Background People with diabetes live shorter lives on average than people without diabetes. This ... more Background People with diabetes live shorter lives on average than people without diabetes. This is not only because they have diabetes, but also more often other chronic diseases. This causes a greater risk of death. It makes a difference what kind of diabetes someone has. In type 1 diabetes, the natural immune system does not work properly. In type 2, an unhealthy lifestyle plays a role. An unhealthy lifestyle increases the chance that someone will get type 2 diabetes and the chance that that person will die of another disease, such as cardiovascular disease. Methods RIVM has linked general practitioners’ data from 2012-2019 to the vital statistics of the Dutch National Statistical Office. The population of people registered with and without diabetes were coupled with the mortality data. Making use of life tables, associated life expectancies were calculated. For people under the age of 45, no robust analysis could be made. Results People aged 45 with type 1 diabetes live on avera...
All future trends carry uncertainty in them. For example, the COVID-19 pandemic showed great un... more All future trends carry uncertainty in them. For example, the COVID-19 pandemic showed great uncertainty about current and future health impacts and how the virus may directly impact our health. Foresight (as a systematic, participatory, future-intelligence-gathering and medium-to-long term vision-building process aimed at enabling present-day decisions and mobilising joint actions) explicitly addresses uncertainty. Doing a foresight study one has to deal with different sources of uncertainty. Next to commonly known statistical uncertainty, foresight studies have to deal with cognitive uncertainty, i.e. uncertainty related to the limited knowledge that we have regarding the complexity of the underlying system or limited knowledge of what future economic growth will be. A better understanding of the location, level, and nature of the cognitive uncertainties helps assess the robustness of future scenarios. In addition to cognitive uncertainty, normative uncertainty are distinguished...
were associated with incident LBP. The associations between workload factors and LBP were not med... more were associated with incident LBP. The associations between workload factors and LBP were not mediated by lifestyle or health-related behaviors. The associations for recurrent or persistent LBP were similar but weaker than those for incident LBP. Conclusions: The findings suggest that physical workload and health-related factors have stronger effects on the development of LBP than on the progression of LBP. Moreover, health behaviors did not mediate the associations for workload. Key messages: Our findings suggest that physical work exposures as well as health-related risk factors are independently associated with incident and recurrent low back pain. Lifestyle and health-related behaviors did not mediate the associations between workload factors and low back pain.
In 1992, governments worldwide agreed to work towards a more sustainable development that would e... more In 1992, governments worldwide agreed to work towards a more sustainable development that would eradicate poverty, halt climate change and conserve ecosystems. Although progress has been made in some areas, actions have not been able to bend the trend in other, critical areas of sustainable development – areas such as those providing access to sufficient food and modern forms of energy, preventing dangerous climate change, conserving biodiversity and controlling air pollution. Without additional effort, these sustainability objectives also will not be achieved by 2050. This report analyses how combinations of technological measures and changes in consumption patterns could contribute to achieving a set of sustainability objectives, taking into account the interlinkages between them. The potential exists for achieving all of the objectives. The fundamental question here relates to the type of governance structures that could bring about the transformative changes required to meet the sustainable development objectives. We suggest a pragmatic governance approach that consists of a shared vision for 2050, strengthened short-term targets, and strong policy actions by governments, building on the strength of civil society and business.
ABSTRACT The Millennium Development Goals aim to halve the number of people without access to saf... more ABSTRACT The Millennium Development Goals aim to halve the number of people without access to safe drinking water and sanitation by 2015, but cost-effective approaches are needed if these aims are to be met. Annette Bos, Huub Gijzen, Henk Hilderink, Moustafa Moussa, Erik de Ruyter and Louis Niessen report on work to identify a way forward.
BACKGROUND One quarter of the global disease burden could be avoided with management strategies f... more BACKGROUND One quarter of the global disease burden could be avoided with management strategies for environmental risk factors such as air and water pollution, food contamination, injuries and poor road safety. Many decisions influencing health are made outside the health sector; thus, the joint consideration and implementation of health and environmental factors in the relevant policies are becoming increasingly important. MATERIALS AND METHODS By means of a selective literature search, we identified important policy documents and selected research articles as a basis for the introduction and current discussion of the Health in All Policies (HiAP) approach. Parallels with the Environment in All Policies (EIAP) approach are debated. RESULTS AND CONCLUSIONS The consideration and reinforcement of environmental topics in HiAP and the link with health in the EiAP approach increase the chances of policies with mutually positive effects, especially with regard to the significance of social factors for health and the environment. The UN Sustainable Development Goals provide a good starting point for a joint strategy for reinforcing health and environmental aspects. Health and Environmental Impact Assessments are accepted procedures in many countries. The HiAP strategy implemented in South Australia provides a well-documented institutional approach to the integration and linkage of health and environmental issues. These examples can be used as well-established starting points for a definition of HiAP incorporating the equitable involvement of environmental issues. Barriers to this goal relate, for example, to the particular interests of the various participating sectors.
