EU structural inequalities in healthcare exposed by COVID-19

The COVID-19 pandemic has exposed structural inequalities in healthcare capacity across EU Member States threatening convergence in healthcare - where central and eastern Member States with lower health indicators had been catching up with more affluent Member States in a number of areas. This could have serious consequences for economies, labour markets and cohesion across the Union.

Eurofound’s new policy brief The COVID-19 pandemic: A turning point for convergence in health and healthcare in the EU? examines the extent to which the EU had achieved upward convergence in terms of health and healthcare outcomes, as well as health expenditures and delivery, prior to the pandemic. It also examines convergence patterns in infections and deaths from COVID-19 and in the mitigating measures adopted by the EU and national governments.

The findings indicate that from 2008 to 2019 the health of EU citizens improved overall, and Member States converged in health outcomes, but disparities in government expenditures and delivery of health services continued to widen. The COVID-19 pandemic caused further divergence, with death and infection tolls varying greatly across countries, as well as differing rates of vaccination and vaccine hesitancy.

In terms of health and healthcare capacity prior to the outbreak of COVID-19, there was overall improvement in a number of important indicators, including life expectancy, self-perceived health, infant mortality, and unmet needs for healthcare. Improvements in this area in Bulgaria were particularly notable, with the share of citizens in the country reporting unmet healthcare needs dropping from 22.4% in 2008 to 2.4% in 2019. However, EU trends in health delivery were less positive, including the supply of physicians, nurses and midwives, where there was growing divergence between east and west immediately preceding the pandemic.

Massimiliano Mascherini, Head of Unit for Social Policies, emphasised the increasingly important role for the EU in terms of coordination, and the risk of allowing health and healthcare provision to diverge in Europe: ‘The COVID-19 pandemic underlined how the EU lacked the tools to manage a severe health crisis. Greater coordination and reporting in the area of health as part of a European Health Union would reinforce the crisis preparedness of the EU. We now have a unique opportunity post-pandemic to collectively improve healthcare provision across Europe and ensure that citizens have access to the best healthcare possible, no matter where they live in the Union.’

Download the report:

The COVID-19 pandemic: A turning point for convergence in health and healthcare in the EU?

More information:

Topic page: Measuring convergence