In the study by Verstraeten et al. higher rates of mortality were observed in Caribbean islands that have a higher degree of autonomy to their original colonizer. This study highlights how population determinants can affect population health. Geoffrey Rose was one of the first to propose to study population determinants and use a population strategy of prevention to create healthy populations. The study by Verstraeten et al. indicates the importance of population determinants and challenges us to think about our own population determinants. We experience an epidemic of obesity, diabetes type 2 and cardiovascular disease in the Netherlands. The current approach of identifying high risk individuals and individually targeting has not brought this epidemic to an end. A population approach could be a promising alternative to greatly improve public health.
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