Course material was prepared by Hanna Tolonen (THL) Material can be edited and used for non-comme... more Course material was prepared by Hanna Tolonen (THL) Material can be edited and used for non-commercial purposes under Creative Commons license 4.0 (CC by-nc-sa) Disclaimer: The views expressed here are those of the authors and they do not represent the Commission's official position.
International Journal of Environmental Research and Public Health, 2022
Background: In many Western countries, the state pension age is being raised to stimulate the ext... more Background: In many Western countries, the state pension age is being raised to stimulate the extension of working lives. It is not yet well understood whether the health of older adults supports this increase. In this study, future health of Dutch adults aged 60 to 68 (i.e., the expected state pension age) is explored up to 2040. Methods: Data are from the Dutch Health Interview Survey 1990–2017 (N ≈ 10,000 yearly) and the Dutch Public Health Monitor 2016 (N = 205,151). Health is operationalized using combined scores of self-reported health and limitations in mobility, hearing or seeing. Categories are: good, moderate and poor health. Based on historical health trends, two scenarios are explored: a stable health trend (neither improving nor declining) and an improving health trend. Results: In 2040, the health distribution among men aged 60–68 is estimated to be 63–71% in good, 17–28% in moderate and 9–12% in poor health. Among women, this is estimated to be 64–69%, 17–24% and 12–1...
A growing number of informal caregivers of older adults combine caregiving with a paid job, raisi... more A growing number of informal caregivers of older adults combine caregiving with a paid job, raising the question of whether they will be able to meet the increasing demand for informal care. The aims of our study are twofold: first, to describe the development of a model providing insight into the factors that play a role in the availability and provision of informal care by working caregivers of older adults, and second, to investigate which societal developments will impact the factors in the model, and thus the future availability of informal care by workers. A mixed-methods approach was applied to integrate evidence from academic and grey literature, with insights from experts through a Group Model Building exercise and a Delphi study. The resulting Working Informal Caregiver (WIC) model presents a range of individual, social and environmental factors that are related to working caregivers’ ability and their willingness to engage in informal care. Experts foresee that future inf...
Supplemental material, sj-xlsx-1-sjp-10.1177_14034948211024478 for The increasing significance of... more Supplemental material, sj-xlsx-1-sjp-10.1177_14034948211024478 for The increasing significance of disease severity in a burden of disease framework by Grant M.A. Wyper, Ricardo Assuncao, Eilidh Fletcher, Michelle Gourley, Ian Grant, Juanita A. Haagsma, Henk Hilderink, Jane Idavain, Tina Lesnik, Elena Von Der Lippe, Marek Majdan, Gerry Mccartney, Milena Santric-Milicevic, Elena Pallari, Sara M. Pires, Dietrich Plass, Michael Porst, João V. Santos, Maria Teresa De Haro Moro, Diane L. Stockton and Brecht Devleesschauwer in Scandinavian Journal of Public Health
Although cities can be characterised as sources of economic, environmental and social challenges,... more Although cities can be characterised as sources of economic, environmental and social challenges, they can also be part of the solution for healthy and sustainable societies. While most cities are situated close to water, whether inland waterways, lakes, or the sea, these blue spaces are not integrated into urban planning to their full potential and their public health impacts are not always recognised by planning authorities. Furthermore, cities face future challenges regarding climate change, economic developments like tourism, urbanisation, and rising social inequalities. The development of healthy blue spaces can support cities in their pursuit of ways to confront these challenges. Interdisciplinary and transdisciplinary analyses of the local impacts of these trends and promising interventions have been scarce to date. The BlueHealth project has explored the use of such methodology by presenting experiences related to five European cities: Amsterdam, Barcelona, Plymouth, Tallinn...
Additional file 2. It describes the experience of countries performing their own burden of diseas... more Additional file 2. It describes the experience of countries performing their own burden of disease study as a case study report.
