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In 2015 zijn de Gezondheidsfondsen voor Rookvrij gestart met een initiatief om sportverenigingen in Nederland rookvrij te maken. Veel kinderen komen op sportverenigingen waar vaak nog buiten wordt gerookt, bijvoorbeeld langs de lijn. Terwijl zien roken, doet roken. Een rookvrije sportvereniging biedt het goede voorbeeld. Het initiatief ‘Rookvrije Sportverenigingen’ stimuleert verenigingen om een rookvrij beleid in te voeren en geeft hen handvaten hoe dit te realiseren. Het initiatief bestaat uit een informatiepakket en verenigingen kunnen begeleid worden door adviseurs, zoals een Team:Fit coach, buurtsportcoach of GGD medewerker. Ook zijn er fysieke promotiematerialen zoals borden beschikbaar om het rookvrij beleid uit te dragen. In 2019 hebben het Amsterdam UMC en Tranzo, Tilburg University een rookvrij beleid op 16 sportverenigingen onderzocht. In deze factsheet worden resultaten en tips gepresenteerd, gebaseerd op interviews met 87 vrijwilligers en groepsgesprekken met 180 jongeren.

Smoking is more common among people with a lower educational level, professional qualifications and income. This is a major contributor to inequalities in health and mortality.- Inequalities in smoking appear to have their origin in early adolescence. Later in life these inequalities increase due to differences in smoking cessation between higher and lower socioeconomic status groups.- The inequalities in smoking cessation have already been explained in great detail. The close association between smoking and a lower level of education during adolescence is much less clear.- Evaluation of tobacco control measures has shown differences in effectiveness between groups of higher and lower socioeconomic status.- There are possibilities to allow measures to control tobacco to be more effective in groups of a lower socioeconomic status. Higher taxes on tobacco products should be accompanied by better access to professional help to stop smoking.- For the early recognition of unforeseen reactions, structural control measures should be monitored

Objective Gaining more insight into any differences in care expenses between minimum and higher income groups. Design Crosssectional study among 6,709 citizens of Amsterdam aged 19 years and over. Method Data on declared health care expenses from 2012 were linked to personal income and to public health survey data. Through weighted logistic regression analysis, differences in expenses for primary care, hospital care, mental health care and other care were compared for minimum and higher income groups, controlling for demographic characteristics, educational level and health status. Results Minimum income groups claimed more often for mental health care costs (11%) than higher income groups (7%). However, after controlling for demographic characteristics, educational level and health status this difference was not significant. Further, minimum income groups claimed fewer expenses for hospital care, but this difference was not significant. The number of claims for other care did not differ. The size of the expenses differed between income groups. Expenses for primary care among minimum income groups were lower versus those for higher earners. Expenses for hospital care, mental health care and other care were higher, but not to a statistically significant level. Conclusion Minimum income groups claim lower costs for primary care. On the other hand, the number of claims for mental health care, hospital care and other care is equal or higher than that of higher income citizens, as is the size of the claimed expenses. Conflict of interest: none declared. Financial support: none declared.

Gaining more insight into any differences in care expenses between minimum and higher income groups. Cross-sectional study among 6,709 citizens of Amsterdam aged 19 years and over. Data on declared health care expenses from 2012 were linked to personal income and to public health survey data. Through weighted logistic regression analysis, differences in expenses for primary care, hospital care, mental health care and other care were compared for minimum and higher income groups, controlling for demographic characteristics, educational level and health status. Minimum income groups claimed more often for mental health care costs (11%) than higher income groups (7%). However, after controlling for demographic characteristics, educational level and health status this difference was not significant. Further, minimum income groups claimed fewer expenses for hospital care, but this difference was not significant. The number of claims for other care did not differ. The size of the expenses differed between income groups. Expenses for primary care among minimum income groups were lower versus those for higher earners. Expenses for hospital care, mental health care and other care were higher, but not to a statistically significant level. Minimum income groups claim lower costs for primary care. On the other hand, the number of claims for mental health care, hospital care and other care is equal or higher than that of higher income citizens, as is the size of the claimed expenses

