Kennis en democratie

Wat is goede kennis en waarom is democratisering van expertise belangrijk?

Gezondheidswetenschappen zijn historisch sterk verbonden met overheidsbeleid. In de context van democratisering en groeiende verantwoordingsdruk zijn gestandaardiseerde, statistische technieken en idealen gaan bepalen wat ‘goede kennis’ is. De vertrouwens- en verantwoordingscultuur in de publieke gezondheidszorg is daardoor sterk gekwantificeerd.

Deze kennisidealen gaan gepaard met een topdownbenadering van preventie. Steeds meer data resulteren in ongebreidelde toename van risico’s, een focus op ‘gemiddelden’ en verwaarlozing van diverse, alledaagse praktijken rond gezondheid.  Verlies van het contact van de publieke gezondheidszorg met haar ’publieken’ is het gevolg: men worstelt met de vraag hoe ‘risicopopulaties’ en ‘doelgroepen’ beter te bereiken.

Herstel van contact met haar ‘publieken’ vraagt om een andere kenniscultuur in de publieke gezondsheidszorg.

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1686557 Wetenschap en politiek 1 apa-no-doi-no-issue 50 date desc title 581 https://klasienhorstman.nl/phekroom/zotpress/
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Temina, O., Zvonareva, O., & Horstman, K. (2025). Invisible Participation: Patients with Oncological and Rare Diseases in Russia. Science, Technology, & Human Values. https://doi.org/https://doi.org/10.1177/01622439241310741
Dijkstra, I., Penders, B., & Horstman, K. (2025). How health promotion prevents itself from tackling health inequalities. A critical analysis of Dutch health promotion’s paradigm through its handbooks (1995-2022). Social Science & Medicine. Qualitative Research for Health. https://doi.org/https://doi.org/10.1016/j.ssmqr.2025.100533
Stoli, N., Horstman, K., & Zvonareva, O. (2025). “We Know Best Because Our Skin Is in the Game”: Doing Politics Through DIY Pharmaceuticals. Social Inclusion, 13. https://doi.org/https://doi.org/10.17645/si.9037
Horstman, K., & Dijkstra, I. (2024). De constructie van een domme doelgroep''. Gezondheidsongelijkheid en epistemisch onrecht in de publieke gezondheidszorg. Tijdschrift Voor Gezondheidszorg En Ethiek, 34.
Raap, S., Knibbe, M., & Horstman, K. (2024). Representing Neighborhood Health: Exploring Citizen Science as a Democratic Force. Citizen Science. Theory and Practice., 9. https://doi.org/https://doi.org/10.5334/cstp.722
Zanden, van der, B. A. M., Hoebe, C. J. P. A., & Horstman, K. (2024). European policies for public health in border regions: no European mindset as yet. BMC Public Health. https://doi.org/https://doi.org/10.1186/s12889-024-18175-9
Denisova, M., Zvonareva, O., & Horstman, K. (2024). To dwell or drown? Private clinics in the swampy infrastructure of cancer care in Russia. Social Science & Medicine. Qualitative Research in Health, 5. https://doi.org/https://doi.org/10.1016/j.ssmqr.2023.100375
Dijkstra, I., & Horstman, K. (2023). Clarifying how social epidemiological research constructs the category of low socioeconomic status: A response to Kamphuis et al.. Social Science and Medicine. https://doi.org/https://doi.org/10.1016/j.socscimed.2022.115610
Kamenshchikova, A., Wolffs, P. F. G., Hoebe, C. J. P. A., Penders, J., & Horstman, K. (2023). Metaphors of foreign strangers: antimicrobial resistance in biomedical discourses. Science as Culture. https://doi.org/https://doi.org/10.1080/09505431.2023.2180628
Horstman, K., & Knibbe, M. (2022). Gezonde stad, uitsluiting en ontmoeting in de publieke ruimte. Uitgeverij De Graaff.
Yang, R., Horstman, K., & Penders, B. (2022). Stakeholder perspectives on infant formula safety governance in China: a decade after the melamine crisis. Food, Culture & Society, 25, 70–88.
Yang, R., Horstman, K., & Penders, B. (2022). Constructing the accountability of food safety as a public problem in China: a document analysis of Chinese scholarship, 2008–2018. Journal of Chinese Governance, 7, 236–265.
