The causes are social isolation and exclusion, helpless communities, embattled schools, and crime and violence on the streets. The causes are joblessness, cultural and language barriers and hostile social and physical environments. The causes are hopelessness, helplessness, loss of ambition and will to strive, and inability to imagine a brighter future. The causes, in sum, are the inequalities of life in modern Europe. All the data indicate that the inequalities are just becoming wider.
Social inequality is in turn a powerful risk factor for health inequality.
The pathologies are widespread and no European society, no community, is immune. This is of course not news for this audience, but merely a synopsis of a well-known and growing problem that requires action right across Europe. That brings me to the promised definition of health promotion. The arenas in which policies and programmes can be evaluated for their impact on health include not just agriculture, but also employment, housing, recreation, science and technology, income security, energy, public safety, transport, education, tourism and economic development. The list could go on.