Utrecht Health Profile
A clear picture of the health of Utrechters
Municipality of Utrecht - November 2022
Foreword
A wonderful city where every Utrechter can reside, live and work in health. That's what Utrecht wants to be. To achieve this ambition, the health researchers, professionals, policymakers and I, as alderman for public health, work together every single day. Because we want the health inequalities between Utrechters in 2040 to be 30% smaller than in 2012. The only way we can achieve that is if we do this together.
The figures from the Utrecht Health Profile 2022 provide a clear picture of where we should focus our choices. The Utrecht Health Profile provides an overview of the health of Utrechters once every four years. It is a result of the continuous research effort conducted as part of the Utrecht Public Health Monitor. I am pleased to present this important knowledge to you.
There is still a lot to do. Eight out of ten Utrechters feel good. But we still see major health disparities, for example between districts. If you are born in Overvecht, you will have 15 fewer healthy years in your life than if you are born in Noordoost. The Utrecht Health Profile 2022 shows that health disparities start at an early age. They are closely related to income, education, residence, and employment. This relationship works both ways. That is why it is so important to invest disparately in all these areas of life, so that every Utrechter has equal opportunities. Preferably as early as possible. That's the only way the differences won't widen further. For me personally, this is one of the major motivations for being an alderman in our beautiful city. Because providing equal opportunities for our children starts already during pregnancies, and sometimes even before.
I'm also concerned about the existing health problems. In particular, the mental health of children, young people and young adults has deteriorated. Substance abuse seems to be becoming normal. And we're seeing serious sleep problems. We need to address that.
During the COVID period, perhaps more than ever, we felt that health cannot be taken for granted. What resilience Utrechters showed in those days! "How do Utrechters keep going in these difficult circumstances?" is a question I have asked myself many times. The Utrecht Health Profile 2022 explores what resilience is and how it works.
At the end of 2023, we will share our health approach for the next 4 years in the new public health policy paper. The Utrecht Health Profile also provides unique and indispensable input for this purpose. We are the only municipality that collects and shares health knowledge in this way. This is only possible thanks to the efforts of thousands of people in our city: citizens filling in questionnaires, or sharing their experience in interviews. Healthcare providers who carefully record health data. Researchers and policy officers having conversations with caregivers and other professionals to really understand what the numbers mean. I have tremendous admiration and appreciation for all of you.
The insights from the Utrecht Health Profile are available for use. I warmly invite you, the reader, to join us in working together in a targeted way for healthy Utrechters.
- Eelco Eerenberg, public health alderman
Summary and Reading Guide
With the new information from the Utrecht Health Profile 2022, professionals and policymakers can work together in a targeted way to promote healthy Utrechters. Because the Utrecht Health Profile provides a clear picture of which health problems are urgent, in whom, and how health disparities develop. Causes of health problems extend far beyond the health domain. As a result, reducing health disparities requires a collaborative, interdisciplinary approach. Plus, targeted and disparate investment. This summary briefly discusses the key points and new insights from the Utrecht Health Profile 2022:
- most Utrechters feel healthy
- problems with money, housing and work are strongly related to health disparities
- mental health and lifestyle require extra attention
Chapter 1 visualises the health of Utrechters to start working together in a targeted way.
To chapter 1: Working together for healthy Utrechters
Most Utrechters feel healthy
More than 80% of Utrecht's youth and adults feel healthy. That suits a city with many people in their twenties and thirties and a large percentage of residents with a college or university education. Nearly 20% (46,000) of Utrecht adults feel unhealthy. They have multiple health problems converging.
Chapter 2 shows for the first time patterns in which health problems converge among Utrechters.
To chapter 2: Patterns in health
Many Utrechters also felt healthy during the COVID pandemic period. This period had a great impact on daily life. Resilience was important.
Chapter 3 presents the results of a new exploration of this 'resilience' topic, what this means for Utrechters, and how they remain resilient.
To chapter 3: Resilience explored
Problems with money, work and housing are strongly related to health disparities
The connection between health and making ends meet, work and living has now been extensively researched and clarified in even more detail. Moreover, this connection is particularly urgent now that livelihood security is under pressure due to, among other things, the housing shortage and high inflation.
The greatest health disparity is seen among Utrechters...:
- who have difficulty making ends meet
- who grow up in a low-income family
- With primary education or pre-vocational education
- with a single-person household
- in single-parent families
- who are older than 65 with a non-Western migrant background
- in a very vulnerable situation (multiple serious problems, such as: serious debt, addiction problems, no housing or home)
Health disparities are present at an early age.
Among the first three groups above, the health disparity is actually increasing. This also applies to children in single-parent families. The above-mentioned groups live all over the city. Some groups are overrepresented in the Noordoost, Overvecht, Zuid and Zuidwest districts.
Chapter 4 is about livelihood security: how health is related to financial situation, work and housing.
To chapter 4: Livelihood security
Mental health and lifestyle require extra attention
The new figures on mental health, substance use and sleep show that commitment is needed.
Mental health of children, adolescents and young adults in particular is under particular pressure. For instance, mental health deteriorated in a proportion of children and adolescents between 2019 and 2021. Also, 46% of young people often feel stressed. 25% of young adults have moderate to severe psychological symptoms.
Chapter 5 takes a closer look at mental health of children, adolescents and young adults.
Furthermore, drug use seems to be normalised among young adults: one in three considers using drugs at home normal. 18% of young adults have used hard drugs in the past four weeks. Other substance use also still requires attention. 30% of fourth-grade youth have drunk alcohol in the past four weeks. This was 25% in 2019. Although the share of Utrecht smokers is declining, 18% of Utrecht adults still smoke. This share is higher among Utrechters with only primary education or pre-vocational education.
Finally, the figures on sleep are unfavourable: more and more children sleep poorly and often feel tired. 43% of adults (18 years and older) have sleep problems.
Read more about lifestyle and other health trends in Chapter 1.
To chapter 1: Working together for healthy Utrechters
The Utrecht Health Model forms the basis for the Utrecht Health Profile and the Utrecht Public Health Monitor. This model is a combination of several theoretical models on health and health disparities. It helps to look at health and health opportunities coherently and across domains, and to engage in a conversation about them.
What do we mean by factors affecting and opportunities for health?
Factors that affect health are in the bottom four layers of the Utrecht health model: from top to bottom personal factors, living conditions, socioeconomic position, and socioeconomic and societal context. The bottom two layers create division in society and are called structural determinants. These can create (structural) differences in health opportunities. As an example, national or municipal employment policies (bottom layer) affect the probability of employment and thus the income and/or employment situation (dark blue layer). This affects one's working conditions, social contacts and lifestyle (light blue and green layer) which directly affects their health. Therefore, we talk about factors affecting health and opportunities for health.
Reading guide and table of contents
Chapter 1 is a general chapter describing trends in health and factors affecting health. In addition, the Utrecht Health Profile highlights four topics in separate chapters. They were already mentioned in the introduction. The chapters are:
- Working together for healthy Utrechters
- Patterns in health: how health problems converge
- Resilience explored: insights from science and resident experiences brought together
- Livelihood security: how health is related to financial situation, work and housing
- Mental health of children, adolescents and young adults