Examining the interaction between macro-level policies and health inequalities

这项研究提案将研究宏观政策与健康不平等之间的相互作用，为此，它将考虑案例研究方法，重点放在一项具体的欧盟(EU)宏观政策--欧洲学期，它指导着欧盟成员国的财政、经济和就业政策。基本论点是，那些决定上游因素、影响生活、工作和教育条件的政策，以及政府应该支出多少资金，以及这些预算分配应该优先考虑哪些方面的政策。归根结底，政治决定因素是这项研究的主要重点，它与人口健康方法的健康结果有关。为了分析欧洲学期，将设计一个概念框架，考虑欧盟的政治格局，包括政治周期和领导层更迭，外部因素如何影响欧盟一级的优先事项；欧洲学期在欧洲一体化进程方面的范围，成员国之间以及它们与欧盟理事机构的协调；经济政策制定的挑战，以及这对社会政策制定的影响，特别是在通过《欧洲社会权利支柱》之后。这项研究的路线图将基于一种论述的制度主义方法，结合公共卫生和政治学方法，在系统思维和逻辑模型中寻找欧洲学期和健康不平等之间的因果关系和反馈回路。特别是，它将从理论概念化和文献回顾开始，然后是欧洲学期每个组成部分的政策和框架分析，导致最佳做法和不平等途径的确定，最后概述卫生公平政策制定的考虑因素。路线图既考虑了欧洲学期的政策指导、具体国家的建议和执行，也考虑了从主要健康结果及其按生物、社会和经济因素分解的健康不平等衡量。最后，研究提案预期的结果将有助于建立一个政策网络，促进切实的政策影响，提供一个框架，明确考虑欧洲学期的健康和其他宏观经济政策工具，并支持一个新的选举周期，以追求基于欧盟团结价值观的健康目标。

The research proposal will pursue an examination of the interaction between macro-level policies and health inequalities, and to do so, it will consider a case study approach, focusing on a specific European Union (EU) macro-level policy - the European Semester, which steers the fiscal, economic and employment policies of the EU's member states. The base argument is that those policies that determine the upstream factors, influencing the living, working and education conditions, and how much money a government should spend and what aspects should be prioritise on these budget allocations. Ultimately, the political determinants are a main focus of the study and it relates to health outcomes, from a population health approach. In order to analyse the European Semester it will be design a conceptual framework that considers the EU's political landscape, including the political cycles and leadership changes and how the external factors are shaping the priorities at EU level; the European Semester's scope, in terms of the European integration process and how member states align between them and with the EU's governing bodies; and the challenges of economic policy-making and how this influences the social policy-making, particularly after the adoption of the European Pillars of Social Rights. The study's roadmap will be based on a discursive institutionalist approach, combining public health and political science methods, in a system thinking and logical model to seek causal relationships and feedback loops between the European Semester and health inequalities. In particular, it will start with a theoretical conceptualization and literature review, followed by policy and framing analysis by each components of the European Semester, leading to best practices and inequalities pathways identification and, finally, outline considerations for health equity policy-making. The roadmap considers both the European Semester cycle of policy guidance, country specific recommendations and implementation, and health inequalities measurement from main health outcomes and their disaggregation by biological, social and economic factors.Finally, the results expected from the research proposal it to build a policy network and contribute to tangible policy impact, provide a framework to explicitly consider health in the European Semester and other macro-economic policy tools, and support a new electoral cycle to pursue health goals, based on solidarity values of the EU.