Background: The GLOBE study is a prospective cohort study specifically aimed at the explanation of socio-economic inequalities in health in the Netherlands. The returns of the study are reviewed after ten years of follow-up, and the studies' contribution to the development of policy measures to reduce inequalities in health in the Netherlands are described. Methods: The study started in 1991 with a baseline postal survey (response rate 70.1% or n=18973, 15-74 years of age). Two sub-samples of respondents to this survey were subsequently interviewed in 1991 (response 79.4% and 72.3%, n=5667). Baseline data collection included measures of socio-economic position, health and possible explanatory factors. Follow-up involved repeated postal surveys and interviews, and routinely collected data on hospital admissions, cancer incidence and mortality by cause of death. Results: Compared with higher socio-economic groups, lower socio-economic groups showed higher prevalence rates of poor self-reported health (perceived general health, health complaints, chronic conditions, disabilities), higher incidence rates of specific conditions (myocardial infarction) and higher rates of all-cause mortality. The higher prevalence of adverse material circumstances, unhealthy behaviour, adverse psychosocial characteristics, and adverse childhood circumstances in the lower socio-economic groups was important in the explanation of socio-economic inequalities in health. Socio-economic differences in health care utilization did not contribute to the explanation. Conclusions: The GLOBE study contributed significantly to the understanding of the explanation of socio-economic inequalities in health in the Netherlands. Study results were a main source of information in the development of policy measures aimed at the reduction of socio-economic inequalities in health in the Netherlands.

Longitudinal studies, Socio-economic inequalities in health, The Netherlands
dx.doi.org/10.1093/eurpub/14.1.63, hdl.handle.net/1765/66463
European Journal of Public Health
Erasmus MC: University Medical Center Rotterdam

van Lenthe, F.J, Schrijvers, C.Th.M, Droomers, M, Joung, I.M.A, Louwman, M.W.J, & Mackenbach, J.P. (2004). Investigating explanations of socio-economic inequalities in health: The Dutch GLOBE study. European Journal of Public Health, 14(1), 63–70. doi:10.1093/eurpub/14.1.63