How the Netherlands and PHAROS are reducing health inequalities and improving health literacy

By Monica van Berkum.

Like other European countries, the Netherlands faces substantial socioeconomic health inequalities. On average, people with a low level of education in the Netherlands live 7 years less than the more highly educated. The difference in healthy life expectancy is even larger-almost 19 years. The Dutch Ministry of Health, Sports and Welfare aims to reduce these differences.

Pharos contributes to this objective by stimulating and supporting an integrated approach to reduce health inequalities. We aim to improve the quality, effectiveness, and accessibility of prevention measures and care for people with little education, limited health literacy, and migrants. In this article we provide a short summary of our programmes and priorities.

Gezond in…’ (‘Healthy in…’)

pharos-image-1A few years ago the Ministry of Health, Sports and Welfare started funding municipalities to stimulate a local integrated approach to reduce health inequalities as part of the National Prevention Programme. Pharos supports this local approach through a programme called ‘Healthy in…’.

Pharos offers tailored advice and support on local approaches to health inequalities to 164 targeted municipalities.

Health inequalities, associated with low income and lower levels of education, are influenced by various matters such as the possibility to participate in society, availability of a social network and a healthy living environment. In the integrated approach that we advise, all these aspects are addressed.

We work together with national organisations specialising in, for example, sports, addiction or mental health. A key partner in this is the Dutch Centre for Healthy Living (CGL) introduced in the previous magazine (EuroHealthNet Magazine#7).

Prevention and Care for Chronic diseases

pharos-image-2People with little education and migrants more frequently suffer from chronic diseases such as diabetes, heart disease and depression. This programme shares knowledge about the prevention of these chronic diseases. Pharos trains care providers, disseminates good examples of effective prevention and care and develops appropriate interventions.

Safe and responsible use of medicines

Research shows that pharmacists have trouble recognising people with limited health literacy skills and lack the techniques to help these patients effectively. Pharos works with the Dutch Association of Pharmacists to improve the safe use of medicines among migrants and people with limited health literacy.

Healthy Youth

pharos-image-3Prevention and Care are not always sufficiently tailored to the needs of children from families with a migrant- or low socioeconomic background. Pharos develops prevention programs for primary schools and tailors interventions to the needs of vulnerable groups in order for youth care professionals and institutions to improve their services.

Patient participation and self-management

We strengthen patient self-management by improving the accessibility and comprehensibility of basic information about health and the health care system. Pharos provides health insurers and municipalities with information to enable them to purchase effective care and support for all. In addition, we promote involvement of patients with migrant backgrounds and patients with lower education in patient organisations.

Female genital mutilation

Pharos has been appointed by the Dutch government as the national knowledge centre for FGM and has taken up the fight against FGM since 1993. We conduct research, disseminate fact and figures on FGM. Pharos supports the prevention of FGM and helps to improve the medical and psychosocial care for circumcised women. For more information and facts and figures.

Asylum seekers and refugees

For asylum seekers with permission to stay, maintaining good health is a condition for their successful integration into Dutch society. For asylum seekers who are refused asylum, good health is a condition for their sustainable return. This programme seeks to improve the quality and effectiveness of (preventive) health care for them. It provides knowledge and advice to municipalities and professionals working with these groups.

Health for the Elderly

Non-Western and less educated elderly people generally have poorer health. This programme supports the development of good, targeted and culturally sensitive care for elderly migrants.

Limited Health Literacy

Health Literacy has been included in our programmes as an overarching theme. Pharos helps health care professionals to communicate effectively with low-literacy patients. In addition we develop informative visual materials that can be used during conversations with patients/clients.

In addition, eHealth applications are often not yet tailored to the needs of people with low health literacy. Pharos encourages eHealth developers to involve clients/patients in the development of eHealth initiatives. We offer them know-how and help test their applications amongst people with limited health literacy. More information: eHealth4All

Through our work Pharos hopes to contribute to a more inclusive society and diminish the health gap.


Monica van Berkum

Monica is The Director of Pharos, the Dutch centre of expertise on Health Inequalities.

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