Public Health in the EU: Is Europe Subject to Americanization?

Article excerpt

1 Introduction

Since the launching of the Single Market, the European Commission with the support of Europe's political leaders have sought to reach out to the people of Europe by promoting a "Europe of the Citizens" to neutralize the widespread disenchantment with the prevailing impression of a "Europe of Merchants". The first attempts to introduce a popular dimension to EU legislation dated from the 1984 summit at Fontainebleu where President Mitterrand of France and Prime Minister Craxi of Italy commissioned a report designed to identify areas where the EU could develop new policy dimensions closer to the concerns of ordinary citizens. In retrospect, this decision was the starting point for the gradual expansion of EU activities in the field of consumer protection, environment, and health. The EU's activities in these policy areas were given a large subsequent boost by the Amsterdam Treaty and Article 152, which extended EU competence to "promoting" in addition to "protecting" the health of EU citizens. The former Constitutional treaty did not focus on health per se, but it granted the Commission a stronger mandate to fight health threats such as tobacco and alcohol. In the new Reform Treaty Article 152 draws attention to the protection of public health concerning tobacco and the abuse of alcohol though fighting health threats, first mentioned in the defunct Constitutional Treaty has been deleted.

One way in which the EU has devoted itself to the interests of ordinary citizens has been through its forays into public health, and in particular its initiatives on tobacco control and obesity. Tobacco control emerged in mid-1980s and is still on the agenda since "tobacco is the single largest cause of avoidable death in the European Union," contributing to approximately 25 percent of all cancer deaths and 15 percent of all deaths in the EU (SANCO 2008). To address this health hazard, the European Commission has passed scores of legislative measures, such as requiring health warnings on cigarette packs, specifying maximum tar content in cigarettes, banning advertising of tobacco products, and collecting a repository of shocking images of the harm done to the smoker. (1) It also funds professional networks to encourage smoking prevention and cessation and it works to ensure that a range of other policies are consistent with tobacco control. In January 2007, the Commission published a Green Paper "Towards a Europe free of tobacco smoke: policy options at EU level" in anticipation of regulations to combat indoor pollution in the workplace and public spaces (European Commission 2007a). (2)

Of more recent vintage is the program to promote healthy diet and nutrition in the EU. In May 2007, the European Commission published a white paper on "A Strategy for Europe on Nutrition, Overweight and Obesity related health issues," which is a call for action to combat weight gain, particularly among children, and prevent future sharp increases in cardiovascular disease, hypertension, type two diabetes, strokes, certain cancers, muscular-skeletal disorders and even a range of mental health conditions due to poor diets and lack of physical activity (European Commission 2007b). The campaign began with an exploratory report, "Eurodiet: Nutrition & Diet for Healthy Lifestyles in Europe," which covered health and nutrients, the translation of nutrient requirements to food-based guidelines and effective promotion of these foods and healthy lifestyles (European Commission 2000).

The Commission, to be sure, has not received much encouragement to extend its activities into public health. Instead, the people of Europe assign low priority to community-wide health programs while many political leaders are extremely hesitant about furthering the reach of the Commission into any novel, undefined areas. In developing its public health initiatives, the Commission has responded neither to pressure from below (e.g., emanating from health-related NGOs) nor to pressure from above from the member state governments. …