Improving neighbourhoods, improving health?

Health inequalities between deprived and non-deprived areas are largely accounted for by socio-demographic differences between populations. There are two possible explanations for the remaining area inequalities in health: selective migration and specific social and physical characteristics of the area. Furthermore, there is scarce evidence on the extent to which policies and interventions aimed to change area characteristics are effective in improving the health of residents and reducing area inequalities in health. The first main objective of this thesis was to evaluate whether inequalities in health between deprived and non-deprived neighbourhoods are influenced by selective migration. The second main objective of this thesis was to identify if changes in specific characteristics of the neighbourhood environment influence health outcomes in the Netherlands. The third main objective of this thesis was to investigate whether the District Approach did improve health outcomes in the 40 most deprived districts of the Netherlands. The results of this thesis have shown that migration does not enlarge inequalities in health between deprived and non-deprived areas in the Netherlands but possibly attenuates the health differences. Furthermore, this thesis have provided some additional support for assuming a causal relationship between some neighbourhood characteristics and health outcomes. This suggests that an implementation of ABI’s have the potential to improve the health of disadvantaged populations and to reduce area inequalities in health. In this thesis, we have been able to show positive developments in some aspects of health outcomes of the residents targeted by the Dutch District Approach.