Between 2011 and 2021, a combination of events, such as poverty, budget cuts, and Corona caused the premature death of over 1 million Britons. That dire conclusion was reached by the British Institute of Health Equity (IHE) last month after a significant study report. There is a "health gap" everywhere, even in the Netherlands. The government was urged to take further action by the Social and Economic Council at the end of January. In the Netherlands, the poorest individuals live an average of 8 years shorter than the richest people, and they even have an average of 24 fewer healthy years of life. Professor Karien Stronks, Professor at APH Amsterdam UMC, discusses this Health Gap.
Nothing is worse for your health then poverty. The socioeconomic circumstances in which you live determine the extent of the health gap rather than factors like nutrition or access to healthcare. Stronks: "The rough picture is that a lower position on the social ladder is associated with all kinds of conditions that are bad for your health." Consider hard physical labor, neighborhoods that are more susceptible to air pollution and have less vegetation, smaller homes that retain more moisture, a bad diet because purchasing good food would be more expensive, and the fact that restaurants in impoverished areas typically offer fewer options for eating out. Furthermore, persistent stress is a direct result of poverty and can have a catastrophic effect on one's health.
Although this knowledge is available, Stronks notes that this is often still difficult in practice. "People are still mainly helped individually to adjust their lifestyle." She brings up the combined lifestyle intervention (GLI), a federal program designed to help those who are overweight. That places a lot of emphasis on changing behavior, however, it is known that if the underlying causes are not dealt with, the behavior is likely to recur as soon as the program is over. Supporting behavior change and addressing the underlying reasons are both necessary.
Significant health disparities also exist in Amsterdam: people living in the Southeast live an average of 6–7 years less than people living in the South, and the disparity in years of healthy life is considerably larger. This is related to neighborhood quality and inequality in income, but ethnic background also matters. According to a large-scale study, the Helius study, conducted by the GGD and the Amsterdam UMC, , people with migrant backgrounds in Amsterdam are more likely to have heart disease, diabetes, and depression. However, the precise connection is still investigated. Stronks: "The suspicion is that it is partly genetic predisposition, partly coming from the stress of living in a new country, and partly because discrimination can also lead to a higher risk of depression."
According to Stronks, much is already being done in Amsterdam to reduce that gap. For instance, if there aren't enough healthful options in a neighborhood, the municipality is investigating its legal options for exerting influence over the selection of retailers. In an effort to lessen health inequities, the municipality launched the Amsterdam Vital & Healthy project in collaboration with Zilveren Kruis and Cliëntenbelang, two medical facilities. "And livelihood security is an important theme for this college - if they succeed in increasing it, it will undoubtedly benefit public health."
Read the full article on Heeft deze Britse stad het antwoord op het dichten van de gezondheidskloof? (parool.nl) (Dutch).