation of the EHU and its implications for EU health policy as a political determinant of health (PDoH). METHODS: The study explores how EU health policy may be appreciated from a PDoH perspective. It draws from EU documents and existing research to analyse the early-stage institutionalisation of the EHU. The study complements this policy output-focused perspective with an outcome-based exploratory assessment of EU health policy as a PDoH focusing on three examples: joint vaccine procurement, health investments under the Recovery and Resilience Facility and the development of a European Health Data Space. FINDINGS: The study shows that the policy change triggered by the EHU and the potential impact on citizens' health are not necessarily congruent: modest change can have a potentially strong impact on health outcomes and vice versa. CONCLUSIONS: The study argues that the PDoH perspective provides a useful and complementary approach to policy output-based perspectives, allowing for a more comprehensive assessment of the EU's role in health.

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In order to restore services to pre-pandemic levels and catch up on care, we need to understand and act on what we have learned from the pandemic, including investing in the health workforce, increasing funding for the health infrastructure of the future, and maintaining the innovative forms of service delivery that proved useful in reaching out to key groups affected by the pandemic. This brief is a valuable resource for policy-makers seeking to understand the extent of disruption to health services caused by COVID-19, the reasons behind this, and what different countries are doing in response. Its aim is to provide options to reduce service backlogs for those who are addressing this challenge in their national contexts.