Social Epidemiology
Embedding poor social conditions in complex public health interventions
Reducing substantial inequalities in health between those in the lowest and highest socioeconomic groups in the Netherlands is a major societal challenge. The fact that socioeconomic health inequalities exist for all major chronic diseases during all periods in life underpins the importance of the conditions in which we are born, live, work, and age for our health. The research line of social epidemiology is committed to (1) deepen the understanding how financial insecurity, harsh family conditions, poor neighbourhood and strenuous working conditions, stress, smoking, poor dietary intake and physical inactivity contribute to health inequalities from preconception to old age, and (2) develop, implement and evaluate prevention strategies targeting these social conditions, and their subsequent impact on onset and progression of major chronic diseases. As with other challenges in public health, such as the rise in obesity, causes of health inequalities are interrelated, we increasingly adopt a complex systems perspective. Because the impact of root causes on the living environment for health cannot be randomized, we advance knowledge by applying causal inference methods to observational studies (‘‘natural experiments’’), thereby including qualitative research methods. We share our knowledge for example in education, such as a new summer course on “Methods to evaluate public health interventions.”
Highlight
Public support for smoke free places
Support for expanding places where smoking is not allowed is strong. This is especially true for places where many children frequent, such as playgrounds and in cars. Worldwide, 86 per cent of people support a ban on smoking in cars with a child. Support for a smoke-free playground and smoke-free schoolyard is 80 and 76 per cent, respectively. These results are based on more than 100 studies on support for expanding smoke-free zone policies, and data of almost 900,000 people from 33 countries. Our meta-analysis, published in eClinical Medicine, paints a picture of broad support for expanding smoke-free policies. For all places surveyed, support was more than 50 per cent, except for private outdoor spaces such as the garden and balcony. Support was higher among non-smokers and ex-smokers than among smokers. Smoke-free spaces not only protect against second-hand smoke, but they also help discourage smoking. The less children see people smoking, the less normal they may believe smoking is. Our results provide both room and need for policymakers to take the next step and protect children from the harmful effects of tobacco smoke.
Climate distress and mental health among youth
Vulnerability to climate change is not equally distributed across the globe. It is linked with social determinants of health, putting marginalised populations disproportionally at risk. Importantly, populations who will be most affected by climate change bear a disproportionate burden of disease for mental health disorders and are least studied. In a paper published in the Lancet Planetary Health, we explore feelings of distress over climate change among Tanzanian youth and assess if distress relates to their mental health. The study is part of a PhD-thesis entitled “Youth mental health in Tanzania – Social determinants, climate change, and the impacts of social protection,” by Leah Prencipe. Almost half (46%) of the Tanzanian youth interviewed, reported any distress about climate change. Distress was higher among female, more educated, more religious, older youth, and those working in extreme temperatures. Depression was higher among youth who had severe water insecurity and among youth who had severe food insecurity. Those reporting climate change distress also had worse mental health. Thus, living in conditions worsened by climate change and feeling distressed over climate change have mental health implications among young people from low-resource settings.

Section: Social Epidemiology














