Annemarie Wagemakers: ‘Health inequities caused by social conditions are unfair’

December 6, 2023

How can we support people in a disadvantaged situation to become healthier? That is the central question in the participatory action research of Professor Annemarie Wagemakers. She is specialised in health promotion and in reducing health inequities. On Dec. 7, she will give her inaugural lecture entitled Participatory Community Health Promotion.

One third of the people in the Netherlands intend to eat healthier, Wagemakers asserts. “The main reason for this is to prevent health problems. However, some of these people also indicate that they do not have the money to buy healthy food. We hear this especially from people in disadvantaged neighbourhoods. They don’t always have the resources, skills or social support to live healthy lives.” 

Many causes 

To start reducing health inequities, one should take all the causes for the inequities into account; not only the individual causes, but also those due to the environment in which people live. Along these lines, Wagemakers states, “The causes of good or poor health often lie outside the health sector, for example, income, education, migrant background and health literacy. In research, we take context into account. The goal of our research is to gain insight into what works, for whom, in what context and how, so that we can make changes together with those involved.”  

People in a vulnerable position 

People in vulnerable positions are more likely to suffer from diseases such as obesity, diabetes and infectious diseases. “The recent corona pandemic demonstrated that people who already had a disease were more vulnerable,” Wagemakers says. “People who already had a disease were more seriously ill and their chances of dying were higher compared to other people. Health inequities arise because of the social conditions in which people are born, grow up, live and age. These differences are unfair since they can be avoided” [if one has the means to do so]. 

Changing research practice 

In participatory action research, researchers work directly with the stakeholders rather than at a distance. “With participatory action research, we connect to the needs and desires of the people involved. By working with them, we gather information in and with practice. At the same time, we facilitate changes that contribute to health. This means we continually provide feedback about our findings, reflect together with the actors and make new plans. It is important to document everything well and to be transparent. It is a learning process with all stakeholders involved.” 

Eliminating inequities 

With her research, Wagemakers strives for ‘a just world where everyone has equal opportunities’. “I want to do this together with the people concerned. My call is to invest in health promotion and address inequities. I am convinced that working with people on their health can help to empower themselves and improve their health and well-being.” 

Intersectoral collaboration 

Wagemakers is pleased that there is a broad focus on health promotion and equal opportunities. “Partly because of corona, health and prevention are receiving extra attention. That is great and I remain optimistic, but it must be supported by policy. People must have the opportunities to exercise sufficiently and live healthy lives. I see more and more different sectors working together to get this done, such as the health and welfare sector. They are working with each other and with the people who are affected. Practice shows that people who are actively involved achieve more health gains.”