Parool March 7th, 2023 - Health differences among Amsterdam residents are related to their ethnic background. For example, 1 out of 5 Turkish Amsterdam residents has symptoms of depression, while for people with a Dutch background this is 1 out of 20. This example is one of the findings of a large-scale study conducted by Amsterdam UMC and the GGD over the past decade. APH researchers Karien Stronks and Anja Lok, both involved in this research project, were interviewed by Parool.

During the first corona wave, the mortality rate among Dutch people with a migration background was one and a half times higher than for Dutch people without a migration background. Cardiovascular diseases are more common amongst people of Ghanaian and Hindustani descent. About 1 in 3 people from Turkish and Ghanaian backgrounds is struggling with extreme obesity, compared to 1 in 10 people from Dutch backgrounds. Also, excessive alcohol consumption is much higher among Amsterdam residents without a migrant background.

These are just a few findings from more than 150 studies conducted over the past decade by Helius, a research collective of Amsterdam UMC and the Amsterdam GGD. Helius stands for Healthy Life in an Urban Setting.

There are roughly three focus areas: mental health, infectious diseases and cardiovascular disease. The goal of the long-term survey of 25,000 Amsterdam residents is to identify the causes of health disparities, which should ultimately help reduce those differences.

For that reason, the researchers argue that registering the background of participants in the study is not stigmatizing, but useful. "Without this data you are missing important information, which makes it impossible to eliminate the big differences,” said Karien Stronks (professor of Public Health at Amsterdam UMC) and founder of Helius. “We also say this to people who feel discriminated because of their background.”

"Depression is not only more common among Amsterdam residents born in Turkey, but also among their children born in the Netherlands," says Anja Lok (researcher and psychiatrist at Amsterdam UMC). "This is partly related to their relatively low socioeconomic position and experience of more discrimination.”

“Depression occurs in a complex and dynamic system,” Lok says. “Individual characteristics play a role, but so does a person's social context, as well as the country they live in. And all those facets interact.”

Beyond social and societal factors, Helius also found biological factors that play a role in health disparities. For example, there is a link between the microbiome - the wide variety of bacteria, viruses and yeasts found particularly in the gut - and depression. The less diverse the microbiome, the greater the likelihood of depression. "That correlation is independent of ethnic or migration background; we saw it in all populations," Lok says.

Whether and how influencing the microbiome is effective as a treatment for depression is now being investigated. Examples include the administration of substances produced by bacteria, but also poop transplantation; by administering the filtered feces of someone with a favorable microbiome, a depressed person may be able to get rid of his symptoms in the future. Such a favorable microbiome in turn influences the formation of neurotransmitters, chemicals that enable communication between brain cells. Antidepressants also act on neurotransmitters.

"The microbiome is a promising research area for psychiatry. We know that current treatments for depression are only effective for one out of two people, so there are improvements to be made. Moreover, the suffering of depression is high. And such a poop transplant involves taking taste-neutral capsules, it really isn't as gross as it sounds."

Source: Parool (DUTCH - Newsdesk LexisNexis)