Inequalities in health have been an important part of the work of the European Union (EU) since 1992 when specific competencies for public health were included in the Maastricht Treaty. However, as noted above large differences in health still exist between and within all countries in the EU, and some of these inequalities are widening. The EU institutions contribute to reducing health inequalities across the social gradient through a variety of strategies, policies, programmes and initiatives which affect the socio-economic determinants of health.