Language and health
After finishing secondary school I studied philosophical and historical sociology at the University of Groningen. I graduated cum laude in 1986 with a master’s thesis on the rise of pragmatist ideas about language.
To help me combine research with teaching, I also earned a degree in didactics and a teaching degree in sociology and economics. Before completing my master’s degree, I began teaching high school economics and business administration in 1985.
Although I enjoyed teaching adolescents, I was keen to continue my research. In 1987, I started my PhD on the interface between philosophy, sociology, history and health at Maastricht University, moving from the very north to the very south of the Netherlands.
I was among the first generation of students in the Netherlands to follow intensive PhD training in science and technology studies, a programme that developed into the Netherlands Graduate Research School in Science, Technology and Modern Culture (WTMC). This programme is still flourishing today, and many of my own PhD students are involved in it.
Research and teaching
From the outset at Maastricht University, I was heavily involved in teaching and in the development of a master’s track in gender and health. After two years I became an assistant professor, and I have divided my working hours between research and teaching ever since.
Combined with starting a family, this meant my PhD took longer than originally planned. I graduated in 1996 with a thesis dedicated to the introduction of the notion of ‘health risk’ in modern life insurance in the 19th and 20th centuries and the public issues this raised. Ever since, my work has been related, in one way or another, to dealing with the prediction and prevention of ‘risks’ in modern society and healthcare.
Lessons from engineers
In 2001 I was appointed Socrates Professor in Philosophy and Ethics of Bioengineering at Eindhoven University of Technology, a special professorship for one day a week. I developed courses for students in biomedical technology and technology management, encouraging them to reflect on the philosophical and ethical issues in their work. I also supervised a PhD student on the meaning of the body in tissue engineering.
I enjoyed working with engineers in the environment of a technical university; it enabled me to observe ‘engineering in practice’, and I learned that social and health scientists who try to emulate the hard sciences by aiming for ‘hard facts’ and ‘engineering solutions’ often neglect the complexities not only of ‘the social’ but also of the engineering sciences. At the same time, I also worked as an associate professor at Maastricht University. During this time my research focused on the introduction of predictive medicine and, in particular, genetic technologies.
Back to the social
After eight years I returned to Maastricht University full time, taking up the post of professor of Philosophy of Public Health in 2009. The focus of my research shifted from genetic technologies to public health, including the prevention of infectious diseases, health promotion, occupational health, youth healthcare and public mental health.
As a field accustomed to top-down policymaking processes, public health seems to address societal developments, such as growing pluralism and democracy, by increasingly relying on experts and becoming ever more technocratic. Public health appears to be afraid of its own object – the public – and the gap between highly educated public health officials and less educated citizens is growing. In short, public health suffers from ‘us’ versus ‘them’ issues.
In my inaugural lecture, in newspaper articles and in many lectures in public health organisations, I have argued in favour of mobilising the knowledge and values of people who are overweight, smoke and do other things regarded as ‘bad choices’. We need to stop treating them as the ‘object’ of steering and control and as ‘the other’, as though overweight people and smokers do not contribute to society.
Although a sense of citizenship and participation is gradually being developed, the public health sector still finds it difficult to acknowledge that health is a contested concept and that we learn from ‘contests’. Interesting experiments with participative public health are currently underway in the Dutch towns of Laarbeek and Peel en Maas, which we are continuing to follow over the years.
While studying various local experiments, I also became involved in the Master in Global Health, which was launched in 2010. The question of how public health connects the global and the local, the different knowledge practices and different social worlds, is of major importance in preventing infectious diseases, obesity and other problems worldwide.
Outside the university
Over the years I have done work for various bodies within the Netherlands. I was and am a member of several research committees of the Netherlands Organisation for Health Research and Development (ZonMW) and the Netherlands Organisation for Scientific Research (NWO).
I am a member of the Scientific Advisory Board of the Public Health Status and Forecast Reports of the National Institute for Public Health and the Environment (RIVM). I was also a member of the Supervisory Board of the Catharina Hospital in Eindhoven from 2004 until 2012.