On 26 August 2022 EUHealthGov held its sixth online seminar. We had the pleasure to host Dr Charlotte Godziewski (City, University of London) to discuss her new book, The Politics of Health Promotion in the European Union.
Dr Godziewski gave a short presentation of the book, which explores how institutional structures, background ideas and active discourse shape the implementation of the Health in All Policies agenda in the European Union (EU). She also spoke about her rationale for writing the book – reflected in the image on the book’s cover, of a sticking plaster over a crack in a concrete wall – and the sense that health promotion is so often an afterthought, applied (ineffectively) as a fix for existing problems, rather than a preventative measure to strengthen the foundations of a healthy society. The book, then, seeks to examine why, despite high rhetoric on Health in All Policies, it is so often undermined in practice.
The discussion touched on three main contributions that the book makes to the existing literature. Its consideration of the macrosocial determinants of health – meaning those upstream determinants in the social, macroeconomic and political fields – is unusual in studies of EU health policy. In particular, the examination of the better regulation agenda and the practice of collegiality within the European Commission are unique in this field, and draws attention to important non-health, meta-regulatory structures that shape policy outcomes. The book’s second major contribution is its challenge to the idea of a monolithically neoliberal EU. Rather than assuming the all-encompassing and inevitable neoliberal dynamic, it takes a more nuanced approach, identifying sites of contestation and resistance (for instance within the European Parliament and the Joint Research Centre), to demonstrate the importance of discourse in challenging dominant paradigms. Finally, in engaging the literature on Evidence and Policy, the book identifies a core lever or pathway by which Health in All Policies might be implemented. It discusses the use of the evidence in EU policy-making and, in particular, the reliance on quantifiable, objectively measurable data that precludes consideration of the complexity of health inequalities. The collective examination of institutional structure, background paradigms and political discourse is supported by the use of a discursive institutionalist framework. This allows the book the move beyond deterministic characterisations of an EU that cannot better account for health, and moderate narratives of radical, transformational change, to analyse the possibility for gradual but positive change.
A recording of the presentation will shortly be available on the EUHealthGov website.