Positive Health as common denominator and driver for a joint integrated health approach as to enable multi-ethnic citizens in Amsterdam Zuidoost with low socioeconomic status to participate and take charge of their own health

The district Amsterdam Zuidoost is characterized by a high ethnic diversity and a high percentage of relative young citizens with low-SES. Growing up and living in socioeconomically deprived neighbourhoods has been shown to have a negative impact on health. It is of great importance to reduce this health inequities. Various strategies have been implemented to reduce health problems and to develop more self-reliance and self-management. Up till now, health promotion strategies have not been able to improve the general health status of citizens in Zuidoost yet, maybe explained by the fact that initiatives are often unfocused, unsubstantial, and of short-term character. Strategies on how to develop health literacy of citizens with low-SES and how to improve their health and lives, thus remains and enormous challenge for all parties involved in Zuidoost. Formal healthcare and welfare are well represented and organized in Zuidoost. However there is much diversity, individuality and fragmentation with respective to supportive and informal care for citizens with low-SES. Besides, there is little to no collaboration between formal and informal care. Although various parties see the need to collaborate, until now an “overall driver” that connects them is lacking to make a step forward. The present project will connect and build on this actual situation, previous experiences and needs assessments. Recommendations from the project Kansrijk Zuidoost pointed at the importance of demand-oriented working in line with needs of citizens, and the joint development of tools to improve the citizens’ "own strength". Furthermore, the need for more experimental research is emphasized, which is more individually driven and, above all is able to connect citizens. Nowadays the concept of Positive Health is more and more used and appreciated, as it addresses people as more than their illness and focuses on strengths rather than weaknesses. In the present project, knowledge will be obtained on how the concept of Positive Health can connect existing interventions/initiatives in Zuidoost as to make them more effective for health promotion specifically in citizens with low-SES and multi-ethnic backgrounds. The present project will also include the living environment as one of the elements to support citizens with low-SES to improve their Positive Health. For the development of a joint integrated health approach recommendations are used from the successful Network Positive Health in the Noordelijke Maasvallei. So the overall aim of the present project is to study the concept of Positive Health as a connector, common denominator, inspiration and driver for a joint integrated health approach in community care, as to enable multi-ethnic citizens in Amsterdam Zuidoost with low-SES to participate and take charge of their own health. Therefore we 1. Further identify and structure the needs and strengths of citizens with low-SES and different multi-ethnic backgrounds with respect to the six domains of Positive Health, their living environment and ethnic-specific social networks through narrative interviewing (25 citizens). 2. Develop the joint integrated health approach (build on existing initiatives) that aligns with the needs and strengths of each ethnic group through workshops and meetings. 3. Evaluate the joint integrated approach in three pilots in Zuidoost via observations, intervision meetings and interviews and 4. To explore via questionnaires and interviews whether the Positive Health, healthy behaviour and health literacy of citizens with low-SES is improvement and if nudging of the living environment is supporting in that. Citizens will be actively involved in every stage of development of the project. Results and findings of the project will be communicated and documented in such a way that they become available to all relevant stakeholders and are anchored in their policies, working instruments and daily actions. Dutch summary: Positieve gezondheid als een verbindende factor voor een integrale gezondheidsaanpak in Amsterdam Zuidoost die de burger met lage sociaal economische status ondersteunt de regie over de eigen gezondheid te kunnen nemen. Amsterdam Zuidoost is een stadsdeel met een multi-etnische bevolking, lage SES en veel gezondheids- en gedragsproblemen. Tot nu toe laten gezondheidsinterventies nog onvoldoende effect zien, mogelijk door onvoldoende samenwerking en focus. Wij willen onderzoeken of het concept Positieve gezondheid als verbindende factor tussen alle relevante professionals en burgers kan zorgen voor actie. Centraal staat daarbij dat we goed aansluiten op behoeften en krachten van burgers, zowel in relatie tot hun Positieve gezondheid als tot de directe leefomgeving. Het belangrijkste doel van het project is om hun veerkracht, eigen regie, zelfredzaamheid en gezondheid aantoonbaar te versterken om zo de gezondheidsachterstanden in Zuidoost terug te dringen.