To determine the contribution of perceived ethnic discrimination to depression in various ethnic minority groups in Amsterdam. Cross-sectional study. We included participants aged 18-70 years of Dutch (n = 1,744), Asian Surinamese (n = 1,126), Creole Surinamese (n = 1,770), Ghanaian (n = 1,072), and Turkish origin (n = 834) on the basis of baseline data from the HELIUS study, collected from January 2011to June 2013 in Amsterdam. Perceived discrimination was determined using the Everyday Discrimination Scale, and the severity of depressive symptoms was assessed using the Patient Health Questionnaire-9. We used logistic regression to investigate the association between discrimination and depression, and quantified the contribution of perceived discrimination to depressive symptoms and disorder using the population attributable fraction (PAF). Results were corrected for sex, age, civil status, migration generation, level of education and employment status. Both depressive symptoms and disorder were most common among participants of Turkish (24% and 14%, respectively) and Asian Surinamese origin (19% and 10%), and least common among participants of Dutch origin (6% and 2%). Participants from ethnic minority groups who had experienced higher rates of discrimination more often suffered depressive symptoms, with odds ratios varying from 1.66 to 2.98. The PAF of perceived discrimination to depression was 18-28% among participants of Asian Surinamese, Creole Surinamese and Turkish origin, and from 13- 16% among participants of Ghanaian origin. Perceived discrimination contributes substantially to the prevalence of depression in ethnic minority groups in Amsterdam. Differences in the prevalence of depression in ethnic minority groups may originate partially from perceived discrimination

To examine if there is a higher uptake of home care among residents of deprived districts and to determine if this can be attributed to the lower levels of income and wealth of these residents. Retrospective, descriptive study. The study focused on residents aged 50 and above. We obtained data on uptake of home care in 2007 from national care registries, which were combined with fiscal registry data on income and wealth. Postcode data were used to distinguish between 40 'deprived' districts and all other Dutch districts. In the deprived districts more residents received home care than in other districts. This difference was greatest among residents aged 50 to 69 years. After correction for age, sex and country of origin, the difference was substantial (odds ratio (OR): 1.31). After correction for differences in income this difference was halved (OR: 1.17).The difference was further strongly reduced after correction for wealth (OR: 1.06). In deprived districts there was a higher uptake of domestic care (OR: 1.12) but the inverse was true for personal care (OR: 0.95). The latter was most marked in residents aged 80 and above (OR: 0.88). The higher uptake of home care among residents of deprived districts can be attributed to low levels of income and wealth. In the Netherlands, changes in home care arrangements at national and local level should take into account people with financial problems and the districts in which they live

To compare blood pressure and the prevalence of hypertension in white Dutch and Dutch of Suriname-hindustani and Suriname-creole ethnic derivation with corresponding ethnic minority groups in England and to assess the quality of hypertension treatment in these groups. Retrospective; comparison of cross-sectional studies. Secondary analyses were performed on data from 3 population-based studies with 13,999 participants in total of European, African of South-Asian origin from England and the Netherlands. English South-Asian men and women had lower blood pressure and lower prevalence of hypertension than people of South-Asian origin in the Netherlands (Suriname-hindustani), except for systolic blood pressure in men of Indian extraction in England. There was no difference in systolic blood pressure between groups of African origin in the Netherlands and England. Diastolic blood pressure levels, however, were lower in English men and women of African origin than in people of African origin in the Netherlands (Suriname-creole). White Dutch had higher systolic blood pressure levels, but lower diastolic blood pressure levels than white English men and women. There was no difference in the prevalence of hypertension between the white groups. In persons being treated for hypertension, a substantially lower percentage of the Suriname-hindustani and Suriname-creole persons in the Netherlands had well controlled blood pressure (lower than 140/90 mmHg) than their English equivalents, with the exception of English of Indian extraction. There were marked differences in blood pressure and prevalence of hypertension between comparable ethnic groups in England and the Netherlands. The relatively poor blood pressure control in Dutch ethnic minority groups partly explained the relatively high blood pressure levels in these groups

OBJECTIVE: Examination of the variations in the pace of old-age (80+) mortality decline in 7 Northwestern European countries for the period 1950-1999, and the impact of smoking DESIGN: Retrospective. METHOD: The population mortality data of 7 Northwestern European countries were collated according to year of death for a 50 year period (1950-1999), single year of age (60+ and 80+) and sex. Both all-cause and non-smoking-related mortality were analysed. In addition, a comparison was made with the pace of mortality decline at younger age among the same cohorts. Regression and correlation analyses were used. RESULTS: Marked variations in the pace of old-age mortality decline were found between countries, periods and sexes. While mortality declines were constantly strong in France and England and Wales, modest declines or even increases in mortality rate were observed in the 1950s in the Nordic countries, and since the 1980s in Denmark, The Netherlands, and (for men only) Norway. For non-smoking-related mortality, a high and consistent pace ofmortality decline was observed. The declines showed a clear cohort pattern, with the smallest declines or even increases for men born between 1890 and 1899, compared to an increased pace of mortality decline among women born between 1847 and 1937. Among men, but not women, the pace of old-age mortality decline correlated with the pace of mortality decline at ages 60-69 among the same cohorts. CONCLUSIONS: Variations in the pace of old-age mortality decline are strongly influenced by smoking and probably also by other factors originating earlier in life. For future decades, substantial further declines in old-age mortality may be expected, even though rates of change in specific countries and periods would be difficult to predict

Mortality among 10 groups of non-western migrants to The Netherlands, observed in the period 1995-2000, is compared with mortality among people who were born in and whose parents were born in The Netherlands. The migrant groups concerned consisted of people who were born in, or whose parents were born in Turkey, Morocco, Surinam, The Netherlands Antilles, Ghana, Somalia, Iraq, Iran, Afghanistan and Vietnam. Differences in mortality were adjusted for age, marital status, region, degree of urbanization, and socioeconomic status. Despite the fact that most migrants originate from countries with a substantially higher mortality rate than The Netherlands, most groups had similar or more favourable total mortality rates than native Dutch people. Men from Turkey and Surinam had slightly elevated mortality rates and men and women from Somalia had a notably higher mortality rate than native Dutch people. The generally favourable mortality rates among migrants are the result of two compensating phenomena: higher mortality among young migrants than among young native Dutch people, and lower mortality among elderly migrants than among elderly native Dutch people. An analysis of cause-of-death patterns revealed relatively low mortality from cardiovascular diseases, cancer and respiratory diseases in most migrant groups, and relatively high mortality from infectious diseases and injuries. These findings are unlikely to have been influenced by incomplete registration of mortality. Selective migration may play a role--some migrant groups have a relatively high level of education for example. Also some of the findings may be explained by a difference in timing between the health benefits and the health risks of migration. Migrant health could be benefiting from the favourable socioeconomic, public health and health-care conditions in The Netherlands, but not yet be affected by the higher risks of cancer and cardiovascular disease associated with prosperity

PURPOSE: To assess whether the stagnation in old age (80+) mortality decline observed in the Netherlands in the 1980s, continued in the 1990s and which factors contributed to this stagnation. Emphasis is on the role of smoking. METHODS: Poisson regression with linear splines was applied to total and cause-specific (3-digit) mortality data by age, year of death (1950-1999) and sex. Age-period-cohort analysis was conducted to determine whether the trends followed period and/or cohort patterns. ICD Revisions were bridged using a concordance table. RESULTS: A sudden reversal in old age mortality occurred around 1980, leading to a stagnation in the decline and even an increase during the 1980s and 1990s. Smoking related cancers, COPD and diseases specifically related to old age contributed to this stagnation. Trends in smoking-related cancers and COPD showed a cohort pattern--especially for males. When excluding these smoking related diseases, the trends in old-age mortality in the Netherlands showed an increasing stagnation for both sexes. IMPLICATIONS: Generation-wise changes in smoking can only partly explain the stagnation in mortality. Other factors like increased frailty and changes in medical and social services for the elderly probably have played a more decisive role in explaining the recent stagnation

The aim of this study was to determine whether the austerely living Trappist and Benedictine monks have a lower prevalence of a number of risk factors and health problems than the general Dutch population. A written questionnaire was submitted to monks of 7 monasteries. The response was 67 per cent (134 monks). The data were compared with data from the national Health Interview Survey of 1989, which used an almost identical questionnaire. Adjustment was made for differences in age and education. Monks consume less alcohol and tobacco and have a more austere diet. Their average Quetelet index is lower. The prevalence of cardiovascular disease is lower. On the other hand, monks more often report a number of other chronic diseases, physical complaints, and problems with activities of daily life. They more often have contact with general practitioners and with consultants. The lower prevalence of a number of risk factors among monks reflects their austere way of life. It is not certain whether the lower prevalence of cardiovascular diseases can be attributed to this way of life. The fact that, in general, health problems are more prevalent among monks suggests that changes in lifestyle do not necessarily lead to compression of morbidity

The geographical distribution of mortality from ischaemic heart disease in the Netherlands has changed dramatically since 1950. In 1950-1954 mortality was highest in high-income, urbanized areas, in 1980-1984 the reverse was true. This development resembles the one observed in the United States of America. The changes in geographical distribution cannot be attributed to differences in cause-of-death certification. The change in the association with income and the association between mortality and a number of ischaemic heart disease risk factors found in 1970-1974, suggest that at least part of the explanation is a change in the geographical distribution of risk factors