Health and policy
Introduction – 1 public policy and PH: what is it and how does it work?
Important concepts in this course (1)
• Public policy: refers to laws, regulatory measures, courses of action, and funding
priorities concerning a given topic by a governmental entity or its representatives
• Health policy: refers to decisions, plans and actions that are undertaken to
achieve specific health care goals within a society (WHO)
• Public health (RIVM, the Dutch PH act): PH refers to health protection + health
promotion of the population as a whole/specific groups, including prevention and
early detection of diseases.
• Public health (WHO): the science and art of preventing disease, prolonging life
and promoting mental and physical health and efficiency through organized
community efforts. Public health may be considered as the structures and
processes by which the health of populations is understood, safeguarded and
promoted through the organized efforts of society.
Life expectancy
• Life expectancy: important indicator for population health.
It reflects the overall mortality level of a population: it summarizes the mortality
pattern that prevails across all age groups in a given year – children and
adolescents, adults and the elderly.
Life expectancy at birth: what can be expected from birth.
Females have a higher life expectancy, and there are big differences between
countries and places.
• Global life expectancy in 2016 was 72.0 years (74.2 years for females and 69.8
years for males).
• Ranging from 61.2 years in the WHO African Region to 77.5 years in the WHO
European Region.
Life expectancy across the world
Can be determined, public infrastructure/money of the country/access to healthcare/
culture/does it has basic healthcare/ infant mortality/ war
,Life expectancy across Europe
Life expectancy: the gender gap
Life expectancy in relation to education
• Males with the lowest education in the Netherlands live on average 7 years
shorter than those with the highest education
• This difference more than doubles (17 years) when looking at number of years
living in good health
What influences our health?
• What determines our health: two basic models
• The Health field concept model by Lalonde (1976)
• The socio-ecological framework by Hahlgren en Whitehead (1991)
,Basic health field: field concept by Lalonde (1974)
Policy and health: a socio-ecological framework
An individual is influences through all kind of things and social network they have.
How well does the government take care of the people, like with social security, care/
access of healthcare and food
Social determinants in health
Your health can be linked to where you life, your income and your education. It is
important to look at factors that look outside the healthcare system, to look how we can
improve health. These non-medical factors are called the social determinants of health.
We mostly think that your health is influenced by our age, gender and genetic factors.
Most people realize your health is also affected by lifestyle factors (exercise, food and
unhealthy habits). But these are only small factors that influences our health, other
, factors like social safety net, early life, education, housing, social exclusion, income,
employment, working conditions, disability.
How do these factors influence our health? Like for example look at food choices,
different factors influence what we decide to eat. Like how much money we can spend
on food, this can be influenced by income and income can be influenced by
unemployment, education and disability. And for example eating habits are influenced
by our family in our early life and friends later on, these habits are maybe difficult to
break.
And for example, unemployment or working conditions create unstable life and can
increase stress. Stress has negative effects on health.
A major factors that influences unemployment and income is education. More
education generally leads to better jobs and more income. And both have a positive
impact on our health.
Even if you are employment some work conditions (like lack of flexibility or control of
your workday or a short contract) can still cause stress. Job stability is important.
You are affect by not only one factor when we look at our health.
There is a relationship between these social factors and getting a disease.
What type of investment would improve our health the most
Look at why people are in the hospital? And why do they have this disease? But why did
that happen? And which social factors influence this?
Always ask but why?
Shift on focus from interventions and treatment to prevention and the state of our
society.
The social determinants of health are based on the social and environmental conditions
individuals live.
Health inequalities means that individuals have poor health and die younger based on
the circumstances they are in, where they live, what they do.
Introduction – 1 public policy and PH: what is it and how does it work?
Important concepts in this course (1)
• Public policy: refers to laws, regulatory measures, courses of action, and funding
priorities concerning a given topic by a governmental entity or its representatives
• Health policy: refers to decisions, plans and actions that are undertaken to
achieve specific health care goals within a society (WHO)
• Public health (RIVM, the Dutch PH act): PH refers to health protection + health
promotion of the population as a whole/specific groups, including prevention and
early detection of diseases.
• Public health (WHO): the science and art of preventing disease, prolonging life
and promoting mental and physical health and efficiency through organized
community efforts. Public health may be considered as the structures and
processes by which the health of populations is understood, safeguarded and
promoted through the organized efforts of society.
Life expectancy
• Life expectancy: important indicator for population health.
It reflects the overall mortality level of a population: it summarizes the mortality
pattern that prevails across all age groups in a given year – children and
adolescents, adults and the elderly.
Life expectancy at birth: what can be expected from birth.
Females have a higher life expectancy, and there are big differences between
countries and places.
• Global life expectancy in 2016 was 72.0 years (74.2 years for females and 69.8
years for males).
• Ranging from 61.2 years in the WHO African Region to 77.5 years in the WHO
European Region.
Life expectancy across the world
Can be determined, public infrastructure/money of the country/access to healthcare/
culture/does it has basic healthcare/ infant mortality/ war
,Life expectancy across Europe
Life expectancy: the gender gap
Life expectancy in relation to education
• Males with the lowest education in the Netherlands live on average 7 years
shorter than those with the highest education
• This difference more than doubles (17 years) when looking at number of years
living in good health
What influences our health?
• What determines our health: two basic models
• The Health field concept model by Lalonde (1976)
• The socio-ecological framework by Hahlgren en Whitehead (1991)
,Basic health field: field concept by Lalonde (1974)
Policy and health: a socio-ecological framework
An individual is influences through all kind of things and social network they have.
How well does the government take care of the people, like with social security, care/
access of healthcare and food
Social determinants in health
Your health can be linked to where you life, your income and your education. It is
important to look at factors that look outside the healthcare system, to look how we can
improve health. These non-medical factors are called the social determinants of health.
We mostly think that your health is influenced by our age, gender and genetic factors.
Most people realize your health is also affected by lifestyle factors (exercise, food and
unhealthy habits). But these are only small factors that influences our health, other
, factors like social safety net, early life, education, housing, social exclusion, income,
employment, working conditions, disability.
How do these factors influence our health? Like for example look at food choices,
different factors influence what we decide to eat. Like how much money we can spend
on food, this can be influenced by income and income can be influenced by
unemployment, education and disability. And for example eating habits are influenced
by our family in our early life and friends later on, these habits are maybe difficult to
break.
And for example, unemployment or working conditions create unstable life and can
increase stress. Stress has negative effects on health.
A major factors that influences unemployment and income is education. More
education generally leads to better jobs and more income. And both have a positive
impact on our health.
Even if you are employment some work conditions (like lack of flexibility or control of
your workday or a short contract) can still cause stress. Job stability is important.
You are affect by not only one factor when we look at our health.
There is a relationship between these social factors and getting a disease.
What type of investment would improve our health the most
Look at why people are in the hospital? And why do they have this disease? But why did
that happen? And which social factors influence this?
Always ask but why?
Shift on focus from interventions and treatment to prevention and the state of our
society.
The social determinants of health are based on the social and environmental conditions
individuals live.
Health inequalities means that individuals have poor health and die younger based on
the circumstances they are in, where they live, what they do.
