Intersectional inequalities in mental health by education, income, gender, and age before and during the COVID-19 pandemic in the Netherlands: a longitudinal study.

Background: It remains unclear how COVID-19 has disproportionately affected the mental health of different vulnerable groups. This study explores how mental health inequalities changed between 2014 (pre-COVID-19) and 2021 (during COVID-19) in the Netherlands across intersectional social strata defined by interplays of educational attainment, income level, gender, and age.

Methods: Using 2014 and 2021 self-reported cohort data on health and living conditions of the adult population of Eindhoven and surroundings (N = 1,157), a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was applied to explore intersectional inequalities in mental health in 2014, 2021, and in mental health changes (2014-2021).

Understanding educational inequalities in sports participation through structurally based resources and individual agency - a sequential mediation analysis.

Educational inequalities in sports participation remain a public health issue in the Netherlands. Combining structurally based resources from Pierre Bourdieu's theory of capital with Amartya Sen's conceptualization of individual agency may offer new insights into the complex mechanisms that drive these inequalities. Specifically, we posited that the way individuals are able to exercise their agency within the structurally based economic, social, and cultural resources they have access to may help explain educational inequalities in sports participation.

An unequal health policy landscape? Examining socioeconomic differences in acceptability and preferences for policies that aim to reduce socioeconomic inequalities in health.

Background: This study explores socioeconomic differences in acceptability and preferences for policies that aim to reduce socioeconomic health inequalities. The investigated policies range from structural policies, requiring no individual agency, to agentic policies, which depend on the individual agency for behaviour change.

Methods: An online, cross-sectional survey was conducted among 1182 participants, stratified by education and representative of Dutch adults (aged 25-65) for age and gender.

Trapped in vicious cycles: unraveling the health experiences and needs of adults living with socioeconomic insecurity.

Background: This study explores the role of health in daily life and needs of Dutch adults (aged 25-49) experiencing one or more forms of socioeconomic insecurity stemming from their financial, housing, or employment situations.

Methods: 28 in-depth, semi-structured interviews were conducted in the Netherlands between October 2022 and February 2023. The interview guide included questions on participants' socioeconomic situation, the role of health in their daily lives, their health-related and broader needs.

Urban densification in the Netherlands and its impact on mental health: An expert-based causal loop diagram.

Urban densification is a key strategy to accommodate rapid urban population growth, but emerging evidence suggests serious risks of urban densification for individuals' mental health. To better understand the complex pathways from urban densification to mental health, we integrated interdisciplinary expert knowledge in a causal loop diagram via group model building techniques. Six subsystems were identified: five subsystems describing mechanisms on how changes in the urban system caused by urban densification may impact mental health, and one showing how changes in mental health may alter urban densification.

The current state of complex systems research on socioeconomic inequalities in health and health behavior-a systematic scoping review.

Background: Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research.

Methods: SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population.

Socioeconomic inequalities in self-assessed health and food consumption: the mediating roles of daily hassles and the perceived importance of health.

Background: Urgent daily hassles, which are more common among people with a lower socioeconomic position (SEP), might limit one's ability to address less pressing goals, such as goals related to health promotion. Consequently, health goals may be viewed as less focal, which could jeopardize one's health. This study examined an understudied pathway: whether a higher severity of daily hassles resulted in a lower perceived importance of health and whether these two factors sequentially mediate socioeconomic inequalities in self-assessed health (SAH) and food consumption.

Applying a systems perspective to understand the mechanisms of the European School Fruit and Vegetable Scheme.

Background: For the past two decades, the percentage of European children who consume fruit daily has remained at around 40%, despite numerous school-based policy efforts and interventions. This study aimed to apply a systems approach to provide an integrated perspective of the mechanisms of the European School Fruit and Vegetable Scheme (the Scheme) to understand better how to increase its long-term impact on children's fruit and vegetable consumption.

Methods: We developed a causal loop diagram by synthesizing peer-reviewed articles and national government documents related to the Scheme, following the conceptualization steps of system dynamics.

Development of a framework to guide research into policies promoting physical activity and healthy diets in the European context: the system-based Policy Evaluation Network (PEN) framework.

Background: The Policy Evaluation Network (PEN) is a multidisciplinary Pan-European research consortium focussing on policies affecting dietary intake, physical activity and sedentary behaviour. At the start, the PEN consortium expressed the need for an overarching, system-based framework covering the complexities between the different domains of the policy process (design, implementation and outcomes) in order to execute all research activities in a coherent way. This article describes the PEN framework itself and its development process.

Dietary behaviour and physical activity policies in Europe: learnings from the Policy Evaluation Network (PEN).

The European Policy Evaluation Network (PEN), initiated in autumn 2018, aimed at advancing the evidence base for public policies impacting dietary behaviour, physical activity and sedentary behaviours in Europe. This is needed because non-communicable diseases-the leading cause of global mortality-are substantially caused by physical inactivity and unhealthy dietary behaviours, which in turn are driven by upstream factors that have not yet been addressed effectively by prevention approaches. Thus, successful policy interventions are required that target entire populations and tackle the 'causes of the causes'.

Reaching consensus on definitions for food and physical activity policies: experience from the Policy Evaluation Network.

