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Scope and Purpose

The contribution of Health Promoting Hospitals and Health Services to health equity

With the 30th International Conference on Health Promoting Hospitals and Health Services (HPH), 2024 marks an important milestone of the global HPH network. It is also the 2nd HPH conference in Asia, a region where HPH experienced stable growth over the years, currently with 6 national / regional networks and 37 organizational members. As we celebrate this milestone, it is time to look back on what HPH originally set out to do, what the network has achieved so far, and what future challenges and changes lie ahead.

Hosted by the Japan HPH Network, the conference will be held in Hiroshima, a city that has experienced nuclear devastation in the past. This serves as a reminder of the importance of peace as an indispensable precondition for health, and thus of our collective responsibility to maintain this fundamental prerequisite not only of health but of life, echoing the principles of Human Rights.

The local host and the Scientific Committee have decided to focus the conference in this historic venue on the contribution of hospitals and health services to equity for health, as one of the main principles of health promotion. This is in line with the World Health Organization’s (WHO) Ottawa Charter, which emphasizes the importance of health equity as a precondition for enabling all people to achieve their fullest health potential.

In response to the United Nations Commission on Social Determinants of Health report in 2008, the International HPH Network discussed the theme of health inequalities at the 18th International Conference in 2010. In 2015, the United Nations adopted the Sustainable Development Goals (SDGs), which included numerous items related to health equity. Building upon these foundations, WHO launched the Geneva Charter for Well-Being in 2021, followed by the Health Inequality Data Repository in 2023.

Against this backdrop, the conference aims to explore health equity from diverse perspectives and by setting multiple focal points. Through plenary sessions, workshops, oral presentations, and poster sessions, fundamental questions about health equity will not only be raised but also thoroughly examined, drawing upon the insights and solutions that HPH can offer. Our objective is to equip participants with actionable take-home messages relevant to their professional work.

The conference will focus on five main themes:

Setting the scene – the importance of equity for health and the role of healthcare and innovation for equity

Despite the scientific evidence for the importance of equity for health, there are many current threats to health equity, including climate change, loss of biodiversity, pandemics, environmental pollution, the threat of nuclear war, demographic change including the ageing of populations, displacements, wars and conflicts, rapid urbanization, infodemics, social exclusion, poverty, all contributing to extensive inequalities, increasingly putting more people at high risk of health inequity. Within the field of healthcare, the access to medical and technological innovation is a potential contribution of the health sector itself to foster or hinder equity in health. Natural disasters, as seen in the magnitude earthquake that hit the west coast of Japan on January 1st, 2024, are also a significant threat to health equity, as they tend to amplify existing health disparities.

These developments also impact healthcare – for example, by disrupting pathways of care, increasing needs for emergency care and mental health issues that require treatment, and overall placing high strain on the healthcare workforce, prompting many to quit. The conference will examine these issues in more detail, outline why health policy and health systems should have a genuine interest in promoting health equity, explore strategies on how they can contribute to leaving no one behind, and delve into the transformative potential of innovations in promoting health equity. WHO has long been advocating for the implementation of Universal Health Coverage (UHC) as a means to ensure people with access to the healthcare they need without incurring financial difficulties. A related approach is taken by the Japanese economist Hirofumi Uzawa, who advocates for the concept of “social common capital”, as a fundamental premise for hospitals and health services (Uzawa, 2005).

Strategies for (HPH) organizations to address health equity

Worldwide, hospitals and health services offer highly important and often life-saving support to billions of patients annually. They are also relevant workplaces for considerable proportions of the global workforce. As training centers for future healthcare professionals, their policies and work culture are also formative to their professional attitude. Therefore, organizational routines and practices can contribute to promoting equity in health – or the opposite. This needs the backing of the organization and thus building up capacity. By implementing HPH standards and organizational health literacy, organizations can promote equity in healthcare and contribute to building a more just society.

In addition, associations and similar entities can play important roles in impacting cultural change and development in healthcare systems and can guide concrete actions in health care organizations. The exploration of options for equity-supportive organizational policies and the assessment of the role of HPH standards in this regard will be one of the main areas of focus of this conference.

Approaches for HPHs to improve health equity for their patients

Hospitals and health services are seeing people of all ages, cultures, sexual orientations, with varying health needs and expectations to care. As another key issue, we will investigate how hospitals and other health services can facilitate quality care to all, for example, by implementing diversity management or social prescriptions, and by focusing on improving the health literacy of their patients. Special attention will be given to vulnerable groups, from children to the elderly, in the discussion of how HPH strategies should differentiate when it comes to equity for these groups.

How HPHs can contribute to health equity in communities

We will also shine a light on how community-level initiatives can address health equity. Innovative aspects of community-based preventive services and healthcare delivery will be explored as well as contributions of hospitals, healthcare and social organizations to multi-sectorial action and collaboration with other sectors. Examples such as home treatment, providing accessible housing, transportation, and healthy food will be examined. Special emphasis will be given to support for vulnerable population groups, including displaced people and those affected by diverse crises. Within this scope, the role of HPHs in removing barriers and promoting both physical and digital infrastructure for health and well-being in communities will also be highlighted.

The role of HPH networks in promoting equity beyond the health sector

While there are many opportunities to adapt health systems to better support health equity, they cannot achieve this goal alone. But, in the spirit of the Ottawa Charter and the Health in All Policies approach (Adelaide Declaration, 2010), they can mediate between differing interests in society for the pursuit of health and advocate for coordinated action by governments, other social, economic, and environmental sectors, nongovernmental and voluntary organizations, local authorities, industry, and the media.

Building up on 30 years of experience of international HPH conferences, we shall examine how HPH networks on regional, national, and international levels can support broader societal developments towards equity in health, including advocacy for universal healthcare coverage for both physical and mental healthcare, and the promotion of planetary health as an important aspect in intergenerational justice and equity.