Additional file 3. It describes the study results comparing the country health profiles and natio... more Additional file 3. It describes the study results comparing the country health profiles and national health statistics and inputs from different countries.
Additional file 1. It describes the summary of survey results and the format of questionnaire use... more Additional file 1. It describes the summary of survey results and the format of questionnaire used to identify the need of European countries for BoD studies.
Background Aims:: Human health effects from exposure to outdoor air pollution, particularly groun... more Background Aims:: Human health effects from exposure to outdoor air pollution, particularly ground level ozone and airborne particulate matter (PM), cause globally, 8% of lung cancer deaths, 5% of ...
Knowledge translation (KT) is an important concept to bridge the gap in health information betw... more Knowledge translation (KT) is an important concept to bridge the gap in health information between research and policy making. Also in Burden of Disease (BoD), with the Disability-adjusted Life Years (DALYs) as its main indicator, this gap exists. KT provides the theory and tools to better link researchers and policy makers to support evidence-informed policy making. The European Burden of Disease Network (COST Action CA18218), serves as technical platform for integrating and strengthening capacity in BoD assessment across Europe and beyond. The network promotes an interdisciplinary approach that integrates KT in the classical BoD framework. One of the work packages working groups focusses on the application of existing KT theory to BoD assessments. Several European countries are undertaking their own National Burden of Disease (NBoD) study, some of them already for many years. They have built up a substantial amount of knowledge on the practical side of KT in relation to BoD asse...
Background People with diabetes live shorter lives on average than people without diabetes. This ... more Background People with diabetes live shorter lives on average than people without diabetes. This is not only because they have diabetes, but also more often other chronic diseases. This causes a greater risk of death. It makes a difference what kind of diabetes someone has. In type 1 diabetes, the natural immune system does not work properly. In type 2, an unhealthy lifestyle plays a role. An unhealthy lifestyle increases the chance that someone will get type 2 diabetes and the chance that that person will die of another disease, such as cardiovascular disease. Methods RIVM has linked general practitioners’ data from 2012-2019 to the vital statistics of the Dutch National Statistical Office. The population of people registered with and without diabetes were coupled with the mortality data. Making use of life tables, associated life expectancies were calculated. For people under the age of 45, no robust analysis could be made. Results People aged 45 with type 1 diabetes live on avera...
All future trends carry uncertainty in them. For example, the COVID-19 pandemic showed great un... more All future trends carry uncertainty in them. For example, the COVID-19 pandemic showed great uncertainty about current and future health impacts and how the virus may directly impact our health. Foresight (as a systematic, participatory, future-intelligence-gathering and medium-to-long term vision-building process aimed at enabling present-day decisions and mobilising joint actions) explicitly addresses uncertainty. Doing a foresight study one has to deal with different sources of uncertainty. Next to commonly known statistical uncertainty, foresight studies have to deal with cognitive uncertainty, i.e. uncertainty related to the limited knowledge that we have regarding the complexity of the underlying system or limited knowledge of what future economic growth will be. A better understanding of the location, level, and nature of the cognitive uncertainties helps assess the robustness of future scenarios. In addition to cognitive uncertainty, normative uncertainty are distinguished...
were associated with incident LBP. The associations between workload factors and LBP were not med... more were associated with incident LBP. The associations between workload factors and LBP were not mediated by lifestyle or health-related behaviors. The associations for recurrent or persistent LBP were similar but weaker than those for incident LBP. Conclusions: The findings suggest that physical workload and health-related factors have stronger effects on the development of LBP than on the progression of LBP. Moreover, health behaviors did not mediate the associations for workload. Key messages: Our findings suggest that physical work exposures as well as health-related risk factors are independently associated with incident and recurrent low back pain. Lifestyle and health-related behaviors did not mediate the associations between workload factors and low back pain.
In 1992, governments worldwide agreed to work towards a more sustainable development that would e... more In 1992, governments worldwide agreed to work towards a more sustainable development that would eradicate poverty, halt climate change and conserve ecosystems. Although progress has been made in some areas, actions have not been able to bend the trend in other, critical areas of sustainable development – areas such as those providing access to sufficient food and modern forms of energy, preventing dangerous climate change, conserving biodiversity and controlling air pollution. Without additional effort, these sustainability objectives also will not be achieved by 2050. This report analyses how combinations of technological measures and changes in consumption patterns could contribute to achieving a set of sustainability objectives, taking into account the interlinkages between them. The potential exists for achieving all of the objectives. The fundamental question here relates to the type of governance structures that could bring about the transformative changes required to meet the sustainable development objectives. We suggest a pragmatic governance approach that consists of a shared vision for 2050, strengthened short-term targets, and strong policy actions by governments, building on the strength of civil society and business.
