Burden of disease in EU legislation: when public health metrics enter legal texts

Abstract

Burden of disease metrics, such as years of life lost and disability-adjusted life years, are increasingly used to inform public health policymaking, yet their integration into EU law remains limited. This session examines how burden-of-disease evidence is used within EU legislation and what this reveals about the legal pathways by which public health priorities are integrated into European law. A study identified legislative and policy documents containing burden-of-disease metrics through a systematic search of EUR-Lex documents published between 2004 and 2023. Most documents appear to be non-binding or indirectly binding instruments and are concentrated in policy fields outside traditional health law, especially environment, social affairs, and climate-related governance. This pattern reflects the EU’s mixed legal basis for health protection, where public health objectives tackling wider determinants of health are frequently advanced through internal market, social policy, and environmental competences rather than through standalone health legislation. From a public health law perspective, these findings show how evidence can shape the scope, framing, and legitimacy of EU action on health determinants. The session discusses how burden-of-disease metrics can strengthen a Health in All Policies approach, improve legislative impact assessment, and support more coherent integration of health protection across EU legal domains.