Social inequalities in health are a major challenge to public health in Europe and hence a priority topic for the EU. While the average level of health in EU countries has continued to improve over the last decades, differences in health between advantaged and disadvantaged sections of the population within each country remain substantial. A broad spectrum of policies influences the determinants of health inequalities. Such interventions are seldom evaluated for their impact on population health in general and even more rarely for their differential impact on different socioeconomic groups. There is an urgent need to extend and strengthen the evidence base on differential policy impact, to help identify the most effective ways to reduce health inequalities in different EU countries. Methodologically, this is a highly challenging task for which traditional experimental evaluation designs are neither adequate nor feasible.
Socioeconomic inequalities in health are a major challenge to public health in Europe and reducing them is a priority for the EU (EC 2009). By socioeconomic inequalities in health we refer to the substantial differences in health between socioeconomic groups found within each European country, with morbidity and mortality rates systematically increasing with decreasing socioeconomic position. People with a lower level of education, a lower occupational class, or a lower level of income tend to die at a younger age, and to have, within their shorter lives, a higher prevalence of all kinds of health problems. These inequalities in health have been found in all European countries with available data, and usually amount to between 5 and 10 years difference in life expectancy, and between 10 and 20 years difference in disability-free life expectancy (Mackenbach 2006).