The Gezondheid en Levens Omstandigheden Bevolking Eindhoven en omstreken (GLOBE)

Isn’t it frustrating? In 1991, a prospective cohort study started specifically aimed at unravelling the underlying mechanisms and causes of socioeconomic inequalities in health. In 2021, the study was still ongoing, providing unique information over a period of thirty years. In more than 100 international scientific publications, the Dutch GLOBE-study found evidence of a role of financial hardship, working and housing conditions, perceived control over life, health behaviour, early childhood circumstances, area-based characteristics and cultural capital. But despite all this knowledge, health inequalities were not eradicated. Why not?

Among other factors, the connection between these underlying causes and interventions and policies has been weak. Too often solutions were sought in behavioural interventions. Rotterdam is not only confronted with large inequalities, it is also a frontrunner in efforts to tackle them. In this unique context, circumstances are now being created to learn if and how living circumstances are connected to health, and collaboration is our key strategy. In an ambitious convergence with colleagues from Erasmus University, Delft University, the Rotterdam University for Applied Sciences, Rotterdam Municipality and the National Programme Rotterdam South, scientists, professionals and residents of the city increasingly work together (https://convergence.nl/nl/resilient-delta). Recognizing that socioeconomic inequalities in health are a wicked problem, in which poverty, education, working and housing conditions and health are interrelated, connecting causes and solutions will be at the core of our activities. Health inequalities that exist over decades will not be eradicated easily. Together however, a frustration can be transformed into a challenge to make the city a truly inclusive and healthy society.