Contents

2-3

Overview

  • Objectives
  • Why should we care about women’s health?
  • A message from the European Institute of Women’s Health

4-6

Day One: What has been achieved?

  • Women’s health across the lifespan
  • Maternal and child health
  • Health of women and families
  • Active and healthy ageing

7-11

Day Two: How do we move forward together?
Incorporating sex and gender from the start
Priority policy areas
1. Health promotion and disease prevention
2. Research and personalized medicine
3. Access, treatment, care and responsive health systems
4. Education, training and health literacy

12-13
Conclusions and next steps

 

OVERVIEW

“Gender inequality is always an injustice. Inequality in health is the worst kind of injustice.”

Mr. Xavier Prats Monné,
Director General for Health and Food Safety at the European Commission

Objectives

In celebration of the European Institute of Women’s Health’s (EIWH) twenty-first anniversary and sixty years of gender equality in EU policy since the Treaty of Rome (1957), the EIWH brought together about seventy decision makers and thought leaders from across Europe.  Delegates participated in the two-day conference Right from the Start: Resetting the Women’s Health Agenda in Europe at the European Economic and Social Committee in Brussels, Belgium on the 4th and 5th of December 2017.

The conference reviewed the progress that has been achieved in sex and gender equity in women’s health employing a life course approach from maternal and child health through older age.   Using a cross sectoral approach, delegates identified priorities and actions needed at policy and stakeholder level to move the women’s health agenda forward together, with particular focus on prevention and early intervention.

Experts were drawn from diverse areas including health and social policy, health care, education, politics, justice, research, industry and health advocacy sectors.  Speakers in each session set the context to drive the debate in four priority policy areas. The conference encouraged dialogue and brainstorming amongst decision makers and influencers generating concrete recommendations for action.

 

Why should we care about women’s health?

Women make up over half of the population.  Large difference between women and men exist across various health conditions.  Some are primarily determined by biological variation. Others are the result of the manner in which society socialises women and men, and power relations between them.  Many health disparities reflect a combination of both biological differences and social factors stemming from sex and gender (S&G).

In striving to achieve the highest standard of health for all, our society’s health policies must recognise that women and men, have different needs and are faced with different obstacles and opportunities with regard to health and well-being.  Understanding this interaction is important when addressing sex and gender (S&G) inequities in prevention, diagnosis, treatment and care, ultimately, improving health for everyone.

This requires a sex and gender (S&G) sensitive approach.

Evidence-based arguments are essential to influence the policy environment in order to promote gender equity in public health, research and social policies across Europe.  Women must be acknowledged so they contribute to this from their perspective as citizens, patients, healthcare professionals, family members and carers.

 

 

A message from the European Institute of Women’s Health

Since 1996, the European Institute of Women’s Health has striven to promote an equitable, gender sensitive approach in health policy, research, treatment and care in Europe.

The EIWH has worked to reduce inequalities in health for all, specifically inequality due to sex, gender, age and socio-economic status by highlighting that sex and gender are important determinants of health. The organisation has taken an evidence-based approach to demonstrate how vulnerability to the onset and progression of specific diseases varies in men and women and that this situation must be improved.

The work undertaken by the EIWH has covered areas, including sex and gender considerations in biomedical and public health research and applying the knowledge of this research to more targeted prevention and treatment options.  We have focused on neglected areas such as pregnant women and use of medicines; older people and polypharmacy.

Thank you for supporting our mission over the last twenty-one years and we hope to partner with you in the coming years to eliminate all sex and gender inequities in health.

From the Board of Directors and Secretariat of the European Institute of Women’s Health

DAY ONE

What has been achieved?

Sex and gender (S&G) inequities in health are evident across the lifespan from birth to older age.  Women’s health is an unfinished agenda with large gaps and unmet needs still persisting. Sex and gender is not systematically integrated into policy, programmes, education, training, research, data collection and analysis. Existing policies, for example in clinical trials, are not fully enforced. Women are the main users of health care and the main providers of that care.  In spite of the evidence to legislate change, health systems are still at times failing women.

Women’s health across the lifespan

Sex and gender (S&G) inequities in health are evident across the lifespan from birth to older age.  Women’s health is an unfinished agenda with large gaps and unmet needs still persisting. Sex and gender is not systematically integrated into policy, programmes, education, training, research, data collection and analysis. Existing policies, for example in clinical trials, are not fully enforced. Women are the main users of health care and the main providers of that care.  In spite of the evidence to legislate change, health systems are still at times failing women.

Maternal and child health

Early intervention and health promotion is key to tackling modern day health problems.  Maternal and child health was identified as a critical control point for public health intervention to promote wellbeing in Europe and reduce the burden of disease.  Maternal health has implications for the long-term health and wellbeing of both mother and child and the next generation.

