Book review: Health and social policies in Europe

Michael 2006;3:96–7.

Abreu L. (ed.) European Health and Social Welfare Policies. Brno: Mazaryk University/ Compostela Group of Universities, 2004. 533 pages. ISBN 84–607–3621-X.

This comprehensive volume is the fourth in the Compostela Group of Universities’ series on European Issues. It is based on a selection of papers from a conference organised in 2002 in Évora, Portugal, organised by PhoenixTN, an Erasmus Thematic Network approved by the European Commission. The participants represented a wide variety of scientific backgrounds and the presentations covered a chronological range from the Middle Ages to the present.

The more than 500 pages long volume is divided in four sections, with an introduction by the editor, the Portuguese historian Laurinda Abreu, and an epilogue by Daniel M Fox, President of the Milbank Memorial Fund in New York, USA.

Health between self-help, informal and formal institutions is the title of the first section, which consists of six articles. With high relevance for the debate on hospital locations of today, it is interesting to note that the opening of a hospital in a Rhenish town in the Middle Age did more to upgrade the infrastructure of the town, than to help the sick!

The seven papers on Social welfare policy and changes in the health of the population deal with examples of socio-economic and political changes affecting health. Quoting the Linköping-based historian Jan Sundin: «during the nineteenth century medical knowledge concerning the causes of infectious diseases and public health interventions, especially on the local level, was able to reduce infant and child mortality in Western Europe» (p. 134).

The third section is titled Innovation in health policies and the institutional level. It consists of eight papers, including Kari Tove Elvbakken’s description of the history of public health and the state in Norway.

Choices of welfare policies and their consequences: local and regional environmental health effects, is the last section and include four articles. These articles address the impact of political decisions on the population’s health and welfare. Examples from Hungary. UK, Norway (by Øivind Larsen) and Sweden are presented.

In his epilogue Daniel M Fox discusses «the politics of policymaking». «Policy for population health evolves constantly», Fox writes. «Those who are charged with making it and their staff calculate what the people to whom they are accountable want (in comparison with other wants). They also assess what the groups (including researchers) trying to persuade them that their interests are the same as those of the public want (and what they are willing to do to promote their interests). Policymakers also know that many, perhaps most, people are not eager to pay for what they say they want» (p. 532).

Comparative history is complex, and these 27 chapters provide a mosaic, making up a picture of the development of European health care and welfare over more than 700 years.

Magne Nylenna

Professor of community medicine

Department of Public Health and General Practice

Norwegian University of Science and Technology

N-7489 Trondheim