ABSTRACT The Millennium Development Goals aim to halve the number of people without access to saf... more ABSTRACT The Millennium Development Goals aim to halve the number of people without access to safe drinking water and sanitation by 2015, but cost-effective approaches are needed if these aims are to be met. Annette Bos, Huub Gijzen, Henk Hilderink, Moustafa Moussa, Erik de Ruyter and Louis Niessen report on work to identify a way forward.
BACKGROUND One quarter of the global disease burden could be avoided with management strategies f... more BACKGROUND One quarter of the global disease burden could be avoided with management strategies for environmental risk factors such as air and water pollution, food contamination, injuries and poor road safety. Many decisions influencing health are made outside the health sector; thus, the joint consideration and implementation of health and environmental factors in the relevant policies are becoming increasingly important. MATERIALS AND METHODS By means of a selective literature search, we identified important policy documents and selected research articles as a basis for the introduction and current discussion of the Health in All Policies (HiAP) approach. Parallels with the Environment in All Policies (EIAP) approach are debated. RESULTS AND CONCLUSIONS The consideration and reinforcement of environmental topics in HiAP and the link with health in the EiAP approach increase the chances of policies with mutually positive effects, especially with regard to the significance of social factors for health and the environment. The UN Sustainable Development Goals provide a good starting point for a joint strategy for reinforcing health and environmental aspects. Health and Environmental Impact Assessments are accepted procedures in many countries. The HiAP strategy implemented in South Australia provides a well-documented institutional approach to the integration and linkage of health and environmental issues. These examples can be used as well-established starting points for a definition of HiAP incorporating the equitable involvement of environmental issues. Barriers to this goal relate, for example, to the particular interests of the various participating sectors.
Course material was prepared by Hanna Tolonen (THL) Material can be edited and used for non-comme... more Course material was prepared by Hanna Tolonen (THL) Material can be edited and used for non-commercial purposes under Creative Commons license 4.0 (CC by-nc-sa) Disclaimer: The views expressed here are those of the authors and they do not represent the Commission's official position.
International Journal of Environmental Research and Public Health, 2022
Background: In many Western countries, the state pension age is being raised to stimulate the ext... more Background: In many Western countries, the state pension age is being raised to stimulate the extension of working lives. It is not yet well understood whether the health of older adults supports this increase. In this study, future health of Dutch adults aged 60 to 68 (i.e., the expected state pension age) is explored up to 2040. Methods: Data are from the Dutch Health Interview Survey 1990–2017 (N ≈ 10,000 yearly) and the Dutch Public Health Monitor 2016 (N = 205,151). Health is operationalized using combined scores of self-reported health and limitations in mobility, hearing or seeing. Categories are: good, moderate and poor health. Based on historical health trends, two scenarios are explored: a stable health trend (neither improving nor declining) and an improving health trend. Results: In 2040, the health distribution among men aged 60–68 is estimated to be 63–71% in good, 17–28% in moderate and 9–12% in poor health. Among women, this is estimated to be 64–69%, 17–24% and 12–1...
A growing number of informal caregivers of older adults combine caregiving with a paid job, raisi... more A growing number of informal caregivers of older adults combine caregiving with a paid job, raising the question of whether they will be able to meet the increasing demand for informal care. The aims of our study are twofold: first, to describe the development of a model providing insight into the factors that play a role in the availability and provision of informal care by working caregivers of older adults, and second, to investigate which societal developments will impact the factors in the model, and thus the future availability of informal care by workers. A mixed-methods approach was applied to integrate evidence from academic and grey literature, with insights from experts through a Group Model Building exercise and a Delphi study. The resulting Working Informal Caregiver (WIC) model presents a range of individual, social and environmental factors that are related to working caregivers’ ability and their willingness to engage in informal care. Experts foresee that future inf...
