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KNOWLEDGE FOR POLICY

Health Promotion and Disease Prevention Knowledge Gateway

A reference point for public health policy makers with reliable, independent and up-to date information on topics related to promotion of health and well-being.

Page | Last updated: 28 Aug 2024

Implemented policies related to inequalities in nutrition and physical activity

Implemented policies related to inequalities in nutrition and physical activity

Restrict or eliminate choice

Limit access to unhealthy food
  • Limitation of the use of industrial trans-fatty acids in foods (see also Dietary Fats in this series) 

Guide choice through (dis)incentives

  • 'Ensure welfare payments in vouchers or in kind include healthy food (e.g. France’s fruit and vegetable vouchers)'.
  • Consider granting free entry to the local swimming pools and other recreational facilities for residents in low-income suburbs

Guide choice through changing default

Limitation of unhealthy food through reformulation or price regulation
  • Examples of reformulation that aim to decrease overall intake of nutrients of concern by directly improving the food products in the market are provided by: the EU salt reduction framework (EU Salt reduction framework), or other efforts framed by the EU framework for national initiatives on selected nutrients (EU Nutrient framework) or the Roadmap for Action on Food Product Improvement (EU Dutch Presidency). 
  • The minimum unit price for alcoholic beverages implemented in Scotland (2017) . This is an example of an economic policy (price regulation) designed to impact mainly on harmful drinkers. 
Regulation of advertising

Enable or guide choice through changing defaults

  • In the context of reducing inequalities in school and promoting healthier diets, Portugal defined new rules on menus and food available in buffets and vending machines in schools and other teaching facilities.
  • Policies addressing other social heath determinants, e.g. housing. In this context, the Finnish Government introduced the programme “Housing First” to provide a safe home to homeless people, helping reducing inequalities.  
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Provide information

Increasing food quality awareness: the Front of Pack (FOP) nutrition labelling
  • Front-of-Pack (FOP) nutrition labelling is another initiative that could potentially help reducing inequalities. It is aimed to ensure better labelling information to help consumers make healthier and more sustainable food choices by introducing standardised front-of-pack nutrition labelling . So far FOP has only been adopted on a voluntary basis by some Member States (e.g. the Nutri-Score summary label was adopted by France from 2017, Belgium and the Netherlands from 2019, Spain from 2018, Germany and Luxembourg from 2020 and the Netherlands from January 2024). Research conducted in France has shown that Nutri-Score allowed reducing social health inequalities.
Campaign initiatives
HealthyLifestyle4All is a campaign launched by the European Commission in 2021, with the aim of promoting healthy lifestyles across generations and social groups. The initiative links sport and active lifestyles with health, food and other policies. In order to reduce inequalities, it involves people with low socioeconomic status and disadvantaged groups, such as people with disabilities or people with a minority racial or ethnic background, and ensures gender-balanced participation .
School initiatives
  • The EU school scheme supports the supply of fruit, vegetables and milk to children together with educational activities, teaching them about agriculture and developing healthy eating habits. 
  • Interventions at vocational schools, as carried out in Denmark, specifically reach young people with a lower education .
     

Monitor

Monitoring effort
  • A recurring issue in addressing health inequalities and identifying measures and policies that effectively diminish them, is lack of data. The Global Observatory for Physical Activity (GoPA), the Global Obesity Observatory (GOO), and the UK National Child Measurement Programme (HSCIC 2015) are three examples of surveillance schemes that not only allow for a better assessment of the health gap between different population groups but also allow for a better evaluation of policies and measures that try to address them. 
  • Also the recent European Cancer Inequality Registry (ECIR) is a free platform containing information on cancer inequalities by country, age, sex, income, education and other dimensions for different types of cancer and over different time spans.
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Other policies from the Best Practice portal 

  • Some examples are represented by the “PRALIMAP-INÈS” (PRomotion de l’ALIMentation et de l’Activité Physique - INÉgalités de Santé) in France , focussed on school-based intervention to tackle social inequalities in adolescents with overweight. Less specific to health, but indirectly tackling also health inequalities are “SURE STAR” in Hungary  aimed to reach families from diverse backgrounds to promote mutual learning, support and integration of children and parents facing multiple disadvantages into the community;  And “FAMILY CENTERS” in Sweden , that provides several activities for parents and children with the aim to reduce health inequalities.