Advocated but Sidelined: Health promotion for the elderly in the Netherlands

Abstract

Health promotion (HP) in the Netherlands is the responsibility of both the national (the Ministry of Health, Welfare and Sport) and local governments. Two government organizations are involved in the development, implementation and monitoring of HP: the Dutch Institute of Public Health (RIVM) and The Netherlands Organization for Health Research and Development (ZonMw). Within RIVM, the Center for Healthy Living (Loketgezondleven. nl) has been established. ZonMw subsidizes the Academic Collaborative Centers (ACC) in eight areas which together cover the whole of the Netherlands. ACC centers are responsible for transferring evidence based scientific knowledge into practical activities. Also, health promotion "thematic" institutes such as the TRIMBOS institute (Institute for mental health) and NISB (Dutch Insitute for Sport and Physical Activity), the GGDs (the municipal institutes for public health), general practitioners and work and health professionals (Arbo-coördinators) are actors in HP. There are two laws that regulate the role of HP namely: The Public Health Law ("Wet publieke gezondheid") (Wpg), and the Social Support Act (Wmo). Funding for HP comes from the central government, local municipalities, health insurance companies and regional care offices. Health insurance companies are mostly responsible for financing indicated and disease related HP. Evidence from Loketgezondleven.nl shows that only few HP are efficient and effective. Because of this both municipalities and insurance companies are reluctant to invest in HP. HP for elderly are mostly financed by public sources and, basic health insurance premiums but also through patient payments.

Good practices in health promotion for older people – Significance for evidence in health policy

“…Analysis conducted under the ProHealth 65+ project was an important source of information about good practices for older people from different European countries (Arsenijevic & Groot, 2017; Falvo et al., 2017; Golinowska, Huter, et al., 2017; Pavlova, Atanasova, et al, 2017; Pavlova, Murauskiene, et al, 2017; Pavlova, Skalkidis, Groot, Sowa, & Golinowska 2017; Poscia et al., 2017; Sitko et al., 2016; Sowa & Szetela, 2017; Sowada et al.&, 2017; Tambor et al., 2017). To confirm an adequate selection of programmes and interventions recognised as good practices, public health experts from the countries selected for analysis (Italy, Portugal, the Netherlands, Germany, Bulgaria, Poland, the Czech Republic, Lithuania, Greece and Hungary) were contacted and posed direct questions in order to collect the overall country‐specific information about good practices in health promotion for older people.…”

“…Information on evaluation and funding sources was also provided. The majority of interesting good practice examples were identified in programmes related to participation of older people in physical activities, like Physical activity on prescription from the Netherlands (Arsenijevic & Groot, 2017). A similar programme of prescribed physical activity ( Rezept für Bewegung ) was also implemented in numerous German regions and municipalities (Golinowska, Huter, et al., 2017).…”

“…Another interesting programmes, considered to be good practices of physical activity for older people include, e.g. the national German programme Im Form , the Italian programme – Colours in Movement (Poscia et al., 2017), example from the Czech Republic Dance as therapy with an effect on health and quality of life of nursing home residents (Sowa & Szetela, 2017) or View on balance from the Netherlands aimed at reducing the fear of falling among seniors and to discourage non‐participation in activities that might lead to falling (Arsenijevic & Groot, 2017).…”

Health promotion policies for elderly—Some comparisons across Germany, Italy, the Netherlands and Poland

“…One of the reasons for this is the concept and the position of policy within the health care system. HPP are broader than health care policies in general and include many other aspects of life and society like schools, the physical environment, the way the public space is designed, the working environment, infrastructure and neighborhoods [7]. In this way health promotion policies are complex and usually saturated with political decisions [8].…”