Supplemental material, sj-xlsx-1-sjp-10.1177_14034948211024478 for The increasing significance of... more Supplemental material, sj-xlsx-1-sjp-10.1177_14034948211024478 for The increasing significance of disease severity in a burden of disease framework by Grant M.A. Wyper, Ricardo Assuncao, Eilidh Fletcher, Michelle Gourley, Ian Grant, Juanita A. Haagsma, Henk Hilderink, Jane Idavain, Tina Lesnik, Elena Von Der Lippe, Marek Majdan, Gerry Mccartney, Milena Santric-Milicevic, Elena Pallari, Sara M. Pires, Dietrich Plass, Michael Porst, João V. Santos, Maria Teresa De Haro Moro, Diane L. Stockton and Brecht Devleesschauwer in Scandinavian Journal of Public Health
Although cities can be characterised as sources of economic, environmental and social challenges,... more Although cities can be characterised as sources of economic, environmental and social challenges, they can also be part of the solution for healthy and sustainable societies. While most cities are situated close to water, whether inland waterways, lakes, or the sea, these blue spaces are not integrated into urban planning to their full potential and their public health impacts are not always recognised by planning authorities. Furthermore, cities face future challenges regarding climate change, economic developments like tourism, urbanisation, and rising social inequalities. The development of healthy blue spaces can support cities in their pursuit of ways to confront these challenges. Interdisciplinary and transdisciplinary analyses of the local impacts of these trends and promising interventions have been scarce to date. The BlueHealth project has explored the use of such methodology by presenting experiences related to five European cities: Amsterdam, Barcelona, Plymouth, Tallinn...
Additional file 2. It describes the experience of countries performing their own burden of diseas... more Additional file 2. It describes the experience of countries performing their own burden of disease study as a case study report.
Additional file 3. It describes the study results comparing the country health profiles and natio... more Additional file 3. It describes the study results comparing the country health profiles and national health statistics and inputs from different countries.
Additional file 1. It describes the summary of survey results and the format of questionnaire use... more Additional file 1. It describes the summary of survey results and the format of questionnaire used to identify the need of European countries for BoD studies.
Background Aims:: Human health effects from exposure to outdoor air pollution, particularly groun... more Background Aims:: Human health effects from exposure to outdoor air pollution, particularly ground level ozone and airborne particulate matter (PM), cause globally, 8% of lung cancer deaths, 5% of ...
Knowledge translation (KT) is an important concept to bridge the gap in health information betw... more Knowledge translation (KT) is an important concept to bridge the gap in health information between research and policy making. Also in Burden of Disease (BoD), with the Disability-adjusted Life Years (DALYs) as its main indicator, this gap exists. KT provides the theory and tools to better link researchers and policy makers to support evidence-informed policy making. The European Burden of Disease Network (COST Action CA18218), serves as technical platform for integrating and strengthening capacity in BoD assessment across Europe and beyond. The network promotes an interdisciplinary approach that integrates KT in the classical BoD framework. One of the work packages working groups focusses on the application of existing KT theory to BoD assessments. Several European countries are undertaking their own National Burden of Disease (NBoD) study, some of them already for many years. They have built up a substantial amount of knowledge on the practical side of KT in relation to BoD asse...
India is playing an increasingly important role in the global economy and, correspondingly, in re... more India is playing an increasingly important role in the global economy and, correspondingly, in resource use and emissions. Yet, the modelling tools for exploring the opportunities and threats for India, and for other parts of the world as a consequence of this development, suffer from conceptual limitations. This report explores options for improvement, especially given the large heterogeneity of India that is difficult to capture in aggregate average data. Model-based simulations indicate that India's population by 2050 will be over 1.5 billion, displaying a large population momentum that is one of the drivers of economic growth.
Forward calculations with the demographic model, PHOENIX, and the IFs Economy model show that such developments of population and income are possible, provided that sufficient and timely investments in health care and education take place. Additional model simulations, including those using the TIMER energy model, indicate that ecological and socio-economic constraints might bar these positive developments. Only rigorous government policy initiatives striving for sustainable management of India's resources (land, water, energy) and appropriate investments in education and health can lead to a real increase in well-being for a large part of the population.
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Papers by Henk Hilderink
Forward calculations with the demographic model, PHOENIX, and the IFs Economy model show that such developments of population and income are possible, provided that sufficient and timely investments in health care and education take place. Additional model simulations, including those using the TIMER energy model, indicate that ecological and socio-economic constraints might bar these positive developments. Only rigorous government policy initiatives striving for sustainable management of India's resources (land, water, energy) and appropriate investments in education and health can lead to a real increase in well-being for a large part of the population.