HEALTH AND SOCIETY

Bridging the health gap

Tackling health inequalities together

Department of Social Sciences

It’s a harsh reality: people on low incomes and with a low education level are more likely to be ill, receive poorer care when they are ill, and have considerably fewer healthy years of life than people who have more money and a better education. To reduce the health gap, researchers at Wageningen University & Research conduct their research in collaboration with people in their daily environment, because they know that’s the only way to achieve sustainable change and improve their health.

This research contributes to Sustainable Develop­ment Goal 3: Good health and well-being.

The fact that health inequality is a reality in countries where people, on average, have a low income will come as no surprise to anyone. But the situation also applies to rich countries, for example for people living in disadvantaged neighbourhoods and people with a migrant background.

How can this so-called health gap be closed in a sustainable way? That’s the key question for the researchers of the Wageningen University Health and Society (HSO) group. “Our aim is to support people, communities and institutions in gaining control and ownership of the factors that influence their health,” says Laura Bouwman, researcher at HSO.

We start exploring the possibilities, impossibilities and the strength of people themselves in their own living situations

The researchers at HSO do not conduct research on people, but do their research in collaboration with people in their daily environment, such as their neighbourhoods, schools, sports fields and care farms. “Our approach of participatory research is based on the solutions and possibilities of the people themselves. In Rwanda, for example, we work with expectant and young mothers in districts where the growth of children is lagging behind. By listening to their stories, we discover how they shape their lives and what challenges they face. How is breastfeeding and supplementary feeding going? How are things in the family? Is it possible to grow food? What about access to care? Are there facilities nearby or does a highly pregnant woman or a mother with a small baby have to walk tens of kilometres to get to a health centre?”

HSO’s researchers conduct research

in collaboration with

people, rather than on people

Participatory research

is based on the solutions and possibilities of the people themselves

This helps people

feel proud and co-responsible,

helping them to sustain changes

Sustainable connections

These are lengthy processes in which the researchers really bond with the families they visit often. “So we don’t come flying in with a plan that was developed at our desks beforehand,” says Bouwman. “On the contrary! We start exploring the possibilities, impossibilities and the strength of people themselves in their own living situations. We use their stories to distil the preconditions for taking good care of your child in difficult circumstances — because there are also children who grow well. What choices and solutions contribute to this? We’re going to look at how we can further expand and disseminate these best practices, for example through women’s groups, so that others benefit from them as well. And we will also involve other actors who have a role to play in this, such as care providers at health centres.”

Laura Bouwman describes HSO’s approach in working together with people to reduce inequality. “We want people to be proud and to feel co-responsible because the solutions suit their living environment and situation.” Sustainable impact is the key concept: “We want to help build sustainable relationships, not only between people, but also between people and nature, for example, so that there is commitment and to make sure the structures remain in place, even after the project is finished and we have left.”

Improving perceived health

Closing the health gap is a long-term matter. It is of the utmost importance to know which approach really works. The researchers from HSO have evaluated the FNO’s “Gezonde Toekomst Dichterbij” programme that aims to increase the chances of families in disadvantageous situations in the Netherlands. Laura Bouwman: “Gezonde Toekomst Dichterbij focuses on improving perceived health: eating healthier, exercising, stopping smoking and drinking less alcohol. Using a so-called realistic evaluation, we analyse what works for whom, in which situation. This way we discover what really works in reducing health inequalities. Essential are, for example, a respectful attitude of professionals, such as welfare workers, towards families and taking the underlying problems of poverty seriously.”

About FNO

FNO is a non-for profit organisation that works on asset funds for health, quality of life and future prospects for those with a vulnerable health. FNO unites different parties, collects and shares information and knowledge, and funds projects to achieve this.

Do you have a question about this topic? Ask our expert:

Laura Bouwman

Assistant Professor Health and Society