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Wat is de potentiële gezondheidswinst van veranderingen in maatschappelijke determinanten van gezondheid?

Review over de invloed van veranderingen in maatschappelijke determinanten op gezondheid

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Tijdschrift voor gezondheidswetenschappen Aims and scope

Samenvatting

Dit artikel geeft een samenvatting van de huidige, beschikbare kennis in reviews over de gezondheidseffecten van veranderingen in verschillende maatschappelijke determinanten van gezondheid, te weten werksituatie, inkomen, opleidingsniveau, fysieke woonomgeving en sociale veiligheid. We vonden negen reviews. Drie reviews rapporteren dat mensen die gaan werken in een betaalde baan een duidelijke verbetering van hun geestelijk welbevinden ervaren. De effecten op fysieke gezondheidsuitkomsten zijn niet eenduidig. Een inkomensstijging gaat gepaard met een betere algemene ervaren gezondheid en minder depressieve symptomen, maar ook met ongezonder gedrag, bleek uit vier reviews. De enige review over veranderingen in het opleidingsniveau concludeert dat er aanwijzingen zijn dat scholing op een positieve manier de gezondheid beïnvloedt, maar er is nog te weinig onderzoek naar verricht voor een definitieve conclusie. De twee reviews over de gezondheidseffecten van verandering in de woonomgeving betreffen alleen evaluatiestudies uit Groot-Brittannië met bovendien inconsistente resultaten. Wij vonden geen reviews over de mogelijke gezondheidswinst die is te behalen door de verbetering van sociale veiligheid. We concluderen dat er voldoende bewijs is dat het verwerven van een betaalde baan of het verhogen van het inkomen van lagere sociaal-economische groepen gepaard gaat met positieve ontwikkelingen in de gezondheid. Dit ondersteunt de gedachte dat het bevorderen van de werkgelegenheid en verhogen van inkomens aangrijpingspunten vormen voor het bevorderen van de volksgezondheid. Of ook veranderingen in het opleidingsniveau, de fysieke woonomgeving en sociale veiligheid potentieel gezondheidswinst opleveren, kan op basis van het beschikbare onderzoek niet geconcludeerd worden.

Abstract

What are the potential health benefits of changes in social determinants of health? Review the impact of changes in social determinants on health.

This article summarizes the current state of knowledge from reviews on the health effects of changes in various social determinants of health, namely employment status, income, education, the physical living environment and social safety. We identified nine reviews. Three reviews reported that people who start working in a paid job experience a marked improvement in their mental well-being. In contrast, the effects on physical health outcomes were inconclusive. An increase in income is associated with better overall perceived health and fewer depressive symptoms, but a more unhealthy lifestyle, as was shown by 4 reviews. The only review on changes in the level of education concludes that there is some evidence that educational level affects health, though not enough for a final conclusion. The two reviews on the health impact of changes in the environment only concern evaluation studies from the UK and show inconsistent results. We did not find any reviews on the potential health benefits that can be achieved by improving social safety. We conclude that the available evidence on the potential health benefits of improvement in education, the physical living environment, and social safety is limited. There is sufficient evidence that getting a paid job or increasing the income of lower socioeconomic groups improves health. This supports the idea that tackling unemployment and increasing low incomes are starting points to improve public health.

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Authors and Affiliations

  1. Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, 22660, 1100, DD, Amsterdam, The Netherlands

    Mariël Droomers & Karien Stronks

  2. Centrum Gezondheid en Maatschappij, RIVM, Bilthoven, The Netherlands

    Nancy Hoeymans & Antonia Verweij

Authors
  1. Mariël Droomers
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  2. Nancy Hoeymans
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  3. Antonia Verweij
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  4. Karien Stronks
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Corresponding author

Correspondence to Mariël Droomers.

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1 Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam

2 Centrum Gezondheid en Maatschappij, RIVM, Bilthoven

Correspondentieadres

Dr. Mariël Droomers, Afdeling Sociale Geneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Postbus 22660, 1100 DD Amsterdam, tel. 020-5661645, e-mail: m.droomers@amc.uva.nl

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Droomers, M., Hoeymans, N., Verweij, A. et al. Wat is de potentiële gezondheidswinst van veranderingen in maatschappelijke determinanten van gezondheid?. Tijds. gezondheids.wetenschappen 93, 139–146 (2015). https://doi.org/10.1007/s12508-015-0057-z

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  • DOI: https://doi.org/10.1007/s12508-015-0057-z

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