This summary captures a one day programme from “VulnerABLE: Pilot project related to the development of evidence based strategies to improve the health of isolated and vulnerable persons final dissemination conference”, which took place on 7th November 2017 in Brussels, Belgium. The programme included presentations, panel discussions, interactive dialogue and 4 thematic sessions to address specific questions about the project. The participant list showed that the event brought together 90 participants and 23 speakers, including 3 from European Commission, from almost 20 countries across Europe.
VulnerABLE is a two year pilot initiative of the European Commission (DG SANTE). It is run by ICF and in partnership with EuroHealthNET, the UCL Institute of Health Equality, the European Public Health Alliance, Social Platform and GfK.
The conference began with opening remarks from the Chairperson, Caroline Costongs, Director, EuroHealthNet and Christina Dziewantska-Stringer, ICF, provided introduction to the project. The aim of the project was to focus on nine target groups which it defines as vulnerable and known to experience health inequality. The nine target groups are:
- Families who are in a vulnerable situation (e.g. lone parents with young children)
- Having physical, mental or learning disabilities, or poor mental health
- The in-work poor
- Older people who are in a vulnerable situation
- People in unstable housing situations (e.g. the homeless)
- Prisoners (or ex-prisoners in a vulnerable situation)
- Persons living in rural/isolated areas in a vulnerable situation
- The long-term unemployed/inactive (not in education, training or employment)
- Survivors of domestic and intimate partner violence.
The project employed different research approaches, with over 4,000 respondents from across 12 member states. The respondents that took part in the project subscribed to the project definition of vulnerability and are known to experience health inequalities.
The Family Centres in Sweden, Open.med Munch clinics provided an insightful and comprehensive overview of the work it undertakes. Their work includes helping refugees and displaced people while travelling through Europe to access medical services, as well as Prison Health.
- Looking at the participants list, there was a clear lack of attendance from disabled people’s organisations. It therefore raises the question whether or not the title of the project VunerABLE could have turned some organisations/participants’ attention away from getting involved. There was an apparent theme underpinning the project, whereupon two separate issues were being explored. Notably, the reason behind how an individual is made vulnerable and why this should result in health inequality.
- It was somewhat a disappointment that there was no representation from respondents or beneficiaries in any of the presentations or panel discussions. This is likely to create a disconnection from people that create policies, those that implement the policies and users of services.
- The Conference was very academic, professional focused and lacked input from people with lived experience which was relevant to the subject. We heard from professionals talking about people they defined as “vulnerable”.
- There was a clear absence of understanding about disabled people’s experiences throughout the report. Thus, the conference is likely to provide a misconstrued view on the term “vulnerable”, which equally affects the perception by others of disabled people. Consequently, at what point do we get healthcare professionals to see disabled people as professionals/experts?
- Health was not recognised as a pillar to disabled people’s achievement of independent living, and it was also vague with regards to how this project will improve health inequalities.
- It was unclear how member states have been informed about the project and encouraged to share the outcomes.
- Has consideration been given to the UK’s Brexit position and will they be invited to this project after 2019?
From the project defined target groups of “vulnerable”, it is evident that from within these groups, the individuals concerned will be predisposed to health problems, but yet are significantly likely to experience health inequality, as well as other exclusions. Having said that, if we are to achieve health equality (equality in general), then we need to understand the root causes of exclusion, analyse service provisions, look at what organisations are doing to address inequality, and apply intersectional approach to the way we work. Health should not be something available to those who happen to fall outside of the parameters of “vulnerable”, it should be accessible, enabling, encouraging and empowering individuals to be involved in their own treatment, plans and reviews, whereby they are able to embrace their human rights and experience good quality health.
- Pilot projects funded by the European Parliament
- VulnerABLE: Pilot project related to the development of evidence based strategies to improve the health of isolated and vulnerable persons
- VulnerABLE – Final Dissemination Conference
ENIL would like to thank Michelle Daley, from the UK, for representing us at the final conference of the VulnerABLE project and for writing this article.