Ongelijkheid en gezondheid

Hoe komt het dat gezondheidsverschillen al decennia niet kleiner worden, ondanks alle beleid, interventies en wetenschappelijk onderzoek?

Gezondheidsverschillen zijn hardnekkig. Eind vorige eeuw bleken de verschillen tussen ‘hoge’ en ‘lage sociaaleconomische statusgroepen’ in welvarende West-Europese landen onverwacht groot. Sindsdien is er veel aan onderzoek en beleidsontwikkeling gedaan om ze te verkleinen. Dertig jaar later zijn de resultaten echter teleurstellend.

Veel auteurs verklaren dat door te wijzen naar het neoliberale beleid en de afbouw van zorgarrangementen. Ze laten de vraag naar de rol van het wetenschappelijk onderzoek buiten beschouwing.

Zouden stigmatiserende wetenschappelijke classificaties – laag en hoogopgeleid, lage en hoge sociaaleconomische positie – en individualistische, psychologiserende theorieën over de motivatie, de keuzes en de cognities van lage sociaaleconomische statusgroepen, ongelijkheid niet eerder bestendigen dan verkleinen?

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1686557 Ongelijkheid en gezondheid 1 apa-no-doi-no-issue 50 date desc title 577 https://klasienhorstman.nl/phekroom/zotpress/
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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
Knibbe, M., Raap, S., & Horstman, K. (2025). Citizen Participation in Health City-Making: An Analysis of Infrastructural Work and Hostilities in a Low-Income City Area. Social Inclusion, 13. https://doi.org/https://doi.org/10.17645/si.9041
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.
Thissen, L., Biermann-Teuscher, D., Horstman, K., & Meershoek, A. (2023). (un)beloning at work: an overlooked ingredient of workplace health. Health Promotion Int. https://doi.org/https://doi.org/10.1093/heapro/daad061
Horstman, K., & Knibbe, M. (2023). Publieke ruime als sociale riolering. Sociaal Bestek. Tijdschrift Voor Werk, Inkomen En Zorg.
Knibbe, M., & Horstman, Klasien. (2023). Pleidooi voor een publieke ethiek van gezondheidsbevordering. Tijdschrift Voor Gezondheidszorg En Ethiek, 33, 60–64.
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
Horstman, K., & Knibbe, M. (2022). Publieke ruimte die gezondheidsverschillen vermindert. Sociale Vraagstukken.
Horstman, K., & Knibbe, M. (2022). Gezonde stad, uitsluiting en ontmoeting in de publieke ruimte. Uitgeverij De Graaff.
Raap, S., Knibbe, M., & Horstman, K. (2022). Making health public: a philosophy café in a disadvantaged neighbourhood. Health Promotion International, daab206.
Knibbe, M., & Horstman, K. (2022). Overcoming the tragedy of the commons. Collective practices for a healthy city ecology in disadvantaged neighborhoods. Health & Place. https://doi.org/10.1016/j.healthplace.2022.102777
Raap, S., Knibbe, M., & Horstman, K. (2022). Clean Spaces, Community Building, and Urban Stage: the Coproduction of Health and Parks in Low-Income Neighborhoods. Journal of Urban Helath. https://doi.org/10.1007/s11524-022-00644-4
Raap, S., Knibbe, M., & Horstman, K. (2021). Caring neighbourhoods: maintaining collective care under neoliberal care reforms. European Journal of Social Work, 1–13.
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.
Teuscher-Bierman, D., Fermin, B., Horstman, K., Meershoek, A., & Thissen, L. (2021). Een etnografisch-participatieve basis voor vitaliteitsbeleid. Gezondheid met de Werkvloer. Sociaal Bestek. Tijdschrift Voor Werk, Inkomen En Zorg.
Knibbe, M., & Horstman, K. (2019). The making of new care spaces. How micropublic places mediate inclusion and exclusion in a Dutch city. Health & Place, 57, 27–34.
Knibbe, M., & Horstman, K. (2019). Woonpijn. Bronnen en drempels voor veerkracht van kwetsbare mensen in de stad Maastricht. [Onderzoek in opdracht van de Gemeente Maastricht]. Maastricht: University Maastricht.
Horstman, K., & Meershoek, Agnes. (2019). Vitaal en bevlogen werknemers? Een pleidooi voor etnografisch-participatief onderzoek. Podium voor Bioethiek, 26(2), 17–20.
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.
Knibbe, M., de Vries, M., & Horstman, K. (2017). Responsible use of media supports ‘critical public health literacy.’ Journal of Public Health, 39, 353–357.
Knibbe, M., de Vries, M., & Horstman, K. (2016). Bianca in the neighborhood: moving beyond the 'reach paradigm' in public mental health. Critical Public Health, 26, 434–445.
Horstman, K. (2016). Een kwestie van betekenissen. Tijdschrift voor Gezondheidswetenschappen, 94(8), 281–282.
Horstman, K. (2013). Patat, shoarma en zuurvlees. De snackbar en de sociale infrastructuur van de stad. In Bestemming gewijzigd. Moderniteit en stedelijke transformaties. (pp. 238–249). Rotterdam: Platform P.
Geelen, E., Horstman, K., Marcelis, C. L., Doevendans, P. A., & Van Hoyweghen, I. (2012). Unravelling fears of genetic discrimination: an exploratory study of Dutch HCM families in an era of genetic non-discrimination acts. European Journal of Human Genetics, 20, 1018–1023.
Hal, L. B. E., Meershoek, A., Nijhuis, F., & Horstman, K. (2012). The 'Empowered Client' in Vocational Rehabilitation: The Excluding Impact of Inclusive Strategies. Health Care Analysis, 20, 213–230.
Aarden, E., Van Hoyweghen, I., & Horstman, K. (2010). Solidarity in practices of provision: distributing access to genetic technologies in health care in Germany, the Netherlands and the United Kingdom. New Genetics and Society, 29, 369–388.
Horstman, K. (2010). Dikke kinderen, uitgebluste werknemers en vreemde virussen: Filosofie van de publieke gezondheidszorg in Filosofie van de publieke gezondheidszorg in de 21e eeuw. Maastricht University.
Van Hoyweghen, I., & Horstman, K. (2010). Solidarity matters: Embedding genetic technologies in private and social insurance arrangements. New Genetics and Society, 29, 343–350.
Sjoerd Kooiker, & Koos van der Velden (Eds.). (2007). Van sturen naar leren. Een gesprek met Klasien Horstman en Rob Houtepen. In Een nuchtere kijk op gezond gedrag. Vier thema’s voor gezondheidsbevordering (pp. 35–43). Den Haag: Sociaal en Cultureel Planbureau.

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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