Working together for healthy Utrechters
Summary
This introductory chapter of the Utrecht Health Profile shows that health disparities remain large and persistent and are present at an early age. The correlation with educational attainment and problems with money, work and housing is strong and complex. These underlying factors of health extend far beyond the health domain. As a result, reducing health disparities requires a collaborative, interdisciplinary approach. Plus, targeted and unequal investment. The current pressure on livelihood security makes this even more urgent.
More than 80% of Utrecht's youth and adults feel healthy. The average life expectancy of Utrechters has increased over the past decade. There are also positive developments for some aspects of Utrechters' lifestyles. For example, children are more likely to eat fruit daily.
Nearly 20% (46.000) of Utrecht adults feel unhealthy. They have multiple health problems converging. 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 exist already at an early age. Among the first three groups and children in single-parent families, the health disparity is growing.
Educational level and problems with money, work and housing are strongly related to health disparity. Utrechters with health disparities live throughout the city. Some groups are overrepresented in the Noordoost, Overvecht, Zuid and Zuidwest districts.
Mental health of children, adolescents and young adults is under pressure. There are also unfavourable rates of substance abuse. Drug use, for example, seems to have normalised among young adults. Differences in obesity by education level, education type and migration background are large. Figures on sleep are unfavourable, as well.
Key trends that may affect health include the city's rapid growth, increasing hard drug trafficking and polarization, an increasing ageing population, concerns about learning loss, current inflation, tightness in the housing market and declining trust in government.
Conclusions and recommendations
A key finding of the Utrecht Health Profile is that health disparities remain large and persistent and are already present at an early age. Persistent health disparities and the complex relationship with educational attainment and problems with money, work and housing also play out at the national level (). The complexity means that, despite efforts from practice and policy, reducing health disparities does not work well. To reduce health disparities, individual and societal factors are important.
A second key outcome is new results on mental health, substance use, obesity and sleep. From a young age, we see stress and mental symptoms, substance abuse, obesity and problems with sleep. These health issues, in line with advice from the WRR, require preventive measures early in the life course, with extra attention to people with low socioeconomic status.
Both to address health disparities and the health topics mentioned above, cooperation between different sectors is essential. Both tasks lend themselves to being addressed through health in all policies. We can achieve health gains not only through a joint effort in prevention, care and support, but also by working together in a targeted way in the areas of income, work and housing. Sometimes for all Utrechters, sometimes by investing unequally for equal opportunities. Preferably as early as possible so that larger differences are avoided.
Finally, it is important to take into account social developments that may put pressure on the health of Utrechters in the future, such as the growth of the city putting pressure on the physical environment. Or the tightness in the housing market. But also, the increasing ageing population and greater tightness in the labour market of welfare and care. Or the great uncertainty surrounding high inflation and rising energy costs. Redesigning the physical environment offers opportunities for health. By paying attention to greenery and exercise, offering healthy food and space for meeting. Increasing population ageing creates urgency for organising the labour market, healthcare and housing market differently. Organising differently is an opportunity for economic development and job creation. Both in turn contribute to health. Joint efforts on these societal developments contribute to the health of Utrechters.