Intersectoral collaboration in tackling health inequalities : A study of sixteen municipalities in the Netherlands

The number of municipalities that are focusing on developing an integrated approach (health in all policies) to improve the health or reduce any health inequalities of their residents has risen in recent years. However, the manner and degree in which sectors both outside and inside the public health domain collaborate to address the problem of health inequalities differs per municipality. On the local level there are opportunities to broaden and intensify collaboration among the various sectors. This was the conclusion drawn from a study on intersectoral collaboration to tackle health inequalities carried out by the National Institute for Public Health and the Environment (RIVM) in sixteen Dutch municipalities. The results of this study could provide support to policy officers at the local level for developing health in all policies. Improved intersectoral collaboration is an important condition for providing health in all policies. Health in all policies is important for reducing health inequalities and is also closely related to inequalities in other aspects, such as low income, unemployment, low educational level, poor living and working conditions and an unhealthy life style. Any attempt to reduce these inequalities demands a serious commitment not only from the public health sector, but also from other sectors (i.e., education, sports, spatial planning). The current local approach to tackle health inequalities appears to be focused on reducing an unhealthy lifestyle (i.e., overweight) and social exclusion and improving the quality of care. The public health sector primarily collaborates with social sectors (i.e., youth, education, sports, social affairs) and less with physical ones (i.e., spatial planning, housing, environments). This study identifies potential improvement points which could improve intersectoral collaboration, including alignment of health with local priorities (such as participation), the improvement of the alignment with physical sectors, the establishment of political and administrative support, and the gradual stepwise implementation of an integrated approach.