Untangling Socioeconomic Health Inequalities: Reinforcing the Evidence Base for Public Health (doctoral Thesis)

Health inequalities persist as a major challenge to public health. We hypothesized that public health policy may have mis-prioritized the determinants and risks for poor health and, consequently may have been barking up the wrong tree because of unmeasured, biased, and neglected risk factors at population level. This thesis investigated those hypotheses using data from the Dutch Lifelines Cohort and Biobank.
The first part focused on unraveling the complexity of socioeconomic determinants of health and highlights socioeconomic disparities in health status and health outcomes. The second part explored the use of objective measurements of nutritional factors to uncover blind spots to make good quality data on diet available for promotion of public health.
The results indicate that 1) public health policy should give particular attention to individuals with low socioeconomic status because they are at higher risks of practicing unhealthy lifestyle and of chronic and infectious diseases; 2) it is crucial to consider not only individual factors, but also neighborhood conditions in prevention policies, especially when targeting behavioral changes, as we neighborhood conditions independently influence both lifestyle and health; 3) regulatory authorities need to create healthier food environments to make healthy choices easier and discourage unhealthy ones; 4) objective measurements of nutritional factors are powerful for better prioritizing of nutrition targets in public health policy.
Addressing socioeconomic determinants and broader determinants of health in disease prevention and health promotion is needed for the health and prosperity of both individual citizens and society as a whole.