Exploring Integration Trajectories for a European Health Union

COVID-19 emerged as a cross-cutting problem across governance sectors and levels, urging the creation of a European Health Union. There are already a number of integrated European governance strategies-such as the European Energy Union (2015) and the European Green Deal (2019)- A dopted for overcoming problems of governance fragmentation and inadequacy of fragmented policy responses to cross-cutting policy challenges. Past studies focused on the interaction between crisis and policy change and investigated the activation of different mechanisms to enhance integration. This article contributes to the debate over the creation of a European Health Union by unpacking the acknowledged dimensions of policy integration-policy frame, subsystem involvement, policy goals and policy instruments-in order to assess their manifestations in the new EU4Health policy and to establish what contextual conditions triggered the activation of the integration-enabling mechanisms that led to a more integrated European Health Union. In so doing, it offers an analytical illustration and discusses implications for decision-making.