Background: An upsurge in policy evaluation research within public health sciences has led to multi-disciplinary research networks like the 'Policy Evaluation Network' (PEN). This multi-disciplinary collaboration highlighted the need for consensus on clear, common terminology and definitions to facilitate the multi-disciplinary research. This article outlines the development process of the PEN definitions glossary tool, with a focus on the key domains of policy design, implementation and outcomes as they apply to physical activity, sedentary behaviour and dietary behaviours.

Sustainable Urban Mobility Plans: implementation process and indicators to evaluate effects on physical activity.

Background: Active mobility and public transport increase physical activity (PA) levels. With varying intensity and effectiveness, European cities implement Sustainable Urban Mobility Plans (SUMPs) to spur transport-related PA. Therefore, we aim to examine drivers and barriers to SUMP implementation and assess its influence on PA across European cities.

How theory can help to understand the potential impact of food environment policies on socioeconomic inequalities in diet: an application of Bourdieu's capital theory and the scarcity theory.

Government policies that promote healthy food environments are considered promising to reduce socioeconomic inequalities in diet. Empirical evidence of effects on these inequalities, however, is relatively scarce and, with a few exceptions, tends to be inconclusive. We use two contemporary theories that help to understand socioeconomic inequalities in health and health-related behaviours (Bourdieu's capital theory and Mullainathan and Shafir's scarcity theory) to reason how policies influencing food environments may differentially impact lower and higher socioeconomic groups.

A wake-up call for social epidemiologists studying health inequalities: Response to Dijkstra & Horstman.

In their paper, published in this journal, Dijkstra & Horstman critically reflect on a selection of social epidemiological articles and examine how low socioeconomic status populations are constructed in these articles. They identify four components which they argue represent the "dominant thought style" of this literature: 1) proliferation, 2) generalization, 3) problematization and 4) individualization. We largely agree with their first two points, but strongly disagree with the other two, and explain why in our reply.

How can National Government Policies Improve Food Environments in the Netherlands?

Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. The Healthy Food Environment Policy Index (Food-EPI) was applied.

Strength of EU-level food environment policies and priority recommendations to create healthy food environments.

Background: Food environments impact on diets, obesity and non-communicable diseases (NCDs). Government policies are essential to create healthy food environments. This study aimed to assess the strength of European Union (EU)-level policies, and identify and prioritize actions for the EU to create healthy food environments.

The potential of food environment policies to reduce socioeconomic inequalities in diets and to improve healthy diets among lower socioeconomic groups: an umbrella review.

Socioeconomic inequalities in diets need to be tackled to improve population diets and prevent obesity and diet-related non-communicable diseases. The potential of food environment policies to reduce such inequalities has to date however not been appraised. The objective of this umbrella review was to assess the impact of food environment policies on socioeconomic inequalities in diets and to identify knowledge gaps in the existing literature, using the Healthy Food Environment Policy Index as a conceptual framework.

What's important to you? Socioeconomic inequalities in the perceived importance of health compared to other life domains.

Background: Pressing issues, like financial concerns, may outweigh the importance people attach to health. This study tested whether health, compared to other life domains, was considered more important by people in high versus low socioeconomic positions, with future focus and financial strain as potential explanatory factors.

Methods: A cross-sectional survey was conducted in 2019 among N=1,330 Dutch adults.

Socioeconomic inequalities in health behaviors: exploring mediation pathways through material conditions and time orientation.

Background: Socioeconomic inequalities in health behaviors have been attributed to both structural and individual factors, but untangling the complex, dynamic pathways through which these factors influence inequalities requires more empirical research. This study examined whether and how two factors, material conditions and time orientation, sequentially impact socioeconomic inequalities in health behaviors.

Methods: Dutch adults 25 and older self-reported highest attained educational level, a measure of socioeconomic position (SEP); material conditions (financial strain, housing tenure, income); time orientation; health behaviors including smoking and sports participation; and health behavior-related outcomes including body mass index (BMI) and self-assessed health in three surveys (2004, 2011, 2014) of the longitudinal GLOBE (Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings") study.

Stakeholder views on taxation of sugar-sweetened beverages and its adoption in the Netherlands.

An increasing number of governments worldwide have introduced a tax on sugar-sweetened beverages (SSB) for public health. However, the adoption of such a policy is still debated in many other countries, such as in the Netherlands. We investigated Dutch stakeholder views on taxation of SSB and perceived barriers and facilitators to its adoption in the Netherlands.

Dynamics of the complex food environment underlying dietary intake in low-income groups: a systems map of associations extracted from a systematic umbrella literature review.

Background: Inequalities in obesity pertain in part to differences in dietary intake in different socioeconomic groups. Examining the economic, social, physical and political food environment of low-income groups as a complex adaptive system - i.e.

How does cultural capital keep you thin? Exploring unique aspects of cultural class that link social advantage to lower body mass index.

A widely used indicator for cultural class is strongly related to a lower body mass index (BMI): cultural capital measured as 'highbrow' taste. This study's objective was to theorise and measure aspects of cultural class that are more plausibly linked to low BMI, and subsequently explore their relevance. Building on Bourdieusian theory we derive four of those aspects: 'refinement' (valuing form and appearance over function and substance), 'asceticism' (self-imposed constraints), 'diversity' (appreciation of variety in and of itself) and 'reflexivity' (reflexive deliberation and internal dialogue).