Public health in Europe

Any attempt to describe public health in Europe faces the twin problems of defining Europe and of dealing with the diversity of health and health syst ems it contains. Health status varies considerably between countries. In so me, health is improving, with substantial decreases In heart disease in man y western and central European countries. In others, especially in the form er Soviet Union, there is concern about the rapid increase in tuberculosis and AIDS. A national analysis does, however, conceal a substantial variatio n within countries, between regions, and between social classes. The respon ses to these threats to health are also diverse. A few countries have devel oped effective mechanisms to design and implement appropriate policies but, in many countries, the public-health community is weak. In particular, pub lic health has largely failed in its role as an advocate of the health of t he population. There are, however, many encouraging signs that this may cha nge in the future.