Author: Annemieke Groenenboom
Complex medication prescriptions or a maze of supplementary forms, for many people in vulnerable positions, this is their daily reality. ‘We do not take enough account of the context in which these people live, and this leads to even greater health disparities,’ says Patricia Heijdenrijk, director of Pharos. During the Preventive Health Conference, she advocates for inclusion and person-centered care.
The problem is significant, according to Heijdenrijk: “Approximately one-third of the Dutch population is in a vulnerable position. These are primarily individuals with practical education, low income, and/or a migration background. They face less favorable living conditions than the rest of the population, including poor housing, physically demanding work, low literacy, and more financial concerns.
This leads to health disparities, with an average of 7 fewer years of life and up to 15 more years with illnesses. Primarily, this is a problem for these individuals themselves, but it also affects society as a whole because healthcare costs are soaring, and it widens the gap between the haves and the have nots.”
A bigger or smaller gap?
“Although we are aware of these differences, we are still developing too many innovations, products, and policy interventions that are ineffective for this group or even further exclude them. This occurs in healthcare itself, where it can be difficult, for instance, for low-literate individuals to navigate a hospital or understand a doctor’s advice. Out of shame, they may not always speak up about this, and their problem remains unresolved,” explains Heijdenrijk.
“Or consider researchers who collect data on this group. What kind of questionnaires and methodologies do they use? Are these also suitable for those with lower language proficiency or non-native speakers? If not, how representative is that data? Especially when governments base their policies on it. Does that policy have any effect on these people, or does it actually widen the gap?”
Inclusion and differentiation
Heijdenrijk advocates for more inclusive and differentiated approaches, in other words, involving the people at the center of the issue more in finding solutions and taking their personal situations into account: “At Pharos, we are working on a ‘quitting smoking’ project in the neighborhood. Instead of providing advice on how to quit smoking, residents turned out to have a greater need for a meeting place in the community and group walks. From there, as a community, they can discuss healthier living and quitting smoking. With a ‘neighborhood mother’ as an ambassador. All experts involved, such as addiction doctors and neighborhood coordinators, must then really hold back. They are so used to coming up with solutions themselves.”
People making a difference
“Small changes in their work often feel like a drop in the bucket for many professionals,” Heijdenrijk continues. “The issues causing health disparities are significant and complex. However, I am convinced that together we can make a difference by critically assessing the impact of our work and delivering more tailored solutions. It requires courage and the ability to step out of your comfort zone.
This is a challenge because we all deal with systems, guidelines, protocols, and their associated separate budgets. For the kind of customization that is needed now, there are no separate funds. But if no one is willing to step outside the established norms, the system won’t budge. It truly is the people who make the difference.”
Preventive Health Conference 2023
Want to hear more from Patricia Heijdenrijk? Join us on the 7th of december for our annual Preventive Heath Conference, with insights from 20+ brilliant speakers, interdisciplinary discussions, invaluable insights, and strategies to promote effective preventive health practices. Join keynote speaker Patricia Heijdenrijk as she delves into the intricate web of health inequalities, shedding light on their enduring presence.