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Review
. 2025 Feb 24:46:1608170.
doi: 10.3389/phrs.2025.1608170. eCollection 2025.

Health Outcomes in EU Cross-Border Regions: A Scoping Review

Sophie Stroisch  1   2 , Viola Angelini  3 , Sebastian Schnettler  1 , Tobias Vogt  2   4
Affiliations
Review

Health Outcomes in EU Cross-Border Regions: A Scoping Review

Sophie Stroisch et al. Public Health Rev. .

Abstract

Objective: This scoping review examines health outcome trends in European cross-border regions, identifies available evidence, and highlights research gaps. The European Union's integration efforts aim to harmonise living standards and healthcare access. Removed border controls and freedom of movement enhanced service availability, benefiting populations in border regions with cross-border healthcare access. However, these populations are exposed to different institutional settings, highlighting health differences worth studying.

Methods: We employed the Joanna Briggs Institute methodology, using the PCC (Population-Concept-Context) framework to set eligibility criteria. The search covered literature databases and international governmental institution websites, yielding 785 studies, with 24 included in the final analysis.

Results: No comprehensive studies investigating longitudinal population health patterns were found. Instead, there are studies on specific diseases or health outcomes in particular border regions, especially around Germany. Most of these studies were cross-sectional. Five key research themes emerged: antibiotic resistance, COVID-19/SARS-CoV-2, other infectious diseases, cancer survival, and additional health outcomes.

Conclusion: The findings suggest that cross-border contexts have predominantly been used to study infectious disease spread, with little attention given to the broader impact of European integration on long-term health trends.

Keywords: European Union; cross-border; morbidity; mortality; public health; scoping review.

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Conflict of interest statement

The authors declare that they do not have any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews; based on Moher et al., 2009 (Netherlands, 2024).
FIGURE 2
FIGURE 2
Temporal Coverage: Observation or data collection period of the selected articles (Netherlands, 2024).
FIGURE 3
FIGURE 3
Geographical coverage of the selected studies. The map on the left summarises all studies in the scoping review. The maps on the right side are categorised according to the respective themes. The darker the shade, the more studies were conducted in the respective region. The numbers refer to the ID as indicated in Table 1 (Netherlands, 2024).
See this image and copyright information in PMC

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