Helmut Brand

In search for a public health leadership competency framework to support leadership curriculum-a consensus study.

BACKGROUND Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project-supported by the EU Lifelong Learning Programme. METHODS The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. RESULTS The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. CONCLUSION The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe.

Health Literacy: The Essential Catalyst for the Responsible and Effective Translation of Genome-Based Information for the Benefit of Population Health

The complexity and novelty of public health genomics poses a challenge to ensure effective and responsible translation of genome-based information for the benefit of population health. The aim of this article is to provide literature-based insight into how the concept of health literacy can act as a catalyst for the translation process and to comment on the necessity to adapt new perspectives in a rapidly changing world, such as e.g. the health literacy-friendly approach of Google. Taking advantage of the potential of health literacy in the population along with a recognized role of health professionals as knowledge brokers and ‘nudges’ will benefit the efficiency and responsibility of translating genome-based knowledge.

Austerity policies in Europe—bad for health

Health protection within the EU mandate is more relevant than ever

Supporting health systems in Europe: added value of EU actions?

Since the start of the economic crisis, the European Unions (EUs) predominant discourse has been austerity and fiscal consolidation. The detrimental effects on Europes health systems and the health status of its citizens are well described. However, little is known about the emerging EU-level initiatives to support national health systems handle the challenges of efficient care provision and system reorganisation aimed to meet their future needs. This review analyses the manner, conditions and prospects of such EU support. First, health system objectives are increasingly entering the EU health policy agenda. Second, professional and patient mobility provisions may support member states (MS) in copying with crisis related health challenges but can potentially acerbate them at the same time. Third, in recent initiatives health system goals are more closely tied to the EUs economic growth narrative. And fourth, health system issues are taken up in existing EU-level structures for debate and exchange between MS. In addition, the design of some policies may have the potential to intensify socioeconomic and health inequalities rather than ameliorate them.

Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

BackgroundThe European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity.MethodsSemi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs.ResultsThe ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients’ rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity.ConclusionsWhen comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development.

Global health in the European Union - a review from an agenda-setting perspective

This review attempts to analyse the global health agenda-setting process in the European Union (EU). We give an overview of the European perspective on global health, making reference to the developments that led to the EU acknowledging its role as a global health actor. The article thereby focusses in particular on the European interpretation of its role in global health from 2010, which was formalised through, respectively, a European Commission Communication and European Council Conclusions. Departing from there, and based on Kingdons multiple streams theory on agenda setting, we identify some barriers that seem to hinder the further establishment and promotion of a solid global health agenda in the EU. The main barriers for creating a strong European global health agenda are the fragmentation of the policy community and the lack of a common definition for global health in Europe. Forwarding the agenda in Europe for global health requires more clarification of the common goals and perspectives of the policy community and the use of arising windows of opportunity.This review attempts to analyse the global health agenda-setting process in the European Union (EU). We give an overview of the European perspective on global health, making reference to the developments that led to the EU acknowledging its role as a global health actor. The article thereby focusses in particular on the European interpretation of its role in global health from 2010, which was formalised through, respectively, a European Commission Communication and European Council Conclusions. Departing from there, and based on Kingdons multiple streams theory on agenda setting, we identify some barriers that seem to hinder the further establishment and promotion of a solid global health agenda in the EU. The main barriers for creating a strong European global health agenda are the fragmentation of the policy community and the lack of a common definition for global health in Europe. Forwarding the agenda in Europe for global health requires more clarification of the common goals and perspectives of the policy community and the use of arising windows of opportunity.

The realisation of a European health information system—time to get the politicians involved

The 2013 European Public Health Conference (EPHC) in Brussels brought together representatives of the European Commission’s (EC) Directorate General for Health and Consumers (DG SANCO), the European Regional Office of the World Health Organization (WHO-EUR), the Organisation for Economic Co-operation and Development (OECD) and EUPHA. The aim of the round table discussion was to explore how the diverse European health information initiatives could be integrated to create an infrastructure that is comprehensive, functional and sustainable. So far, the EC has given financial support to projects to develop common European instruments …

Financing Public Health in Europe

AIM The aim of this study was to ascertain the levels and mechanisms of funding public health in Europe. METHODS A review of published and unpublished documents and expenditure data was undertaken. RESULTS Expenditure on public health in Europe is difficult to determine, but data from national health accounts suggest that it differs greatly across countries, both as a percentage of total health expenditure and per capita. Better data are urgently needed, given that a lack of sustainable, long-term funding may be the most significant barrier to public health programmes and interventions in Europe. CONCLUSIONS In view of the current economic crisis, it will be essential to safeguard financing for public health and to put it on a more sustainable basis.

A new agenda for health in Europe.

In 2013 we saw the 20th anniversary of the public health mandate of the European Union (EU). Looking back we can conclude that progress towards a healthier Europe has been made and that the glass of achievements in European public health policy is half full already (see also the viewpoint section in this issue). There are now institutional structures with a directorate for health, agencies (e.g. the European Centre for Disease Control), health programmes and a health strategy. Additionally, the European Court of Justice’s (ECJ) decisions shaped the work as crises like BSE, SARS and H1N1 did. Work on the main determinants of health has been evaluated with mixed results. In 2014, there will be European parliament elections. The turnout of voters might be at an all-time low with austerity as the solution to the sovereign debt crisis the European project lost …

Ten years on: Time for a public health celebration or sober reflection?

Ten years ago Malta was deeply divided into two camps: those in favour and those against membership of the European Union (EU). The referendum was a narrow victory for supporters of membership, and the rest is history. At the time of accession, the health sector was not one of the key areas targeted for debate or scrutiny.1 This may have been due to the fact that European competence in health was limited and Member State competence in matters of health policy was held to be supreme. The potential ‘brain drain’ resulting from the free movement of health-care professionals was highlighted at the time of enlargement.2 While professional mobility is a complex phenomenon, recent analysis of data indicates that although the numbers of doctors from the new EU 12 present in the old EU 15 more than doubled between 2003 and 2007, estimated outflows have rarely exceeded 3% of the domestic workforce.3 Malta was particularly concerned about the potential loss of health-care professionals to other countries.4 Shortly after accession, ∼80% of newly graduated doctors started to migrate annually. This situation called for immediate …