Examining the interaction between macro-level policies and health inequalities

该研究提案将审查宏观政策与健康不平等之间的相互作用，为此，将考虑采用案例研究方法，重点关注欧洲联盟（欧盟）的一项具体宏观政策-欧洲学期，该政策指导欧盟成员国的财政、经济和就业政策。基本论点是，那些决定上游因素的政策，影响生活，工作和教育条件，以及政府应该花多少钱，应该优先考虑这些预算拨款。最后，政治决定因素是研究的一个主要重点，从人口健康的角度来看，它与健康结果有关。为了分析欧洲学期，它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的变化，以及外部因素如何在欧盟层面上形成优先事项;欧洲学期的范围，在欧洲一体化进程方面，以及成员国如何在它们之间以及与欧盟的管理机构保持一致;以及经济决策的挑战，以及这如何影响社会决策，特别是在通过欧洲社会权利支柱之后。该研究的路线图将基于一种话语制度主义方法，结合公共卫生和政治学方法，在系统思维和逻辑模型中寻求欧洲学期和健康不平等之间的因果关系和反馈循环。特别是，它将从理论概念化和文献综述开始，然后由欧洲学期的每个组成部分进行政策和框架分析，从而确定最佳做法和不平等途径，最后概述健康公平决策的考虑因素。路线图考虑了欧洲学期周期的政策指导，国家具体的建议和实施，以及主要健康结果的健康不平等测量及其生物，社会和经济因素的分解。最后，研究建议的预期结果是建立一个政策网络，并有助于切实的政策影响，提供一个框架，在欧洲学期和其他宏观经济政策工具中明确考虑健康问题，并支持新的选举周期，以实现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.