Examining the interaction between macro-level policies and health inequalities

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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.