The European Semester and health equity Findings from the Recovery and Resilience Plans in eight EU Member States

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Key findings from interviews with experts

  • The Country Report put greater emphasis on healthcare opposed to public health interventions. More attention should be directed towards health promotion and disease prevention, with a specific focus on youth and vulnerable populations.

  • There are several challenges regarding the RRP process including the extensive administrative processes around the recovery plans.

  • It is important to prioritise the sustainability of the recovery plan projects, by for example developing frameworks to embed current actions into future legislation and plans.

The Spanish Recovery and Resilience Plan A short overview

POLICY AREA 3: Fair and inclusive energy transition
Renewable energies implementation and integration 3,165
Fair transition strategy (addressing the environmental, digital, and social infrastructures of areas in transition) 300
POLICY AREA 7: Education and knowledge, lifelong learning, and | capacity-building investments
National plan for strengthening digital skills 3,593
Strategic plan for vocational training (including reskilling and upskilling of the workforce, digital transformation, innovation and internationalisation) 2,076
Modernisation and digitalisation of the education system, including early education (0-3 years) 1,648
POLICY AREA 6: Science, innovation and the national health system
Renewal and expansion of national health system’s capacities (including technological and digital) to foster resilience and promote healthcare skills 1,069
POLICY AREA 8: The new care economy and employment policies
Emergency plan for the care economy and reinforcement of inclusion policies (modernising social services, childcare, services for victims of violence against women, asylum reception systems) 2,492
Public policies for resilient, digital and inclusive labour market (mechanisms of stability and flexibility in employment, modernisation of active employment and labour policies) 2,363

2022 Country specific recommendations for health equity

Each spring, the European Commission and European Council make Country Specific Recommendations to provide tailored advice to individual Member States on how to boost jobs, growth and investment, while maintaining sound public finances.

Spanish Country Specific Recommendations 2022 that are most relevant for health equity

3. [...] Increase recycling rates to meet EU targets and promote the circular economy by enhancing coordination among all levels of government and undertaking further investment to meet separate collection of waste and recycling obligations, as well as to enhance water reuse.


  • Health workforce shortages and uneven distribution of staff
  • Working conditions in the healthcare sector remain a challenge
  • COVID-19 pandemic put a strain on low number of acute and intensive care unit beds


  • The share of people at risk of poverty or social exclusion is high, with significant regional disparities, and it worsened during the pandemic
  • The unemployment rate in Spain in 2020 was higher than the EU average in all Spanish regions
  • The initial shock of the COVID-19 crisis highlighted the long-standing structural challenges facing the Spanish labour market
  • The rate of early leavers from education and training of low-skilled adults remains very high


  • Spain is highly vulnerable to the adverse effects of climate change
  • Climate transition challenges differ significantly between Spanish regions
  • Meeting Spain’s renewable and decarbonisation targets represents a significant challenge
  • Spain needs to tackle challenges facing the road transport system

Country Report 2022

The accompanying Country Report analyse each EU Member State’s key socioeconomic challenges with the aim of providing a framework for the coordination of social and economic policies across the European Union.

The Spanish 2022 report contained a number of elements that are directly relevant to health equity.

Project under the RRP

The Public Health Strategy 2022 

The Public Health Strategy 2022 is a response to the need to strengthen public health and contribute to people’s health. It includes cross-cutting an integrative approaches that build on the work of the determinants of health, the One Health approach, and governance for health. The strategy includes a comprehensive analysis of the health status of the population, as well as a reflection on the state of public health. This analysis not only reflects the state of the situation at this time, but also helps to establish the priorities that should guide public health actions in the coming years. The strategy states the future priorities of public health actions, as well as indicators to assess them. It received a fundamental boost from the RRP.

Read more about the project here.

Other projects under the Spanish Recovery and Resilience Plan

Suggestions for the future

  • Increase investments in public health

  • Support health promotion and disease prevention policies toward young people

  • Strengthen primary care systems and community health, focusing on prevention

  • Foster screening programmes

  • Support public health campaigns related to healthy lifestyles

“The report puts greater emphasis on healthcare rather than public health interventions. More attention should be given to health promotion and disease prevention.”
Expert at Andalusian Regional Ministry of Health and Consumer Affairs, Spain

“The COVID pandemic has provided a window of opportunity to address priorities that were already there or were highlighted by the impact of the pandemic. The recovery plans helped take action to address them.”
Expert at The Ministry of Health, Spain

This report was produced by EuroHealthNet, the European partnership of organisations, institutes, and authorities working on public health, disease prevention, promoting health and wellbeing, and reducing inequalities. We aim to tackle health inequalities within and between European States through action on the social determinants of health. Read more about us on our website.


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