Abstract
Over the past decade, the Dutch government has pursued a research-based approach to tackle socioeconomic inequalities in health. We report on the most recent phase in this approach: the development of a strategy to reduce health inequalities in the Netherlands by an independent committee. In addition, we will reflect on the way the report of this committee has influenced health policy and practice.A 6-year research and development program was conducted which covered a number of different policy options and consisted of 12 intervention studies. The study results were discussed with experts and policy makers. A government advisory committee developed a comprehensive strategy that intends to reduce socioeconomic inequalities in disability-free life expectancy by 25% in 2020. The strategy covers 4 different entry-points for reducing socioeconomic inequalities in health, contains 26 specific recommendations, and includes 11 quantitative policy targets. Further research and development efforts are also recommended.Although the Dutch approach has been influenced by similar efforts in other European countries, particularly the United Kingdom and Sweden, it is unique in terms of its emphasis on building a systematic evidence-base for interventions and policies to reduce health inequalities. Both researchers and policy-makers were involved in the process, and there are clear indications that some of the recommendations are being adopted by health policy-makers and health care practice, although more so at the local than at the national level.
Highlights
Before 1980, socioeconomic inequalities in health were a non-issue in public health in the Netherlands
Interest among policy-makers was further strengthened by the "Health For All by the year 2000" targets of the World Health Organization that the Dutch government officially endorsed in 1985 [3]
In 1986, the Ministry of Health published its Health 2000 report which was the first government document to include a paragraph on socioeconomic inequalities in health [4]. This was followed in 1987 by a conference organized by the prestigious Scientific Council for Government Policy
Summary
Before 1980, socioeconomic inequalities in health were a non-issue in public health (research) in the Netherlands. Targets The committee decided to base its strategy on a number of quantitative targets, because these can aid in plotting a clear policy course and can function as milestones for interim assessments of the strategy It took the World Health Organization target as its starting point [15], and reformulated it for the Netherlands as: "By the year 2020, the difference in healthy life expectancy between people with a low and people with a high socioeconomic status should be reduced from 12 to 9 years, due to a (stronger) increase in healthy life expectancy in the lowest socioeconomic groups.". These recommendations were partly based on reported positive results of intervention studies This applies to the recommendations relating to school health promotion programs, technical and organizational measures to reduce physical workload, reinforcement of primary care in disadvantaged areas by employing practice nurses and peer educators, and local care networks to prevent social problems among chronic psychiatric patients. These include the integrated programme to prevent school children from starting smoking, and the local care networks for chronic psychiatric patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
