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Background: There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes.Methods: This review scoped 77 papers from nine European countries (Austria, Cyprus, France, Germany, Greece, Italy, Malta, Spain, and Sweden) in English and in country-specific languages in order to provide an overview of migrants' access to healthcare. The review aims at identifying what is known about access to healthcare as well as healthcare use of migrants and refugees in the EU member states. The evidence included documents from 2011 onwards.Results: The literature reviewed confirms that despite the aspiration to ensure equality of access to healthcare, there is evidence of persistent inequalities between migrants and non-migrants in access to healthcare services. The evidence shows unmet healthcare needs, especially when it comes to mental and dental health as well as the existence of legal barriers in accessing healthcare. Language and communication barriers, overuse of emergency services and underuse of primary healthcare services as well as discrimination are described.Conclusions: The European situation concerning migrants' and refugees' health status and access to healthcare is heterogeneous and it is difficult to compare and draw any firm conclusions due to the scant evidence. Different diseases are prioritised by different countries, although these priorities do not always correspond to the expressed needs or priorities of the migrants. Mental healthcare, preventive care (immunization) and long-term care in the presence of a growing migrant older population are identified as priorities that deserve greater attention. There is a need to improve the existing data on migrants' health status, needs and access to healthcare to be able to tailor care to the needs of migrants. To conduct research that highlights migrants' own views on their health and barriers to access to healthcare is key. [ABSTRACT FROM AUTHOR]

Europe is undergoing rapid social change and is distinguished by its cultural superdiversity. Healthcare is facing an increasing need for professionals to adapt to this environment. Thus, the promotion of cultural competence in healthcare has become a priority. However, the training being developed and their suitability for the European context are not well known. The aim of this qualitative study has been to map the scientific literature in order to comprehend the current state of research on this topic. For this purpose, we conducted a systematic scoping review of the empirical publications focused on cultural competence interventions for healthcare professionals in European countries. The search was conducted in eight thematic (PsycINFO, MedLine, and PubPsych) and multidisciplinary databases (Academic Search Ultimate, E-Journals, Scopus, ProQuest, and Web of Science) to identify relevant publications up to 2023. Results were presented qualitatively. Out of the initial 6506 records screened, a total of 63 publications were included. Although the interventions were implemented in 23 different European countries, cultural competence interventions have not been widely adopted in Europe. Significant heterogeneity was observed in the conception and operacionalización of cultural competence models and in the implementation of the interventions. The interventions have mostly aimed at improving healthcare for minority population groups and have focused on the racial and ethnic dimensions of the individual. Future research is needed to contribute to the conceptual development of cultural competence to design programs tailored to European superdiversity. This scoping review has been registered in OSF and is available for consultation. [ABSTRACT FROM AUTHOR]

Health policy in Europe is at a crossroads. Longstanding challenges, such as persisting social and geographical inequalities, ageing populations, and rising burdens of chronic diseases, are being compounded by new, global threats, such as pandemic infl uenza and crises in the world's fi nancial markets. Signifi cant improvement in the health of Europe's population has been driven by factors both inside and outside the health sector. Key obstacles to improving population health in Europe result from underlying failures to overcome political and economic issues, including those shaping healthcare fi nancing and delivery systems. How can the public health community respond to these challenges? This paper discusses three examples of how power and politics have shaped the world in which public health works. The focus on individual risk factors diverts attention from underlying determinants, such as the dominance of the market in healthcare, and the political decision to favour a rapid transition from communism in the 1990s. Effective public health policy requires addressing these political forces, seeking to understand the dominant paradigms, how they have been defi ned and shaped, and how they might be changed. Their effects are often subtle but powerful, shaping the language that is used, the assumptions that are made, and the rules that are implied. We can formulate key policy options to help improve health outcomes by reshaping the critical forces that affect public health risk factors among those populations currently most burdened by signifi cant disease in Europe today. [ABSTRACT FROM AUTHOR]