Conclusions:

  • Position pregnancy and standards of maternal healthcare high on the research agenda
  • Encourage the exchange of best practice and knowledge on effective strategies to prevent maternal obesity, its complications and its impact on the foetus/child.
  • Target early prevention of risk factors.  Support regular visits to control for metabolic or other risk factors in high risk patients.
  • Create, maintain and monitor infrastructure for medicines safety in pregnancy and lactation.
  • Promote health in pregnant women (when they and their partners are most open to health promotion), focusing on smoking, alcohol cessation, healthy diet and lifestyles as well as immunisation of pregnant women.

Health of women and their families

The biological differences between females and males are relevant for the prevention, early intervention, diagnosis and treatment of various diseases and conditions.  Sex and gender differences also interact with socio-economic determinants to influence health. Important social issues with consequences for health include education, employment, access to financial resources and family life.  

Conclusions:

  • Ensure that women, disadvantaged and minorities are included and targeted in prevention, screening and treatment programmes.
  • Tackle inequalities that are outside the health sector but influence health. This includes socio-economic, environmental, educational, housing and employment and pension issues.
  • Systematically integrate sex and gender in design of programmes that focus on the prevention of chronic diseases and reduce unhealthy behaviours as a horizontal priority.
  • Implement comprehensive cancer screening programmes to reduce preventable cancers, including targeting high risk and difficult to reach populations.
  • Develop resources to enhance food literacy, skills and knowledge, starting with pregnant mothers.
  • Ensure present and future generations benefit from a healthy, affordable and varied diet and create a healthy food and drink environment for all.
  • Encourage early intervention to improve health and wellbeing in Europe and reduce the burden of disease (for example, vaccination, timely screening, and promotion of health and wellbeing).
  • Support frontline healthcare workers professionally and personally.

Active and healthy ageing

Europe has the highest proportion of older women in the world. Health policies and care systems must respond more forcefully to this demographic change, to better protect the health of its citizens (both men and women) in an increasingly ageing population.  Women are at the forefront of ageing due to their greater longevity as well as their family caregiving roles. Despite an increased lifespan, women’s older years are disproportionately burdened by ill health. This combines with an increase in ratio of the older to the younger population and subsequent reduction in the government tax base, challenges the sustainability of Europe’s health systems.

Conclusions:

  • Promote active and healthy ageing through education, information and awareness initiatives.
  • Empower women by creating technology for and by women that take into account the unique health needs of women.
  • Ensure that brain diseases are included in the women’s health agenda in Europe.
  • Provide practical assistance to existing coalitions and networks that support prevention and screening of cancer, particularly in Central Eastern European and the Baltic countries.
  • Encourage medical and social research on women and Alzheimer’s Disease.  Support awareness campaigns about the challenges facing women with Alzheimer’s Disease.
  • Empower and support caregivers and families to enable active and healthy ageing.
  • Address and facilitate equitable access to appropriate treatment and supportive therapies for cancer patients in all Member States though policy and programming.
  • Promote healthy behaviours and empower citizens in order to reduce the burden of cancer and other health conditions (health promotion, timely presentation for screening programmes, etc.).

 

 

DAY TWO

How do we move forward together?

Presentations combined with facilitated discussions with delegates who are experts on health, policy and S&G issues in Europe took place on the second day.  Participants concentrated on four priority policy areas and used the evidence base from the first day (which focus on what has been achieved) to develop The European Action Plan for Women’s Health.  Delegates worked together to make concrete recommendations on moving forward together. They responded to the question:

Where do we want to go in the field of sex and gender equity in health?

How do we advance the women’s health agenda together?

 

Incorporating sex and gender in health from the start

Women are the gatekeepers of health in society, yet they are under-represented in the development, design and application of policy, programming and practice.   We must employ a life-course approach towards health and wellbeing that accounts for inequities due to sex and gender (S&G). It is essential to make a concerted and collaborative effort to improve women’s health and wellbeing.  We must take action now.

Through vibrant dialogue, delegates identified central issues on how to get it right from the start.  It is vital that we reach out to and engage with all relevant stakeholders on an ongoing basis and come together to solve this important societal challenge.  We must take ownership of actions that drive change in order to enable all citizens in Europe to live healthier lives. Concerted actions must also anticipate and adapt to future needs.  We must align, work together, communicate and accept that this is our (not someone else’s) responsibility.

 

Priority policy areas

1. Health promotion and disease prevention
2. Research and personalized medicine
3. Access, treatment, care and responsive health systems
4. Education, training and health literacy

 

 

1. Health promotion and disease prevention

Society must invest in a life course approach to health promotion and disease prevention, taking action early and at critical points to ensure health and wellbeing from childhood through old age.