Dijkstra, I., & Horstman, K. (2021). 'Known to be unhealthy': Exploring how social epidemiological research constructs the category of low socioeconomic status. Social Science & Medicine, 285, 114263.
Hees, S. van, Wanka, A., & Horstman, K. (2021). Making and unmaking ageing-in-place: Towards a co-constructive understanding of ageing and place. In Paine, Alexander, Marshall, Barbara L., Martin, Wendy, Neven, Louis (Ed.), Socio-gerontechnology. Interdisciplinary critical studies of ageing and technology (pp. 133–146). Routledge.
Hees, S. van, Horstman, K., Jansen, M., & Ruwaard, D. (2020). How does an ageing policy translate into professional practices? An analysis of kitchen table conversations in the Netherlands: Hoe wordt een verouderingsbeleid vertaalt in de praktijk van professionals? Een analyse van keukentafelgesprekken in Nederland. European Journal of Social Work, 23, 215–226.
Knibbe, M., & Horstman, K. (2020). Constructing democratic participation in welfare transitions: An analysis of narrative interactions. Health Expectations, 23, 84–95.
Moes, F., Houwaart, E., Delnoij, D., & Horstman, K. (2020). Questions regarding 'epistemic injustice' in knowledge-intensive policymaking: Two examples from Dutch health insurance policy. Social Science & Medicine, 245, 112674.
Horstman, K. (2019). Performing health promotion: an analysis of epistemic and political technologies of accountability. Critical Public Health, 1–12.
Moes, F., Houwaart, E., Delnoij, D., & Horstman, K. (2019). Collective constructions of 'waste': epistemic practices for disinvestment in the context of Dutch social health insurance. BMC Health Services Research, 19, 633.
Moes, F. B., Houwaart, E. S., Delnoij, D. M. J., & Horstman, K. (2019). "Strangers in the ER": Quality indicators and third party interference in Dutch emergency care. Journal of Evaluation in Clinical Practice, 25, 390–397.
Horstman, K., Essen, B. van, Schmitz, & Gort, W. (2019). Uw initiatief past niet in ons kader. En wat doen we nu? Een uitgave van Synthese, Universiteit Maastricht en de Vereniging Kleine Kernen Limburg. Onderzoek op verzoek van de Provincie Limburg.
Helberg-Proctor, A., Krumeich, A., Meershoek, A., & Horstman, K. (2018). The multiplicity and situationality of enacting 'ethnicity' in Dutch health research articles. BioSocieties, 13, 408–433.
Helberg-Proctor, A., Meershoek, A., Krumeich, A., & Horstman, K. (2017). 'Foreigners', 'ethnic minorities', and 'non-Western allochtoons': an analysis of the development of 'ethnicity' in health policy in the Netherlands from 1970 to 2015. BMC Public Health, 17, 132.
Moes, F., Houwaart, E., Delnoij, D., & Horstman, K. (2017). Contested evidence: a Dutch reimbursement decision taken to court. Health Economics, Policy and Law, 12, 325–344.
Helberg-Proctor, A., Meershoek, A., Krumeich, A., & Horstman, K. (2016). Ethnicity in Dutch health research: situating scientific practice. Ethnicity & Health, 21, 480–497.
Hees, S. van, Horstman, K., Jansen, M., & Ruwaard, D. (2015). Conflicting notions of citizenship in old age: An analysis of an activation practice. Journal of Aging Studies, 35, 178–189.
Horstman, K. (2015). Een burgertop over een Gezonde en Zorgzame Stad: Experimenteren met de vierde D. Tijdschrift voor gezondheidswetenschappen, 93(7), 257–260.
Hees, S. van, Horstman, K., Jansen, M., & Ruwaard, D. (2015). Betekenissen van burgerschap van ouderen in de participatiesamenleving: Een analyse van 'Voor Elkaar in Parkstad.' Tijdschrift voor Gezondheidswetenschappen, 93(5), 191–196.
Horstman, K. (2015). Struggling with science and democracy: Public health and citizenship in The Netherlands. In Huisman, Frank & Oosterhuis, Harrie (Eds.), Health and Citizenship: Political Cultures of Health in Modern Europe (pp. 191–208). Routledge.
Horstman, K., Lecluijze, I., Penders, B., & Feron, F. (2014). Sturing verhindert leerprocessen. Jeugdbeleid, 8, 9–16.
