Tranzo Pearl | Citizen participation in public health policy
We have been dealing with health disparities in the Netherlands for years. We call this the health gap. On average, in vulnerable neighborhoods people live shorter than in other neighborhoods in the Netherlands. They also live longer in poorer health and children grow up unhealthier. Bridging this health gap is a challenge. By involving and activating citizens themselves in local health policy and activities to promote a healthier neighborhood or lifestyle or living environment, the large health differences between groups with a higher and lower socio-economic position could be bridged. Researcher Esther de Weger of the Academic Collaborative Center Public Health Brabant has investigated whether and how citizens can be better involved in health policy.
This study found that citizens do want to be involved in (health) policy making. In doing so, they mentioned issues that they consider important to improve the quality of life and living environment of their community, such as adequate housing, public transportation, and neighborhood health and care services. In contrast, professionals' priorities focused on single public health issues, such as prevention and addressing lifestyle factors.
What is needed?
The results showed, among other things, that citizens felt responsible for driving citizen participation and representing the community's needs to the municipality, but that there is a need for the municipality to improve communication and accessibility in order to do so successfully. In addition, professionals on the panel expressed a need for training on how to reach out to citizens. Such training should clarify how they can better tailor their language to citizens' perceptions. They also wanted their organizations to provide more space, flexibility, and resources to build relationships with citizens to improve communication and accessibility for citizens.
An approach in which citizens are directly involved, willing, and able to take charge themselves is of great importance for bridging the health gap. If we succeed in involving citizens in this way in all interventions (throughout the Netherlands), then an intervention will be more likely to succeed and thus have a greater impact. The findings from Esther de Weger's PhD research show that in order to improve the participation environment, it is necessary to invest in improving organizational cultures, structures, and processes. This is to ensure that these:
address skewed power relations between residents and professionals;
better match the different ways different residents want to be involved;
are more accessible to a wider range of residents and communities.
Without investment, resident participation will remain a "positive addition to the health and welfare system," rather than being seen as crucial to implementing a person-centered and accessible system.
Esther de Weger received her PhD October 19, 2022, with her thesis, A Work in Progress: Successfully Engaging Communities for Health and Wellbeing. A realist Evaluation.
