Making prevention work: an effective agenda for European resilience

Life expectancies across the EU continue to rise: by 2100, the European Commission projects they could exceed 90. Healthy life expectancy, however, has not kept pace – meaning citizens spend more years in poor health. As the demographic transition reshapes EU labour markets, care systems and public budgets alike, this gap between lifespan and “healthspan” risks becoming a central political pressure point.

To date, preventive health policies have largely relied on individuals’ making behavioural changes – starting to eat better, move more, get enough sleep or attend screenings. This approach assumes a capacity that many people, especially those facing time and financial constraints, may lack. Layered on top of an already overburdened life, individual prevention demands can generate cognitive overload;3 rather than producing healthier choices, they may lead to stress and disengagement.

Taking a page out of climate science, we can conceptualise this as a tipping point4 beyond which individual behavioural change may collapse. The individual is still the agent – but whether healthy choices are made is shaped by conditions they cannot easily control: affordable healthy food, safe neighbourhoods, predictable working hours and housing free of mould and similar issues. Making prevention work thus means creating the conditions that determine whether it feels within reach, rather than only demanding more behavioural change from individuals. Starting from this understanding, legislation must build the necessary infrastructure.

While COVID-19 led the EU to expand its efforts in healthcare, investments in prevention have barely changed, making up only 5.5% of member states’ health budgets on average.5 According to WHO, patients’ overall health stems primarily from socioeconomic determinants rather than medical factors.6 As healthcare costs rise, this makes the case for more efficient, horizontal allocations across policy areas – moving past treatment-outcome targets to consider prevention holistically. This requires realigning structural incentives with the evidence and dissolving policy siloes.

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Elizabeth Kuiper is Associate Director and Head of the Health and Societal Resilience Programme at the European Policy Centre.  

Viktoria Henkemeier was a Junior Policy Analyst in the European Policy Centre’s Health and Social Resilience Programme.

Samuel Goodger is a Policy Analyst in the European Policy Centre’s Health and Societal Resilience Programme.

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