Definición de prioridades en las políticas de salud

What priorities should a government have in its health policies? Twelve experts in public health provide Spanish politicians with a roadmap to draw up the most effective policy in improving public health. Coordinated by the ex-director general of public health Ildefonso Hernández and published by the Esteve Foundation, the book Definición de prioridades en las políticas de salud is the result of a debate organized in 2015 in Barcelona by the Spanish Society of Public Health and Health Administration.

¿What do we understand by health? The concept is usually associated with disease, but many now prefer to relate it to wellbeing and happiness, as everything that surrounds us influences our health. Governments should set their health policies within this wide spectrum, to include fields as diverse as education and employment. At present there is no clear definition in Spain of public health priorities. ?This low-priority model of health -warns Joan Subirats, professor of political sciences of the Universitat Autònoma de Barcelona- is not sustainable?.

Ricard Meneu, of the Foundation of the Research in Health Services Institute, opens the book by underlining the need to define the purpose of health policies. This is the first step to establish an order of priorities. ?What do we want to improve, health in general, equity or the major handicaps of health??. According to the experts, this would be the first question that a government should ask itself when determining its policies. ?Are we seeking to improve health of those in the worst situation in order to put them up to the average level, or do we want to improve global health? The strategy will change depending on the purpose?, he added.

In her chapter Beatriz González López-Valcárcel, professor of quantitative methods in economics of the Universidad de Las Palmas de Gran Canaria, picks out the ten most relevant questions that politicians should consider when giving priorities in public health. According to Joaquín Nieto, director of the International Labor Organization in Spain, prioritization must inevitably count on the participation of the public and interest groups. ?However, participation mechanisms in different sectorial and territorial fields, and in information, prevention and health promotion actions are still to be defined in our country?, he advised.

Which policies should be prioritized? Soledad Márquez Calderón, also of the Foundation of the Research in Health Services Institute, considers policies on social health determinants to be priority, and within these, three of the most urgent areas: housing, basic income and childhood. Sebastián Mora, general secretary of Cáritas España, seconds this position and considers measures on severe exclusion to be priority. ?The wide gap is health exclusion, and hence it is necessary to strengthen social capital in this subject?, he concluded.

Participants in the book also include the professor of preventive medicine and public health of the Universitat Autònoma de Barcelona Miquel Porta, the professor of economics of the Universitat Pompeu Fabra Guillem López Casasnovas, and the councilor of the Nuclear Security Council and ex-minister of the environment Cristina Narbona. Definición de prioridades en las políticas de salud can be requested and downloaded free of charge below.

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