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Social Epidemiology

Differences in health between populations and socio-economic groups form the subject matter of our research. Our objective is to describe these differences and to understand what may cause them. We also aim to investigate the (potential) impact of equity-oriented population health policies.

Social determinants of population health 1 Social determinants of population health 2

To reduce inequalities in health
Life expectancy in the Netherlands and many other western countries has increased. However, there are clear differences in the size of this increase between various subgroups of the population. Poor health is still more common in lower socio-economic groups. Reducing these health inequalities is high on the public health agenda in many countries. Equity-oriented policies are being developed at the national and European level, which use our studies as an important basis for priority setting.

Some of our recent contributions

  • The HOPE project - This EU-sponsored project aims to support the development and implementation of obesity prevention policies. As a lead collaborator in this project, we reviewed socio-economic inequalities in physical activity and dietary intake. We also explored which elements of the environment contributed to these inequalities. For inequalities in dietary intake, we found little evidence for a contribution by environmental characteristics. For inequalities in physical activity however, we found that social environmental factors such as area attractiveness and social cohesion did exert an influence (website HOPE project).
  • Studying socioeconomic health inequalities in 22 European countries - Our study found a large variablity in the size of health inequalities for different countries. This implies that there is opportunity to reduce these inequalities, and that this reduction should be an urgent priority in public health policy and research (Mackenbach et al. N Engl J Med  2008;358:2468-81) 

Ongoing projects

  • Causes and consequences of rising life expectancy: Netspar
    We study the causes and consequences of the recent increase in life expectancy in the Netherlands, to provide an empirical underpinning for policy discussions about solidarity between socio-economic groups in the financing of health care utilization and pension schemes.
  • Differences in health behaviour
    Low socioeconomic groups are more likely to make unhealthy food choices than high socioeconomic groups. We investigate to what extent differences in culture ('cultural capital'), social capital and economic capital can explain differences in health-related food choices.
  • Socio-economic inequalities in health
    EURO-GBD-SE is a European funded project, in which we estimate the contribution of a number of specific risk factors to socioeconomic inequalities in mortality in different European countries. Moreover, we aim to assess the potential for reduction in health inequalities in Europe by developing counterfactual scenarios.
  • Small-area health differences in Rotterdam
    We develop a novel (Bayesian) approach to estimating small-area summary measures of population health and use this methodology to decompose neighborhood health inequalities in terms of individual and contextual effects.
  • Physical activity for frail elderly
    We study (1) whether physical activity affects the dynamic frailty process among elderly, (2) whether physical activity can contribute to long-lasting independent living and (3) what the physical and social environmental determinants of ohysical activity among the elderly are.
  • Walking in the neighbourhood among older adults
    In this project we investigate whether social or physical environmental changes in the neighbourhood or a combination of both is (most) effective to promote walking among older adults living in low SES neighbourhoods.

Head of research group: