In need of a collaborative response: An analysis of collaboration between public health, primary care and social care in deprived neighbourhoods

The main research question in this thesis is: Is collaboration between primary care, public health and social care a potentially effective measure to improve the health of people living in deprived neighbourhoods? Studies in this thesis showed the complexity of problems in combination with the way patients deal with their own problems, and the difficulty of having a fruitful relationship with patients, make it difficult for professionals to provide what the patients need. Our findings reveal promising elements in the pilot projects that might compensate for the lower chance of good health in deprived neighbourhoods: The collaborative response is a promising element as it 1) might help to embed services promoting health and healthy behaviour, 2) might help overcome difficulties to provide patient-centred care or a ‘whole-person approach’, and 3) might help to support patient self-management. The response given by professionals to patients’ health needs consisted of applying a holistic approach, activating and coaching patients, and population health orientation. Also the response of these professionals showed consistency as they all aimed at treating the root causes through coaching and activating, were sensitive to the realities of the patient’s everyday life, and communicated with each other. This consistency was reached because professionals collaborated to develop this response. Improved possibilities for taking public health measures, in close cooperation with primary and social care are a promising element. By collecting varied information, close collaboration has the potential to provide more insight into the problems that need ‘fixing’ outside the realm of health care.