Exploring Health and Well-Being in a European Context

Abstract

The third Sustainable Development Goal sets out to ensure healthy lives and promote well-being for all at all ages. This will be measured in terms of 13 targets, many of which are direct life and death issues. For example, specific targets relate to reduction of maternal, neonatal and under-5 mortality, addressing communicable and non-communicable diseases, and reducing other causes of death including substance abuse (drugs, alcohol, tobacco) and road traffic accidents. A focus on improved quality of life is also seen in the target of ensuring universal access to sexual and reproductive healthcare services, and providing access to quality essential healthcare and safe, effective, quality and affordable essential medicines and vaccines for all. This chapter will begin with an overview of SDG3, outlining the 13 targets and associated indicators. It will then turn to an evaluation of how well we are doing in relation to this goal, drawing on data from 2015, when the SDGs were instigated, the current status of the indicators, and the latest predictions for the 2030 end date of the SDGs. An international and regional comparative perspective will be used in order to set the context. While the perception may be that Europe is ahead of other regions in achieving targets related to SDG3, there are also areas where the region is lagging behind. As we look within Europe, it will also become clear that there are distinct variations at a national level, and that specific challenges remain. Some consideration will be given to the fact that some of the progress made in many health areas before the COVID-19 pandemic, including improving maternal and children health, increasing immunisation coverage, and reducing communicable diseases, has now halted or even been reversed. Disruptions to essential health services, even within relatively wealthy regions such as Europe, have affected services mental, neurological and substance use disorders; HIV and hepatitis B and C; cancer screening and services for other non-communicable diseases. Moving beyond the statistical data, the chapter then turns to consider some of the questions arising out of SDG3 within the European context. Across the continent, the population structure is changing. Two forms of demographic ageing are being experienced. On the one hand, ‘bottom up’ ageing is being seen as birth rates decline and the younger age cohorts of the population pyramid become smaller than the older generations. On the other hand, ‘top down’ ageing is also evident as life expectancy increases. While European governments are attempting to address this issue, one of the consequences of more people living longer is that there is an increase in a range of non-communicable diseases. Furthermore, as we appear to have entered the late stages of epidemiological transition, health issues associated with degenerative diseases, lifestyle and emerging diseases are on the rise. In its final section, the chapter will look outward from the European perspective, considering responsibilities and ethical issues relating to overseas aid, globalisation and policies which impact on the capacity of other regions and nations to achieve the targets set out by SDG3.