Evidence and power in EU governance of health promotion: Discursive obstacles to a “Health in All Policies” approach

This article explores the relation between the meaning of what constitutes ‘evidence’ in the European Commission (EC) and the Health in All Policies (HiAP) concept. Since the 2006 Finnish EU presidency, HiAP is regularly referred to by the Commission, but has not yet been implemented as an overarching political vision. While there is a growing literature on technical implementation of HiAP, little work has delved into the political obstacles to HiAP. This article explores three ways in which the dominant meaning of ‘evidence’ in the EC reinforces neoliberal institutional characteristics in a way that undermines HiAP: The problematization of health reinforces constitutional asymmetry; the definition of ‘EU added value’ hampers positive integration; and the politicization of evidence strengthens the Better Regulation meta-regulatory agenda. The article suggests that the meaning of evidence in the EC reinforces neoliberal rationality present at institutional level, and calls for more dialogue across public health ontologies.