Healthy communities

A person’s physical and social setting and their socioeconomic status have an impact on their health, health behaviour and whether they are able to participate in society.

A healthy living environment is a topical and important subject, not only for individuals, but also for regions, towns, village and communities. It is a key focus for policymakers in the physical and social domains, as reflected, for example, in the Healthy & Active Living Agreement (GALA).

ZonMw is identifying what new knowledge local authorities need, and what is necessary to implement knowledge properly. Collaboration and knowledge exchange are key concepts here. The goal is to ensure that professionals at local authorities have the right tools to promote health in communities.

What effects does the design of the living environment have on health, health behaviour, and participation in society? Local green spaces appear to have a positive impact on health. Professionals from various disciplines involved in practice, policymaking and research are researching how exactly this works.

Local authorities that take an environment-based approach make certain choices about the design of the living environment. They might for example choose to build an attractive cycle path or create a park with lots of greenery. Does a park encourage local residents to exercise more?

• The seven Make Space for Health / Maak ruimte voor gezondheid (available in Dutch) partnerships are working on an environment-based approach in their region.

Local authorities play a key role in improving the health of residents and reducing health inequalities. We provide knowledge to support local authorities in daily practice. Researchers are developing knowledge designed to promote approved interventions, with a focus on learning together.

Prevention requires an integrated approach. Besides healthcare, consideration must also be given to welfare, spatial planning, income, education, participation, environmental policy and community services. It is therefore important that local authorities, municipal health services, Public Health Academic Collaborative Centres and Social Collaborative Centres work together in each region.

• Six local partnerships for disease prevention 'Aan de slag met preventie in uw gemeente' are working on local authority prevention policy (available in Dutch).
• These short films (available in Dutch) show how this is being done.

Local authorities will make increasing use of municipal health services over the coming years, in their efforts to achieve the ambitions set out in the Integrated Care Agreement (IZA) and the Healthy & Active Living Agreement (GALA). A ZonMw incentive scheme has allowed the municipal health services to step up their knowledge and advisory role, enabling them to play an important role for local authorities as a regional link in the knowledge infrastructure for health promotion and disease prevention.

Municipal health services will for example help with the implementation of approved preventive interventions in the local or regional context. These include combined lifestyle interventions, the system approach to overweight children, fall prevention for the elderly, and wellbeing on prescription.

Local authorities are working on various pathways to health promotion and a healthy living environment. But how to ensure that they are implemented successfully? Researchers are developing knowledge to increase the chances of success and devise promising approaches.

They are doing so by consolidating promising approaches and making them more sustainable, both in terms of the policy infrastructure and of practical implementation. Local authorities, knowledge partners, municipal health services and residents’ organisations are working together closely to achieve progress and highlight impact in the local context.

• The 10 Local Authorities Healthy Together / Gemeenten Samen Gezond (available in Dutch) projects focus on implementing promising approaches in local authority health policy.

Many studies have shown that people’s immediate social and physical setting and the services available there have a major impact on health. Factors such as education and income also play a major role.

Many adjustments can be made locally to promote the health of residents. Researchers are focusing on positive health, citizen participation, a broad integrated approach and health topics like diet and exercise.

• Eleven projects in the Living in a healthy community and setting (available in Dutch) are investigating the effectiveness of different approaches.

The most vulnerable groups in society, people with low socioeconomic status (SES), are more likely to have health problems and have a shorter healthy life expectancy. They also often face other problems, which makes it difficult for them to make healthy/healthier choices.

There are major differences in health and healthy life expectancy between different groups in society. These differences actually appear to be growing. The lower someone is on the social ladder, the smaller their chance of living a long and healthy life. We therefore need more knowledge to prevent and reduce these differences, such as knowledge about effective interventions.

To explain, prevent and reduce these health deficits, eleven projects are researching Socioeconomic Health Inequalities (SEGV) (available in Dutch):

• Six projects are working on integrated local approaches to reducing health deficits.
• Five projects hope to find explanations for the mechanisms, dynamics and interactions that play a role in the emergence and persistence of these differences.

De meest kwetsbare groepen in de samenleving, burgers met een lage sociaaleconomische status (SES), hebben vaker gezondheidsproblemen en een minder lange (gezonde) levensverwachting. Ook kampen ze vaak met andere problemen waardoor het lastig is gezonde(re) keuzes te maken.

Tussen groepen in de samenleving bestaan grote verschillen in gezondheid en (gezonde) levensverwachting. De verschillen lijken groter te worden. Hoe lager op de maatschappelijke ladder, hoe kleiner de kans op een lang en gezond leven. Daarom is er behoefte aan meer kennis om die verschillen te voorkomen en te verminderen. Zoals kennis over effectieve interventies.

Om deze gezondheidsachterstanden te verklaren, te voorkomen en te verkleinen doen elf projecten kennis en inzicht op over Sociaaleconomische gezondheidsverschillen (SEGV):

• Zes projecten werken aan integrale lokale aanpakken om gezondheidsachterstanden te verminderen.
• Vijf projecten willen met verklarend onderzoek inzicht geven in de mechanismen, dynamiek en interacties die een rol spelen bij het ontstaan en voortduren van verschillen.