Abstract: The World Health Report 2000 proposed three fundamental goals for health systems encompassing population health, health care finance and health systems responsiveness. The goals incorporate both an efficiency and equity dimension. While inequalities in population health and health care finance have motivated two important strands of research, inequalities in responsiveness have received less attention in health economics. This paper examines inequality and polarisation in responsiveness, bridging this gap in the literature and contributing towards an integrated analysis of health systems performance. It uses data from the World Health Survey to measure and compare inequalities in responsiveness across 25 European countries. In order to respect the inherently ordinal nature of the responsiveness data, median-based measures of inequality and polarisation are employed. The results suggest that, in the face of wide differences in the health systems analysed, there exists large variability in inequality in responsiveness across countries. [Copyright &y& Elsevier]

This article discusses the Social Protection Floors Recommendation, 2012 (No. 202). This instrument takes account of the global recognition that social security plays a key role in addressing major challenges such as financial instability, growing inequality, insecure labour markets, large-scale migration flows, and population ageing. A national social protection floor is meant as a tool to prevent and reduce poverty and social insecurity by providing, over the lifecycle, health care and income security for all, at least at a basic level. After briefly depicting the background, objectives and substance of the Recommendation, the article examines its relevance for EU countries. The usefulness of the Recommendation for states with well-developed welfare systems, is demonstrated by pointing to several topical social security issues that constitute a lack of compliance with the concept of social protection floors. [ABSTRACT FROM AUTHOR]

During an economic downturn the non-productive sectors (education, health, and social services) are the most exposed to sudden policy changes, as a result of austerity measures. This article aims to assess the impact of the late 2000's crisis on some European countries' healthcare systems in order to highlight the link between the breakdown of the economic context and the negative outcomes on a social level. In this regard, a panel data analysis was employed, focusing on out-of-pocket health expenses as an estimation of a nation's wellbeing and healthcare development level. The cross-time results indicated a clear collapse of all national healthcare systems in 2009 while the cross-section effects implied that the twenty three countries could be divided in three groups according to their healthcare policy, especially regarding health insurance. Thus, countries should pay more attention to the private insurances component of the healthcare systems as the others are defenseless against business cycle fluctuations. [ABSTRACT FROM AUTHOR]

The article discusses key issues concerning the proposed new Cochrane Public Health Collaborative Review Group (PHCRG) in the area of public-health decision making in Europe. The PHCRG aims to provide editorial direction and leadership in the synthesis of evidence on public-health interventions that address health inequalities and upstream, population-level determinants of health. The scope of the PHCRG includes systematic reviews of public-health programs and interventions aimed at reducing health inequalities and improving health equity. Also cited are the issues' implications for public health.

Equity in health has been the underlying value of the WHO Health for All policy for 30 years, distinguished from equality and difference in a commissioned series of theoretical reports in the early 1990s. This article examines how cities translated this principle into action. Using information designed to help evaluate Phase III (1998–2002) of the WHO European Healthy Cities Network, plus documentation from city programmes and websites, an attempt is made to assess how far stakeholders in cities understood the concept of equity in health, had the political will to tackle the issue and the types of action undertaken. Results show that cities focused mainly on support for vulnerable groups, and a wide range of actions were being implemented, including lifestyle-oriented methods or those to improve access to care. Few cities made the necessary shift towards more upstream policies to tackle determinants of health such as poverty, unemployment and housing. There was little experience of evaluating the impact of interventions to reduce the gaps. This is partly explained by a frequent lack of local level data reflecting inequalities in health. The article concludes that although half the cities in the Network needed stronger action to make equity in health an integral part of long-term planning, innovative experience was available to be shared by its members in Phase IV (2003–2008) of the Network. [ABSTRACT FROM PUBLISHER]

Focuses on the problems relative to the changes in health care systems in Europe. Challenges faced by governments regarding the issue on social inequalities; Evidences indicated for the nature of the problems; Details on the equitable policy of the health sectors.