Download the final 'Closing the Gap' publication: Taking Action on Health Equity.
This publication contains summaries of what each of the 21 ´Closing the Gap´ partners are doing to address health inequalities in their countries, as well as the conclusions and recommendations of this 3-year initiative.
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Belgium is a small country with over 10 million inhabitants. It is a federal state consisting of a Flemish (Dutch speaking) region (almost 60% of the population), a Walloon (French speaking) region (40%) and the bilingual Brussels region (the capital). The composition of the Belgian population has changed a lot in the last 50 years, apart from the classic demographic transition, as there have been three main waves of immigration. Belgium has a Bismarck-type insurance system, which covers almost 100% of the population. Indicating a relatively high degree of income inequality, Belgium scores low on equality measurements as indicated by the Gini coefficient is 0.33, where 0=perfect equality and 1=perfect inequality (United Nations Human Development Report, 2007/8).
Since the 1970s, as a result of several state reforms, work in health and combating poverty are complexly divided between the federal state, the regions and the communities. For example, the communities are responsible for disease prevention and risk management but the federal state remains responsible for regulation of finance and care delivery. The different approaches are the result of a bottom-up development. In the years after the May 1968 student revolution, socially motivated family physicians, nurses and social workers in deprived areas of some cities started to build community health centres integrating curative care, health promotion and patient empowerment. The study of poverty and its relationship with health became a topic for researchers at universities, departments of public health and primary health care facilities. There was an increasing self-organisation by the impoverished and ethnic minorities that resulted in reports that described the living conditions from the perspective of the people involved. Politicians, both at the federal and the local level, started to subsidise projects with a emphasis on deprived areas for the improvement of housing conditions, living conditions and the creation of educational opportunities. It was not a clearly established stepwise approach, but rather an incremental pragmatic approach that inspired development, very often starting at the local level.
This section gives examples of strategies driven both by the health sector and sectors outside of health which are working to address the Social Determinants of Health Inequalities
In this section main tools used to implement and monitor national policies in the field of health inequalities are listed.
In this section key actors that are in a position to have an impact on health inequalities policies, such as ministries, state agencies, universities and/or independent institutes are listed.
Please click here to learn about the databases where you can find a collection of good practices aiming at reducing health inequalities collected in Belgium.