Recommendations:

    • Early intervention is vital at critical points to improving women and family health and wellbeing to reduce the burden of chronic disease and improve health in Europe.
    • Health promotion activities need to employ a life-course approach while creating cost-effective tailored healthcare solutions.
    • Personalised medicine must pay proper attention to sex and gender specific characteristics.
    • A coordinated and comprehensive life-course immunisation strategy must be adopted which includes targeting vulnerable groups, such as children, pregnant women and older people.
    • Research and development of new antibiotics as well as informational campaigns on prudent antibiotic use must be urgently encouraged (gender and life-course approach)
    • A comprehensive and supportive approach, which includes mental health, must be taken to empower women and men to actively and healthily age in order to reduce the chronic disease burden and dependency in later years.
    • Programming and policy should encourage women and their families to engage in healthy lifestyles, such as eating a healthy diet, reducing alcohol consumption, stopping smoking and engaging in physical exercise to reduce chronic disease to remain independent as long as possible.
    • Socio-economic and cultural influences on health, including the gender pay and pension gap, need to be tackled to improve women’s health and wellbeing.
    • Commercial influences on health accounting for gender and behavioral stereotypes need to be combated.
    • Promote women’s mental health right from the start in areas such as education, occupation, and caregiver support.
    • Align actions in women’s health working with existing initiatives like the Strategy on women’s health and well-being in the WHO European Region.

2. Research and personalised medicine

Translating the evidence from sex and gender (S&G) research into regulatory practice will lead to more targeted, effective opportunities for health promotion, disease prevention, treatment and care.

Recommendations:

  • Cross-national data collection across the EU must be improved and expanded to be easily processed and interchanged between local, national and EU levels.
  • Research and data should be required to be disaggregated by such factors as sex, gender and age.
  • Sex and gender (S&G) should be horizontally integrated into research.
  • A S&G balance must be promoted throughout all stages of research in order to develop more targeted, effective opportunities for prevention, treatment and care.
  • The continued under-representation of women in clinical trials needs to be urgently tackled.
  • Educate and increase awareness, particularly amongst younger generations, on the importance of including S&G in research and medicine.
  • Provide targeted training on S&G in research content.
  • Employ a holistic person-centered approach to precision medicine.
  • Adopt stricter rules on the inclusion of women in clinical trials and systematic gender and sex analysis and make this transparent.
  • Healthcare needs to take a collaborative approach, not working in silos, in order to improve efficiency and effectiveness.
  • (MM)

CONCLUSIONS AND NEXT STEPS

What’s Next?

Women on The Frontline of Health

Based on the conference outcomes and in preparation for the European Parliament elections, which will be held in May 2019, a working document for a European Action Plan for Women’s Health 2018 has been developed. It outlines how we can do we advance the women’s health agenda together in key areas based on the conference outcomes.  A draft version can be accessed here.

Through this aligned approach, we hope that together we might achieve more than each of us can on her own.  Thus, stakeholders can remain true to their own mission and organisation’s agenda while joining forces to advocate for sex and gender equity in health and research policy right from the start.  We kindly ask all delegates if they are interested to commit to supporting the Plan, which we hope to turn into a European Manifesto for Women’s Health for the 2019 European Parliament elections.  We warmly welcome input and contributions from delegates and members through the online form or by email.


European Women’s Health Steering and Working Groups

We hope to invite interested multidisciplinary and multi-sectorial expert delegates from local, national and European levels relevant to women and family health to join our European Women’s Health Steering Group.  We will aim to include policymakers, healthcare professionals, academics, non-governmental organisations, patients, sex/gender experts, researchers and other thought leaders in this group.

Based on delegate feedback, a small group of these experts will hopefully be brought together to direct a Steering Group that will meet virtually with the aim of implementing conference objectives and outcomes.  We hope that the experts on the group might play a key role in developing further strategies on setting priorities for moving the women’s health agenda forward at the European as well as local and national levels.  If you are interested in more information on or joining the Steering and/or Working Groups, please contact us.

Women’s Health Webinars

As a follow-up to the conference, the European Institute of Women’s Health hopes hold a series of online webinars on selected women’s health issues to support interested expert delegates.   Please follow us online and participate in the discussion if you are interested. The themes and schedule should be posted and distributed over the coming months. Your input, advice, participation, contribution and insight are warmly welcomed.

Join the European Institute of Women’s Health

The European Institute of Women’s Health has a diverse membership.  We regularly update our members on developments relevant to women and family health.  We also draw on their expertise for our work and advocacy as we move forward together.  Membership is free. We encourage all interested organisations and individuals to join online here.

Follow the European Institute of Women’s Health

For more information on our activities, please visit the European Institute of Women’s Health website.  Please also follow us on Twitter @EIWH.