URBAN40, a natural experiment with integrated neighborhood-oriented healthpolicy

In 2008 at the initiative of the then Minister Ella Vogelaar a large scale program was started in 40 neighborhoods to increase the quality of life in those neighborhoods and improve the social position of the inhabitants. In this context, a wide range of activities was undertaken, focusing on five themes: housing, employment, education, integration, and security. The activities included renovating the housing, programs to reduce unemployment, community schools, construction of playgrounds, measures to reduce nuisance and activities to strengthen social cohesion in a neighborhood. Because this approach aimed to improve the living conditions and socioeconomic status of inhabitants, and both factors affect health, the neighborhood approach offered a unique opportunity to examine whether improvements in health and health related behavior of the inhabitants of those neighborhoods would occur. The URBAN40 study investigated whether this was indeed the case. Late last year, the initial findings of this research became available. In this Spectrum, these initial results are briefly described by Mariël Droomers and colleagues. The Social and Cultural Planning Office reported earlier that this neighborhood approach showed no effect on liveability and safety, two primary goals of the neighborhood program. Therefore, we invited Jeanet Kullberg of the Social and Cultural Planning Office for a response on these results. Secondly, Age Niels Holstein, program manager of one of the 40 priority neighborhoods, Nieuw-West in Amsterdam gives his response to the findings. Finally, a response is given by Inge Vossenaar of the Ministry of the Interior, and by Marianne Donker and Laetitia Kuipers of the Ministry of Health, Welfare and Sports. The important message from the responses is that the effects found sound hopeful, but that more insight is needed into the underlying mechanisms, to be able to provide tools for action to residents, workers and policymakers.