The unequal health of Europeans: successes and failures of policies | The Lancet

Europe, with its 53 countries and divided history, is a remarkable but inadequately exploited natural laboratory for studies of the effects of health policy. 

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In this paper, the authors review developments in population health in Europe, with a focus on trends in mortality, and draw attention to the main successes and failures of health policy in the past four decades. 

The falls in mortality noted in western Europe are associated with many different causes of death and show the combined effects of economic growth, improved health care, and successful health policies (eg, tobacco control, road traffic safety). Less favourable mortality trends in eastern Europe show economic and health-care problems and a failure to implement effective health policies. 

The political history of Europe has left deep divisions in the health of the population. Important health challenges remain in both western and eastern Europe and signify unresolved issues in health policy (eg, alcohol, food) and rising health inequalities within countries.