The European Health Map: A Comparative Literature and Policy Analysis of the Definition of Health in Europe to Realize Healthy and Sustainable Diets

Background and Objectives: In the current era of overshooting both planetary boundaries and social limits, the question arises as to whether the 1948 definition of health (DoH) from the WHO is fit for purpose. As healthy and sustainable diets (HSDs) are among the key societal and planetary challenges in the 21st century, this report focused on the DoH in European policy aimed at realizing HSDs. Methods: The viability of the European DoH of eight European high-income countries was evaluated in a comparative mixed-methods approach, combining a literature review with qualitative and quantitative policy analyses. In addition, national policy documents were analysed in order to define national DoHs and get insight into their operationalizations. To evaluate policies on HSDs, sustainability was uniquely conceptualised as being interrelated to human health, planetary health, and the food system. Results: The operationalizations of the European and national DoHs appear to not be in line with the 1948 WHO DoH. Vastly holistic definitions of sustainability as described in scientific literature are currently absent in European policy, and science-policy gaps are found at several levels. In the DoHs, we identified an anthropocentric bias, with economic growth as the ultimate goal of health policies. HSDs appear to be promoted primarily to address these policy goals, instead of being a health goal on their own. This unravels the lack of intrinsic value of sustainability in European health and sustainability policy. Moreover, the potential of the food system to simultaneously benefit human and planetary health is not acknowledged in national health policies. Discussion: In conclusion, the current European DoH appears to not be viable to face 21st century challenges. In order to improve this, the food systems perspective in policy can be used as the unifying concept for both human and planetary health. European policy could benefit from the implementation of a focus on resilience, combined with acknowledging the interrelations between human health, planetary health, and the food system in the eye of sustainability. The insights provided in this report can be used for effective policy-making to improve health, food systems thinking, and as policy guidance towards the realization of HSDs, especially in the European context.