Hall, L., Meershoek, A., Nijhuis, F., & Horstman, K. (2013). A sociological perspective on "the unmotivated client": public accountability and professional work methods in vocational rehabilitation. Disability and Rehabilitation, 35, 809–818.
Lecluijze, I., Penders, B., Feron, F., & Horstman, K. (2013). Innovation and justification in public health: The introduction of the child index in the Netherlands. In Strech, D., Hirschberg, I., & Marckmann, M. (Eds.), Ethics in Public Health and Health Policy. Concepts, Methods, Case Studies. (pp. 153–173). Springer International.
Horstman, Klasien. (2011). De stem van ouders. In Lame, Jos (Ed.), Spookrijders in de zorg. Pleidooi voor gezondheidszorg zonder meldplicht, privacyschending, afbraak van insituties, en zonder megalomane systemen (pp. 27–29). Eburon.
Horstman, K. (2011). Leren van rokers en dikkerds. Tijdschrift voor Gezondheidswetenschappen, 89(3), 139–141.
Horstman, Klasien. (2010). Experts en hun publiek: over vertrouwen, achterdocht en dialoog. In Steenbergen, Jim van & Bakker, Catharina Th. (Eds.), Het leeft onder de bevolking. Maatschappelijke aspecten van infectieziektenbestrijding vroeger en nu (pp. 83–93).
Horstman, K. (2009). De rol van evidence, politiek en geschiedenis bij de constructie van ‘verzekerbaarheid.’ Tijdschrift voor Gezondheidswetenschappen, 87(5), 194–196.
Vries, G. de, & Horstman, K. (2008). Learning from the work that links laboratory to society. In Vries, Gerard de & Horstman, Klasien (Eds.), Genetics from Laboratory to Society. Societal learning as an alternative to regulations (pp. 171–190). Springer.
Aarden, E., Van Hoyweghen, I., Horstman, K., & Vos, R. (2008). Learning from co-evolution of policy and technology. Different PGDs in the Netherlands, Germany and Britain. Journal of Comparative Policy Analysis: Research and Practice, 10, 191–206.
Vries, G. de, & Horstman, K. (2007). Genetics from laboratory to society: societal learning as an alternative to regulation. Springer.
Vos, R., Houtepen, R., & Horstman, K. (2005). Evidence-based medicine and power shifts in health care systems. In Meulen, R. ter, Biller-Andorno, N., & Lenk-Lie, C/ (Eds.), Evidence-based Practice in Medicine and Health Care. A discussion of ethical issues (pp. 17–23). Heidelberg: Springer Verlag.
Horstman, K. (2005). From Laboratory to Practice: Learning about normative issues. Converging Technologies. The Hague: STT, 134–155.
Benschop, R., Horstman, K., & Vos, R. (2003). Voice beyond choice: Hesitant voice in public debates about genetics in health care. Health Care Analysis, 11, 141–150.
Horstman, Klasien. (2000). Om het beheer van de arbeidsongeschiktheid. Het politieke debat over de Ongevallenwet en het wel en wee van een medische markt. Tijdschrift voor Sociale Geschiedenis, 25, 383–406.
Horstman, Klasien. (1999). Besluiten over risico’s. Kennis en Methode. Tijdschrift voor Empirische Filosofie, 23, 401–414.
Vries, G. de, Horstman, K., & Haveman. (1997). Politiek van preventie. Normatieve aspecten van voorspellende geneeskunde. Werkdocument 58. (p. 88) [Onderzoek in opdracht van het Rathenau Instituut]. Den Haag.
Horstman, K., Berg, M., Heusden, M. van, & Plass, S. (1997). Standaarden en het rechtskarakter van de sociale verzekeringen. Een onderzoek naar de werking van standaarden in de verzekeringsge­neeskundige gevalsbehandeling in het kader van de WAO. (p. 124) [Onderzoek in opdracht van het LISV]. Maastricht/Amsterdam: University Maastricht.

Klasien Horstman

  • Professor Philosophy of Public Health
  • Faculty Health, Medicine and Life Sciences
  • Department Health, Ethics and Society
  • Researchschool Public Health and Primary Care
  • Maastricht University
  • Postbus 616
  • 6200 MD Maastricht
  • +31 43 388 1144
  • +31 43 388 1118
  • info@klasienhorstman.nl
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