2.4 Report structure

Subregion Country coverage

Euro 1 (21 countries) All countries belonging to the EU before May 2004 and western European countries on comparable developmental level (such as Norway and Switzerland)

Euro 2 (13 countries) All countries joining the EU after May 2004

Countries included

EU countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, United Kingdom Non-EU countries: Andorra, Iceland, Monaco, Norway, San Marino, Switzerland

Bulgaria, Croatia, Cyprus, Czechia, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Romania, Slovakia, Slovenia

Euro 3 (12 countries)

Euro 4 (7 countries) All countries belonging to the former Soviet Union (except the Baltic states)

All countries in the south-east of the WHO European Region including the Balkans, Turkey and Israel Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, Uzbekistan

Albania, Bosnia and Herzegovina, Israel, Montenegro, Serbia, North Macedonia, Turkey

2.3.4 Coverage of inequality dimensions

Inequalities can be quantified as absolute and relative inequality dimensions; both are important for an accurate assessment. For example, the absolute inequality between two population groups may be 10% between poor households with an exposure rate of 15% and rich households with an exposure rate of 5%. In this case, the relative inequality would be represented by a ratio of 3:1. When the exposure rate is 12% for poor households and 2% for rich households, however, the same absolute inequality of 10% is valid but the relative inequality doubles to a ratio of 6:1, showing a much stronger relative inequality between household types. This assessment report therefore aims to present both the absolute and relative inequality dimensions to provide a better understanding of the magnitude of inequalities. The ratios are labelled accordingly, showing, for example, income ratios (inequalities between lowest and highest income groups) and sex ratios (inequalities between females and males), which are added to the figures as a second y-axis with a separate scale and legend.

Owing to the available data on environmental health inequalities, this report is limited to assessing differentials in environmental risk exposure or injury outcome. Unfortunately, no data could be compiled to enable an assessment of the vulnerability differential, which is very important as vulnerable groups can react more strongly to environmental conditions and develop more severe health impacts. Vulnerable groups include children, elderly people, pregnant women and people with pre-existing health limitations, among others. Similarly, socially disadvantaged population subgroups may be more vulnerable due to, for example, psychosocial stress or fewer resources to cope with an environmental burden.

Chapters 3–7 of this report present detailed data on intracountry environmental health inequalities, categorized into five main functional or settingbased domains:

• Chapter 3: housing-related inequalities; • Chapter 4: inequalities related to basic services; • Chapter 5: urban environment and transport inequalities; • Chapter 6: inequalities related to work settings; • Chapter 7: injury-related inequalities. Chapter 8 presents an overview for the WHO European Region of the changes and trends in environmental health inequalities, showing the environmental health inequalities that have tended to decline or increase in most countries in the Region in recent years.

Finally, Chapter 9 offers conclusions on the current state of environmental health inequalities in the Region, clustered around a set of 10 key messages.

The annexes include a detailed methodology section (Annex 1) and short summaries of the published systematic reviews (Annex 2). As a supplement to the second assessment report, country profiles on environmental health inequalities will be made available via the report website (WHO Regional Office for Europe, 2019).

References

WHO Regional Office for Europe (2010). Environment and health risks: a review of the influence and effects of social inequalities. Copenhagen: WHO Regional Office for Europe (http://www.euro.who.int/en/ health-topics/environment-and-health/social-inequalities-in-environment-and-health/publications-onenvironment-and-health-in-the-european-region/environment-and-health-risks-a-review-of-the-influenceand-effects-of-social-inequalities, accessed 9 May 2019).

WHO Regional Office for Europe (2012). Environmental health inequalities in Europe: assessment report. Copenhagen: WHO Regional Office for Europe (http://www.euro.who.int/en/publications/abstracts/ environmental-health-inequalities-in-europe.-assessment-report, accessed 9 May 2019).

WHO Regional Office for Europe (2019). Environmental health inequalities in Europe: second assessment report. In: WHO/Europe [website]. Copenhagen: WHO Regional Office for Europe (http://www.euro.who.int/en/ EHinequalities2019).